腹腔镜胆囊切除术中几种胆道造影方法的临床应用价值

Clinical Study about lntraoperative Cholangiography during Laparoscopic Cholecystectomy by Epidural Needle Puncture

目的探讨腹腔镜胆囊切除术中几种胆道造影方法的利弊。方法回顾分析153例选择性术中胆道造影的临床资料。结果152例插管成功，发现胆总管下端结石13例，胆总管损伤1例，副肝管2例。经硬膜外穿刺针行胆道造影所需插管时间最短（2—5min），其他两种方法所需时间相近（8—20min）。结论采用硬膜外穿刺针作为造影管直接穿刺胆囊管行胆道造影，具有较多优势，易在临床上推广应用。

Objective To discuss the advantages and disadvantages of several biliary imaging method during laparoscopic cholecystectomy. Methods Review and analyse the clinical data of 153 cases of selective intraoperative cholangiography. Results 152 cases of intubation succeed. And found that choledocholith in 13 cases,injury of common bile duct in 1 case, accessory hepatic duct in 2 cases. The shortest time required for intubation is to puncture by epidural needle puncture （2 - 5 min）, and the time required for the other two methods is closed （8 - 20 rain）. Conclusion The application of epidural needle puncture as a tool of intraoperative cholangiography is more advantaged, and could easily applied in chnical practice.