胆囊切除术中胆道造影方法及其临床价值

Method and clinical value of intraoperation cholangiography

为探讨胆囊切除术中胆道造影检查的最佳方法及其临床价值。对 396例术前诊断为单纯胆囊结石而行胆囊切除术的患者于术中行胆道造影 ,造影选用经 Hartmann袋切口及 16号注射针头 ,2 5 %～ 30 %胆影葡胺为常选造影剂。造影成功 391例、失败 5例 ;发现胆总管结石 39例、左肝管结石 2例、Mirizzi综合征 12例、胆囊管与胆总管并行 5例、胆总管损伤 1例。表明经 Hartmann袋切口造影成功率高 ,并发症少。术中胆道造影有利于提高胆总管结石的检出率 ,及时处理胆道残余结石 ,减少胆总管阴性探查率 ,及时发现胆道解剖变异 ,减少术中胆道损伤。

To study the best method and clinical value of intraoperation cholangiography in patients with cholecystectomy 396 patients with simple gallbladder stones preoperation diagnosis were treated by cholecystectomy and were performed intraoperation cholangiography Contrast examination selective incisional through Hartmann′s pouch and syringe needle NO 16 Contrast medium constant selective 25%～30% iodipamide methylglucamine Results showed that the intraoperation cholangiography of 391 patients were successed,5 patients were failured 39 patients of choledocholith and 2 of left hepatic duct stones were found Mirizzi syndrome in 12 patients Cystic duct comitans common bile duct in 5 patients Injury of common bile duct in 1 patients Results showed that the rate of success were high and complication were less through Hartmann′s pouch This suggest intraoperation cholangiography is improve on the rate of common bile duct stones It helps to management retained stones and avoid unnecessary exploration of the common bile duct and demonstrate any abnormalities in anomalies of the biliary tree and reduce the chance of accidental injury of common bile duct