选择性术中胆道造影在腹腔镜胆囊切除术中的应用价值

Application value of selective intraoperative cholangiography on laparoscopic cholecystectomy

目的探讨选择性术中胆道造影在腹腔镜胆囊切除术中的应用价值。方法回顾性分析该院行腹腔镜胆囊切除术(LC)并有相对胆总管探查指征的结石性胆囊炎患者98例术中经胆囊管插管行胆道造影的结果。结果 98例患者中插管造影成功95例,阳性发现32例,其中胆总管下段结石20例均行腹腔镜胆总管切开取石加T管引流术;假阳性1例行腹腔镜胆道探查术后置T管引流。结论选择性术中胆道造影操作简单,不增加患者痛苦,对降低LC术后胆道残余结石的发生率、降低胆道阴性探查率、明确胆道解剖及变异、避免或减少胆道损伤的发生有重要意义,值得推广应用。

Objective To explore the value of selective intraoperative cholangiography on laparoscopic cholecystectomy. Methods To analysis the result of eholangiography in patients of choleeystitis with laparoscopic choleeystectomy （LC） and relatively common bile duct exploration indications. Results In 98 cases patients with selective cholangiography, succeed 95 cases,positive detection 32 cases ,20 cases were cured by laparoscopie common bile duct cut stone plus T-tube drainage. False positive 1 cases was cured by laparoscopic biliary surgical exploration plus T-tube drainage. Conclusion Selective intraoperative cholangiography is simple, and does not increase the suffer- ing of patients. Selective intraoperative cholangiography can reduce the incidence of LC biliary residual stones, reduce the rate of negative exoloration, clear biliary anatomy and variation, avoid or reduce the incidence of bile duct injury and worthy of clinical application.