CO_2胆道造影的初步临床应用

Preliminary experience with CO_2 cholangiography via T-tube

目的探讨T管CO2胆道造影的临床价值。方法外科胆道术后留置T管患者40例。拔管前先行经T管CO2胆道造影,同时行T管泛影葡胺胆道造影对照。结果40例中36例造影示肝内外胆管无扩张,造影剂顺利进入十二指肠,拔除T管。其中2例发生胆漏,予介入7F猪尾巴导管留置2周。1例发现残余结石,予以胆道碎石,保留T管2周。1例胆总管下段炎性狭窄,保留T管1周。CO2胆道造影摄片甲级片率67.5%(27/40)。未发生与CO2及泛影葡胺造影有关的并发症。结论CO2胆道造影是一种安全、有效的诊断方法,可以作为常规T管造影的补充。

Objective To evaluate the clinical value of CO2 cholangiography via T-tube. Methods Forty patients after bile-duct operation with installing drainage T-tube were studied. Before withdrawing T-tube, trans-T-tube cholangiography with CO2 was performed,simultaneously with renografin cholangiography as control. Results Among them 36 patients appeared to have no dilation and no filling defect of the bile duct with contrast media entering duodenum smoothly and taking away T-tube immediately. Two cases showed bile leakage and were managed by retaining 7F pig tail catheter for 2 w; including one with residual calculi treated by lithoclrypsy with further retention drainage for 2 w, and another one of lower segmental stenosis of common bile duct with further retaining of T tube for 1 w. No complications related to CO2 cholangiography occurred. Conclusions CO2 cholangiography is a safe and effective diagnostic method, it could be used as an adjuvant to the routine cholangiography.