胆道造影检查在腹腔镜胆囊切除术中的应用

Clinical application of intraoperative cholangiography in laparoscopic cholecystectomy

目的探讨腹腔镜胆囊切除术中经胆囊管胆道造影的临床价值。方法通过对58例LC术中经IOC的病人临床资料进行回顾性分析。结果本组病例成功55例,占94.83%,失败3例,占5.17%。50例胆总管未发现结石,占90.91%,发现胆总管小结石(0.4 cm)5例,占9.09%。其中4例经中转开腹行胆道探查,1例经腹腔镜胆总管切开胆纤镜网篮取石。胆囊管汇入右肝管1例。全组病例无胆道损伤、胆总管结石残留、胆漏、腹腔感染及IOC相关并发症。结论 LC术中行IOC操作简单易行,成功率高,显影效果好,能及时发现胆道解剖变异;对基层医院减少胆道阴性探查、术中胆道损伤、术后胆总管结石残留等具有重要的临床应用价值。

Objective To investigate the clinical value of intraoperative cholangiography（IOC） by cystic duct during laparoseopic chol-ecysteetomy（LC）. Methods The clinical data of 58 patients with LC received intraoperative cholangiography by cystic duct were analyzed retrospectively. Results In this group, Successful treatment of 55 cases （94.83 % ）, failed in 3 cases （5.17 % ）, no common bile duct calculi in 50 cases（90.91% ） ,small common bile duct calculi（0.4 era） in 5 cases（9.09% ）. Among them 4 cases were received common bile duct exploration via laparotomy, 1 case treated by laparoscopic transcystic biliary calculus extraction with Dormia basket. The cystic duct drained into the right hepatic duct in 1 patient. In all the cases, no bile duct injury, residual choledocholith, bile leakage,intra-abdominal infection and IOC related complications. Conclusion IOC during LC is simple and easy, with high success rate and good development effect, which can promptly discover the anatomical variations of biliary tract. It has important clinical application value to reduce biliary negative exploration,in- traooerative iniurv of biliarv tract and nostonerative common bile duct residual stone in basic hosnital.