腹腔镜胆囊切除术中胆道造影与术前ERCP诊治可疑胆总管结石的临床比较

目的：比较腹腔镜胆囊切除术（laparosocopic cholecystectomy,LC）术中胆道造影与术前ERCP对诊治可疑胆总管结石的临床价值。方法：回顾分析2005年3月至2006年11月于LC术中行胆道造影43例患者与术前行ERCP63例患者的临床资料。结果：术中胆道造影组发现胆总管结石16例,阳性率占37.21%,造影不成功2例,占4.65%,无明显造影并发症,术前ERCP组发现胆总管结石19例,阳性率占30.16%,不成功13例,占20.63%,致术后胆道感染12例,急性胰腺炎9例,占33.33%。结论：术中胆道造影不仅简便,而且患者痛苦小,并发症少,治疗费用低,明显优于术前ERCP检查。

Introperative cholangiography versus preoperative ERCP in laparoscopic cholecystectomy: a clinical comparison of diagnosis and treatment effects on common bile duct calculi

Objective: To compare the diagnosis and treatment value between intraoperative cholangiography and preoperative ERCP for common bile duct calculi in laparoscopic cholecystectomy(LC).Methods:Forty-three cases of LC with intraoperative cholangiography and 63 cases of LC with preoperative ERCP in our hospital from Mar.2005 to Nov.2006 were analyzed retrospectively.Results:In intraoperative cholangiography group 2 cases(4.65%) failed 16 cases(37.21%) were found with common bile duct calculi.No complication occured.In preoperative ERCP group,13 cases(20.63%) failed;19 cases(30.16%) were found with common bile duct calculi.21 cases(33.3%) were associted with postoperative complications(12 cases of postoperative bile duct infection and 9 cases of acute pancreatitis occurred both of which was almost 33.33% of total cases).Conclusions:Compared with preoperative ERCP,intraoperative cholangiography is not only convenience,but also with less pain,fewer complications,and lower cost.