Postoperatif Safra Fistülleri ve ERCP (İki Olgunun Sunumu)

Year 2008, Volume: 9 Issue: 3, 19 - 22, 01.12.2008

Sezgin Yılmaz

Abstract

Keywords

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Postoperatif Safra Fistülleri ve ERCP (İki Olgunun Sunumu)

Abstract

Safra kanalı yaralanmaları kolesistektomi sonrası hastaların morbidite ve mortalite artışına neden olan ciddi komplikasyonlardandır. Cerrahi tedaviye ihtiyaç duyulan safra kanalı yaralanmaları % 11 oranında mortaliteye neden olur. En sık görülen yaralanmalar sistik kanal güdüğünden kaynaklanan yaralanmalardır. Safra kanalı yaralanması olan hastalarda öncelikle endoskopik tedaviler denenmelidir. ERCP yaralanmanın tipini belirlemeye yardım ederken sfinkterotomi ve/veya stentleme yapılarak da kanal içi basıncı azaltılır ve fistülün kapanması hızlandırılır. Ancak çepeçevre yaralanmalarla birlikte seyreden olgularda endoskopik tedaviler yarar sağlamaz ve hepatojejunostomi gibi ciddi cerrahi işlemlere ihtiyaç duyulur

Keywords

Safra kanalı yaralanması, kolesistektomi, ERCP, stentleme

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• Resim 3: Safra kanalı yaralanmalarında tedavi algoritması