选择性术中胆道造影的合理应用

Reasonable Application of Selective Intraoperative Cholangiography

目的探讨在胆道手术中正确、高效的选择性应用术中胆道造影. 方法回顾性分析2000年10月～2004年10月333例术中胆道造影.结果经胆囊管术中胆道造影181例,发现胆道残余结石47例,假阳性3例,Mirizzi综合征3例.经'T'管术中造影152例,胆道结石残余为16例,假阳性2例,胆道解剖异常5例;胆道探查术中结合胆道镜检查取出结石数目与术前B超检查所示一致者92例,行术中胆道造影未发现胆道残余结石. 结论术中胆道造影应合理的选择性应用,要避免不必要的术中胆道造影.选择性术中胆道造影可避免胆道结石及不必要的胆道探查,能够提高手术的安全性,在临床手术中有着广泛的应用价值.

Objective To investigate the correct and effective application of selective intraoperative cholangiography in operation on biliary duct. Methods 333 cases of intraoperative cholangiography from October 2000 to October 2004 in our hospital were retrospectively analyzed. Results 181 patients underwent transcystic intraoperative cholangiography, 47 were found to have bile duct stones, 3 were found false-postive and 3 were found to have mirizzi syndrome. 152 patients underwent intraoperative T-tube cholangiography, 16 were found to have bile duct residual stones, 2 were found false-postive, 5 were found to have abnormal anatomy of bile duct; 92 cases were not found to have residual calculus, whose stones which were found in bile duct exploration combined with the choledochoscope, accorded with preoperative examine with B uhrasonography. Conclusions Intraoperative cholangiography should be selective used reasonably, we should avoid unnecessary intraoperative cholangiography. Selective intraoperative cholangiography could avoid bile duct residual calculus and unnecessary bile duct exploration.