T-Tüp Drenajı ile Tedavi Edilen Çoklu Ana Safra Kanalı ve Safra Kesesi Taşları

Bu vaka raporu, çok sayıda koledok ve safra kesesi taşı olan bir hastanın T-tüp drenajı ile tedavi sürecini sunmaktadır. Yirmi dokuz yaşında bir kadında yaklaşık üç gündür karın ağrısı, mide bulantısı ve kusma vardı. Hastanın iki kez endoskopik retrograd kolanjiyopankreatografi (ERKP) ile koledok taşlarını çıkarma öyküsü vardı. Karın fizik muayenesinde sağ üst kadran ağrısı ve derin palpasyonda defans vardı. Laboratuvarda c-reaktif protein (CRP) (9.4 mg/L) ve gama-glutamil transferaz (65 U/L) düzeyleri yükseltmişti. Magnetik rezonans kolanjiyopankreatografi (MRKP)’de safra kesesi ve ana safra kanalında çok sayıda taş vardı. Ana safra kanalında taş çokluğu nedeniyle hastaya cerrahi planlandı. Ameliyat laparoskopik olarak başladı, ancak laparoskopi zorluğu nedeniyle laparotomi yapıldı. Ortak safra kanalından yedi taş çıkarıldı ve ana safra kanalına bir T-tüp yerleştirildi. Postoperatif 15. günde yapılan T-tüp kolanjiyografide kontrast ekstravazasyonu ve obstrüktif patoloji saptanmadığı için T-tüp çıkarıldı. Hasta postoperatif 17. günde komplikasyonsuz olarak taburcu edildi.

Anahtar Kelimeler:

Kolanjiyografiler, Kolelitiazis, ortak safra kanalı

Multiple Common Bile Duct and Gallbladder Stones Treated with T-Tube Drainage

This case report presents the treatment process with T-tube drainage of a patient with multiple common bile duct and gallbladder stones. A twenty-nine-year-old female had abdominal pain, nausea, and vomiting for about three days. The patient had twice a history of removing common bile duct stones with endoscopic retrograde cholangiopancreatography (ERCP). She had right upper quadrant pain and defence on deep palpation on the physical examination of the abdomen. In the laboratory, she had increased a c-reactive protein level (CRP) (9.4 mg/L) and a gamma-glutamyl transferase level (65 U/L). Magnetic resonance cholangiopancreatography (MRCP) showed multiple calculi on the gall bladder and common bile duct. Surgery was planned for the patient because of the large number of stones in the common bile duct. The surgery started laparoscopically, but laparotomy was performed due to laparoscopic difficulty. Seven stones were removed from the common bile duct, and a T-tube was placed in the common bile duct. Since contrast extravasation and obstructive pathology were not detected in T-tube cholangiography performed on the 15th postoperative day, the T-tube was removed. The patient was discharged on the 17th postoperative day without complications.

Keywords:

Cholangiographies, Cholelithiasis, common bile duct,

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