腹腔镜胆囊切除术中胆道造影在术前磁共振胰胆管成像可疑胆总管结石的临床价值

Clinical Value of Intraoperative Cholangiography During Laparoscopic Cholecystectomy in Preoperative MRCP Suspicious Common Bile Duct Stones

目的探讨腹腔镜胆囊切除术中胆道造影在在术前磁共振胰胆管成像可疑胆总管结石的临床应用价值。方法对115例患者的临床资料进行回顾性分析。结果 115例患者术中均顺利完成造影。胆道造影阳性者为2例,于术中胆总管切开,胆道镜探查均发现结石并用取石篮取出。胆道造影阴性者术后无腹痛、黄疽,术后24 h内发热10例,予对症退热治疗后无不适。结论胆道造影可提高胆道结石诊断的敏感性和特异性。帮助医师在首次手术中提高胆道结石清除率,降低阴性胆道探查率,减少再手术率,减轻患者痛苦及经济负担。

Objective To investigate the clinical value of cholangiography in laparoscopic cholecystectomy for suspected common bile duct stones before MRCP. Methods The clinical data of 115 patients were analyzed retrospectively. Results All 115 patients underwent angiography successfully. IOC was positive in 2 cases. Stones were found during choledochoscopic exploration,and were removed with stone baskets. LC-IOC negative patients had no abdominal pain and jaundice after operation, and fever occurred in 10 cases within 24 hours after operation. There was no discomfort after symptomatic antipyretic treatment. Conclusion IOC can improve the sensitivity and specificity of diagnosis of biliary calculi to help doctors to improve the clearance rate of biliary calculi, reduce the rate of negative biliary exploration, reduce the rate of reoperation, and reduce the pain and financial burden of patients in the first operation.