摘要
目的 探讨在腹腔镜胆囊切除术 (LC)中经胆囊管胆道造影的价值。方法 分析 5 1例因慢性胆囊炎胆囊结石、急性胆囊炎胆囊结石、胆囊息肉和胆源性胰腺炎行LC的患者 ,在术中经胆囊管插管行胆道造影的结果。结果 5 1例中 ,插管成功 4 7例 ,成功率为 92 .2 % ,其中 4 6例显影满意 ,显影率为 97.9%。术中造影发现胆总管结石 3例 ,中转开腹行胆总管切开取石、T管引流术 ,发现胆囊管走行异常 2例 ,插管造影过程中发现胆囊管结石 4例 ,造影平均时间为 (16 .7± 2 .7)min。结论 LC术中胆道造影操作简便安全 ,显影清晰 ,成功率高 ,能发现胆总管结石、胆囊管结石及胆道解剖变异 ,可降低胆道残留结石和胆管损伤的发生率 ,并能及时发现胆道损伤 。
Objective To evaluate the value of intraoperative transcystic cholangiography(IOC) during laparoscopic cholecystectomy(LC). Methods IOC was conducted in 51 patients who underwent LC because of cholelithiasis with chronic or acute cholecystitis, gallbladder polypi and biliary pancreatitis and the results were analyzed. Results Cannulation was successfully completed in 47 of 51 patients, the success rate was 92.2%, 46 of 47(97.9%) had satisfactary visualization. The common bile duct stones were detected in 3 patients by IOC, and they were converted to common bile duct exploration and T-tube drainage by open cholecystectomy. 2 cases were found abnormal cystic duct by IOC, and 4 cases were found cystic duct stones by cannulating during IOC. The average time of IOC was about 16.7±2.7 minutes. Conclusions IOC is a safe and convenient procedure with a high success rate, and can provide clear films of biliary tree. The benefit of IOC is the detection of common bile duct and cystic duct stones and abnormal biliary anatomy. It can reduce the rate of retained common bile duct stones and bile duct injuries, and increase the early identification of bile duct injuries. So IOC can improve quality and security of LC.
出处
《消化外科》
CSCD
2004年第1期23-26,共4页
Journal of Digestive Surgery
关键词
腹腔镜胆囊切除术
术中胆道造影
胆道损伤
残留结石
laparoscopic cholecystectomy intraoperative cholangiography bile duct injury retained stones
