胆囊切除时漏诊胆总管结石的预防及治疗

The Methods of Avoiding Common Bile Duct Stones Left out During Cholecystectomy

目的 探讨胆囊切除时避免漏诊术前未发现的胆总管结石的手段和方法。方法 本组回顾分析胆囊切除6 2 5例 ,术中发现胆总管结石 14例。结果 术中通过胆总管外的触膜发现胆总管结石 7例 ,术中胆道造影发现胆总管结石 3例 ,术中经胆囊管胆道镜发现胆总管结石 2例 ,术中 B超发现胆总管结石 2例。结论 胆囊切除术中通过对胆总管的触摸、造影、胆道镜或 B超检查可以发现术前未发现的胆总管结石。为防止漏诊术前未发现的胆总管结石 ,应用上述方法是必要的。

Objective To study the methods of avoiding common bile duct stones left out undiscovered before opreation during cholecystectomy patients.Methods The data of 625 patients performed with cholecystectomy were analyzed retrospectively.There were 13 common bile duct stones during ch olecystectomy that undiscovered before opreation.Results Common bile duct stones were discovered in 7 patients with touching common bile duct,in 3 patients with intraoperative cholangiography,in 2 patients with intraoperative cholangioscopy and in 2 patients with intraoperative ultrasonography during cholecystectomy.Conclusion It was necessary for discovering common bile duct stones druing cholecystectomy that undiscovered before opreation,touching common bile duct,intra operative cholangiography,Intraoperative cholangioscopy and Intraoperative ultrasonography during cholecystectomy.