胆囊切除后胆总管有无代偿性扩张

IS THERE A COMPENSATORY DILATATION OF THE COMMON BILE DUCT AFTER CHOLECYSTECTOMY?

对43例病人胆囊切除术前后胆总管径的改变进行对照观察与测量。43例中,23例于手术前后分别行静脉胆道造影,20例于术中行胆道造影、术后行静脉胆道造影。结果,术后胆总管较术前扩张者13例(其中5例造影阳性),无变化者27例(其中2例造影阳性),缩小者3例。造影阴性者36例,其手术前后胆总管管径的变化差异无显著性(P>>0.05)。说明作为生理现象,胆囊切除术后胆总管的代偿性扩张在大多数胆道造影阴性病人是不存在的。提示将术后胆总管管径与其术前标准对照观察,对判断其病变更有价值。

The caliber of the common bile duct was measured in 43 patients who had undergone cholecystectomy. It was measured by intraveneous cholangiography (IVC) before and after cholecystcctomy in 23 cases and by operative cholangiography or IVC after operation in 20 cases. The results showed that after cholecystectomy, the common bileduct enlarged in 13 cases, including 5 patients with positive results of IVC; showed no changes in 27, including 2 with positive results of IVC, and diminished in 3.The pre-and post-operative measurements of the common bile duct showed no significant difference (P>>0.05) in all the 36 patients who had a negative result of IVC. It is concluded that, as a physiological phenomynon, the post-cholecystectomy dilatation of the commonbile duct does not occure in most of the patients with nagetive result of IVC.The comparison of the common bile duct caliber before and after surgery was suggested for evaluating the changes of common duct.