剧烈的性胆囊炎复杂的中肝静脉血栓症:一个病例报告
Fan Gao1, Zhe Tang1, Luting Zhang1
1Department of Hepatobiliary and Pancreatic Surgery, Shangyu People's Hospital of Shaoxing, Shaoxing University, No. 517, Citizen Avenue, Baiguan Street, Shangyu District, Shaoxing City, Zhejiang Province, 312300, China.
Journal of surgical case reports
|December 30, 2025
概括
急性胆囊炎可以导致严重的肝静脉血栓形成,即使在无症状的个体. 通过成像和外科干预的早期诊断对于有效的管理至关重要.
科学领域:
- 肝胆道手术 肝胆道手术
- 血管外科 血管外科
- 胃肠病学 胃肠病学
背景情况:
- 肝静脉血栓症 (HVT) 是急性胆囊炎的一种罕见但严重的并发症.
- 与胆囊炎相关的HVT的手术前诊断在诊断上具有挑战性.
- 手术管理需要精细的手术前规划.
研究的目的:
- 报告偶然诊断的急性胆囊炎病例与同时发生的肝静脉血栓形成.
- 为了强调手术前成像在诊断这种罕见并发症的重要性.
- 讨论手术管理和结果.
主要方法:
- 一名63岁的男性患者提出了选择性 inguinal Hernia 修复.
- 在手术前CT上偶然发现胆结石和疑似肝静脉血栓.
- 通过MRI确认急性胆囊炎和中肝静脉血栓形成.
- 手术包括开放胆囊切除术,粘结溶解和部分胆囊切除术.
- 在手术期间冷切口排除恶性瘤.
主要成果:
- 患者被诊断出患有急性胆囊炎和中等肝静脉血栓症.
- 进行了成功的手术管理,包括胆囊切除术和粘结溶解.
- 患者经历了无事件的恢复,并在术后第19天出院.
- 最终的病理学证实了良性发现,尽管最初担心恶性瘤.
结论:
- 急性胆囊炎可以伴随或进展为复杂的肝静脉血栓,即使在无症状患者中也是如此.
- 术前成像在HVT的诊断和手术规划中起着至关重要的作用.
- 建议在恶性瘤不能被最终排除的情况下,采取早期手术干预,坚持完全切除 (R0) 的瘤学原则.
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