腹腔镜胆囊切除术中胆道造影的临床价值研究

目的探讨腹腔镜胆囊切除术中行胆道造影的临床价值。方法回顾性分析武警北京总队医院2008年12月～2011年10月腹腔镜胆囊切除术中经胆囊颈管行胆道造影78例患者资料,将其作为观察组,另外,随机选取同期入院单纯行腹腔镜胆囊切除术患者80例为对照组,观察两组患者术中情况、术后并发症、住院时间及患者满意度,并进行对比分析。结果观察组发现胆道损伤、胆囊管变异、胆总管结石、中转开腹的概率分别为0.00%、1.28%、11.54%、16.67%明显低于对照组（8.75%、7.50%、18.75%、26.25%）,两组比较,差异有统计学意义（P〈0.05）。两组患者手术均获成功,两组患者住院时间比较差异无统计学意义（P〉0.05）,观察组治愈率为100.00%、术后并发症率为1.28%、患者满意度为97.44%,明显优于对照组（83.75%、6.25%、87.50%）,差异有统计学意义（P〈0.05）。结论腹腔镜胆囊切除术中胆道造影避免了不必要的胆道探查及损伤,其方法简便、安全、可靠,临床值得推广。

Clinical value study of cholangiography in laparoscopic cholecystectomy

Objective To investigate the clinical value of cholangiography in laparoscopic cholecystectomy. Methods 78 cases with cholangiography in laparoscopic cholecystectomy from December 2008 to October 2011 in Beijing Armed Police Corps Hospital were retrospectively analyzed,and selected as the observation group,and 80 cases of patients with alone laparoscopic cholecystectomy were randomly selected as control group. The intraoperative condition,postoperative complication,length of stay and patients＇ satisfaction of two groups were observed and compared. Results The rates of biliary injury,cystic duct variation,choledocholithiasis and laparotomy of the observation group were 0.00%,1.28%,11.54%,16.67%,which were significantly lower than the control group（8.75%,7.50%,18.75%,26.25%）,the two groups had significant difference（P〈 0.05）. The operations of two groups were successful. The length of stay had no significant differences between the two groups（P〉 0.05）. The cure rate,postoperative complications and patient satisfaction of the observation group were 100.00%,1.28% and 97.44%,which were significantly better than the control group（83.75%,6.25%,87.50%）,the differences were statistically significant（P 〈0.05）. Conclusion Cholangiography in laparoscopic cholecystectomy can avoid unnecessary exploration and damage. That is a simple,safe and reliable method,which is worthy of clinical application.