腹腔镜胆囊切除术前静脉胆道造影的价值

目的 :探讨腹腔镜胆囊切除术前常规作静脉胆道造影的价值。方法 :回顾性总结我院 1991年 10月至1995年 6月术前所作的静脉胆道造影 1971例 ,分析造影结果与胆囊的病理改变、胆管结石、手术难度及手术时间长短的关系。结果 :胆囊显影良好者 ,其胆囊的急性炎症、重度粘连、胆囊颈管的结石嵌顿、胆囊积液积脓、胆囊萎缩等病理改变的发生率均明显低于胆囊不显影、显影浅淡及肝外胆系不显影者。其平均手术时间也明显低于后三者。在B超未揭示胆管异常的情况下 ,发现胆管结石 5 9例 ,占作静脉胆道造影病例的 3% ,均经手术证实。结论 :腹腔镜胆囊切除术术前常规作IVC能充分预见胆囊及其周围的病理改变、发现胆道解剖结构的异常、预测手术难度、筛检胆管结石 ,避免胆道损伤 。

胆囊、胆管

9740601 慢性胆管结扎狗肾神经活性对高氯化钠食物摄取的反应/Matsuda T//Hepatology.-1996,23(2).-303～3093029740602

螺旋CT胆道系统造影技术研究

本文介绍了螺彷CT胆系造影检查方法，讨论其优缺点。认为螺旋CT胆系造影弥补了常规胆系造影和CT平扫在诊断胆管系统疾病中的不足，是一种无创伤，方便，实用，能可靠地显示胆系结构的新方法。

经胆囊腹腔镜下胆管造影(英)

胆管造影应当是腹腔镜胆囊切除术的一个必须步骤，通过胆管造影可清楚地了解胆道解剖，避免胆损伤。以往的一些腹腔镜下胆管造影方法几乎都需经胆囊管插管，操作复杂难度较大，耗时较长。作者介绍了一种简单、快速的经胆囊腹腔镜下胆造影方法。

Portal vein cannulation:An uncommon complication of endoscopic retrograde cholangiopancreatography

Portal vein cannulation is a rare complication of endo-scopic retrograde cholangiopancreatography(ERCP).It has been reported that it usually occurs after endo-scopic sphincterotomy,whereas in cases without prior sphincterotomy,the presence of portobiliary fistulas has been shown.Here,we present a case in which cannulation of the portal vein occurred despite careful wire-guided cannulation and the absence of sphinc-terotomy.Although fatal cases of cerebral and pulmo-nary air and/or bile embolism have been reported in patients with combined portal and hepatic vein trauma after ERCP and sphincterotomy,isolated portal vein cannulation,as in the current case,does not usu-ally result in mortality or serious morbidity.However,awareness of this rare complication is important so that no further intervention is performed.