关键词: 单中心, 腹腔镜胰十二指肠切除术, 肝脓肿, 抗生素

Abstract: Objective   To analyze the etiology,diagnosis and treatment of liver abscess(LPA) after laparoscopic pancreaticoduodenectomy(LPD) in single center. Methods   From January 2017 to January 2021,4 patients with secondary liver abscess who received LPD in the Second Department of General Surgery of Handan Central Hospital were collected,and their clinical data were collected to analyze the etiology and treatment of liver abscess.  Results   All the 4 cases were secondary liver abscess after LPD.The etiology was retrospectively analyzed according to medical records and imaging data.Case 1 was the main branch of right hepatic artery injured during operation.The right hepatic artery in case 2 originated from superior mesenteric artery and was accidentally injured and ligation during operation.The superior mesenteric vein was narrowed after wedge resection in case 3.Case 4 was a case of recurrent biliary retrograde infection.All 4 cases recovered after antibiotic therapy combined with interventional therapy.Case 1 died 16 months after surgery due to multiple liver metastases and ascites.Patient 2 survived healthy for 19 months after LPD without recurrence and metastasis.Case 3 died of jaundice 26 months after surgery due to multiple liver metastases and lymph node metastasis in the pancreatic head region.Patient 4 died of recurrent retrograde biliary tract infection 13 months after surgery.  Conclusion   Liver abscess after LPD is mainly related to hepatic artery and vein injury and recurrent biliary tract retrograde infection.Rational antibiotic use combined with interventional therapy is the preferred effective treatment.

Key words: single center, laparoscopic pancreaticoduodenectomy, liver abscess, antibiotics