MRCP术前评估预防腹腔镜胆囊切除术中胆管损伤的体会(附360例报告)

Experiences on preoperative MRCP evaluation to prevent bile ducts injuries in laparoscopic cholecystectomy: with a report of 360 cases

目的：探讨术前应用磁共振胰胆管造影（magneticresonancecholangiopancreato舒aphy，MRCP）评估预防腹腔镜胆囊切除术（1aparoscopiccholecystectomy，LC）中胆管损伤的可行性。方法：回顾分析2010年1月至2013年4月360例Lc患者术前行MRCP检查的临床资料。结果：360例手术均获成功，术中无一例发生胆管损伤；手术时间平均（80±50）min，腹腔引流管均于术后48～96h拔除；无肠漏、出血、胆漏及切口感染等并发症发生；术后6h即下床活动，6～24h后恢复进食，术后平均住院（4．5±1．5）d。结论：Lc术前常规行MRCP检查可有效预防术中胆管损伤，且价格合理，方便简单，无临床副作用，患者易于接受。

Objective：To study the feasibility of application of preoperative magnetic resonance cholangiopancreatography （MRCP） evaluation in preventing bile ducts injuries in laparoscopic eholecystectomy （LC）. Methods：The clinical data of 360 patients who underwent MRCP examination before LC between Jan. 2010 and Apr. 2013 were analyzed retrospectively. Results：LC was conduc- ted successfully in all 360 patients with no bile ducts injuries. The mean operation duration was （ 80 ± 50 ） min, and the abdominal drainage tube was removed 48 to 96 h postoperatively. No intestinal or bile leakage, hemorrhage or incision infection occurred. Patients took ambulation 6 h postoperatively, and recovered to normal diet 6 to 24 h after operation. The mean postoperative hospital stay was （ 4.5 ± 1.5 ） d. Conclusions ： Routine preoperative MRCP examination could effectively prevent intraoperative bile ducts injuries. It is a kind of safe, inexpensive and simple examination without clinical adverse reaction, and can be easily adopted by patients.