术中经胆囊管胆道造影在腹腔镜胆囊切除术中的应用

Application of intraoperative cholangiography to laparoscopic cholecystectomy

目的探讨术中经胆囊管胆道造影在腹腔镜胆囊切除术中的临床应用价值。方法回顾性分析术中经胆囊管胆道造影94例腹腔镜胆囊切除患者的临床资料。结果 91(96.8%)胆道造影成功,造影结果示16例胆总管结石,3例胆囊管结石,3例副肝管,2例发现有胆管损伤。行中转开腹手术21例,腹腔镜下缝扎副肝管3例。未见造影相关的并发症。结论术中经胆囊管胆道造影在腹腔镜胆囊切除术中方法简单、安全,可以减少胆总管及胆囊管结石的残留,避免不必要的胆道阴性探查,预防胆管损伤。

Objective To explore the clinical application value of intraoperative cholangiography in laparoscopic cholecystectomy.Methods The clinical data of 94 patients who underwent laparoscopic gallbladder excision with intraoperative cholangiography technique were retrospectively analyzed. Results There were 91 successful cases（ 96. 8%） of intraoperative cholangiography. Angiography results showed 16 cases of common bile duct calculi,3 cases of gall bladder,3 cases of accessory hepatic duct and 2 cases hepatic duct injury. Twenty-one cases transferred to laparotomy,3 cases undergoing laparoscopic transfixion of accessory hepatic duct. No related complications were found. Conclusions Laparoscopic cholecystectomy with intraoperative cholangiography is simple and safe,which can reduce the residual common bile duct and gallbladder,avoid unnecessary biliary negative detection,and prevent bile duct injury.