Study on sequential minimally invasive treatment of diffuse biliary peritonitis
ZHU Yong-qiang
WANG Tao
CHENG Long
CHEN Qi
Abstract：Objective To carry out the minimal invasion －based step－up approach strategy in the treatment of diffuse peritonitis caused by iatrogenic bile leakage , and to evaluate its clinical values.Methods We retrospectively an-alyze the 36 patients diagnosed with diffuse peritonitis caused by iatrogenic bile leakage and treated by minimal invasion －based step－up approach strategy from January 2010 to December 2015 in our center.The cure rate, symptom remission rate, short－term and long－term complications occurrence rates , and hospitalization stay were analyzed to evaluated the minimal invasion－based step－up approach strategy in the treatment of diffuse peritonitis caused by iatrogenic bile leak -age.Results In the current cohort, the total cure rate was 97.22%(35/36); the hospitalization stay was 22 d (7 d－47 d); the mortality rate was 2.78%(1/36); the incidence rate of short －term complications was 13.89%(5/36), in-cluding 3 cases of acute cholangitis (8.33%, 3/36) and 2 cases of acute pancreatitis (5.56%, 2/36); the occurrence rate of long－term complications (2.78%, 1/36).After the first step with ultrasound －guided intervention, 22 patients were cured (61.11%, 22/36), and 14 patients entered the following steps.There were 12 cases (33.33%, 12/36) re-ceived endoscopic nasobiliary drainage (ENBD) and 10 cases were cured.There were 4 patients (11.11%, 4/36) un-derwent laparotomy, among whom 3 cases were cured and 1 cases died.Conclusion Minimal invasion－based step－up approach strategies is effective on the treatment of iatrogenic bile leakage －induced diffuse peritonitis , and prospectively becomes the preferred option.
Keywords：iatrogenic bile duct injurybile leakageinterventional ultrasoundendoscopic biliary drainage
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1823-1826 )