摘要
为探讨腹腔镜下胆道造影的方法和价值，对６００例胆囊结石并慢性或急性胆囊炎（其中４例伴阻塞性黄疸，６例为胆源性胰腺炎）病人行无选择性腹腔镜胆囊切除和常规术中经胆囊管插管胆道造影术。５６８例（９４．７％）完成了术中胆道造影。术中造影发现胆总管病变４２例，其中３２例为术前未曾检查出的胆管异常。全组共发生胆管损伤３例（０．５％）。表明腹腔镜下经胆囊管插管胆道造影成功率高，术中胆道造影具提高手术质量和防止或减少胆管损伤的作用。
To explore the method and value of intraoperative cholangiography(IOC) during laparoscopic cholecystectomy(LC),this paper represents the results of 600 unselected consecutive patients who underwent routine IOC during LC.All patients had cholelithiasis with chronic or acute cholecystitis before operation,of which 4 had obstructive jaundice and 6 biliary pancreatitis.IOC was performed in 568 cases(94 7%).Forty two (7 0%)were found to have choledocholithiasis or common bile duct(CBD)dilitation due to carcinoma of pancreas causing partial obstruction of CBD.Among them 32 cases(5 3%) were unsuspected ductal stones(31)and CBD dilitation secondary to carcinoma of pancreas(1).Among 42 cases ,17 were converted to open operation and CBD exploration,15 cases received endoscopic sphincterotomy and CBD stones extraction following LC,8 underwent laparoscopic flexible choledochoscopy and stone extraction through the opening of cystic duct,and 2 had laparoscopic choledochotomy and stone extraction.There were 3 common duct injuries(0 5%).These results suggested that about 95% of patients could have IOC through cystic duct during LC and IOC help to prevent or reduce duct injury.
出处
《中华消化内镜杂志》
1997年第2期84-86,共3页
Chinese Journal of Digestive Endoscopy
关键词
胆结石
胆囊切除术
腹腔镜
胆道造影
Cholelithiasis Laparoscopic cholecystectomy Intraoperative cholangiography
