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腹腔镜胆囊切除术中胆道造影的应用 总被引:2,自引:2,他引:2
目的:探讨腹腔镜胆囊切除术中胆道造影的应用价值。方法:回顾性总结110例腹腔镜胆囊切除术中胆道造影的临床资料。结果:造影均成功,术中胆道造影发现胆总管下段结石9例,并经中转开腹手术证实。全组无胆管损伤,除2例并发胆漏外。其余均痊愈。术后平均住院时间3d。结论:腹腔镜胆囊切除术中胆道造影对降低胆管结石的残留,避免胆管损伤。提高腹腔镜胆囊切除术的疗效有重要价值。 相似文献
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腹腔镜胆囊切除术中胆道造影的应用 总被引:2,自引:1,他引:2
作者自1995年1月至1997年1月,选择性对16例有指征的腹腔镜胆囊切除术病人进行了术中胆道造影,并对造影方法作了一些改进。5例病人胆道造影有阳性发现,11例病人造影未发现肝外胆管结石。对4例胆总管有结石的病人3例行腹腔镜胆囊切除术,胆总管切开取石T管引流术。另1例因结石嵌顿于胆总管下端而中转开腹手术。1例造影怀疑胆总管内胆泥淤积病人,术后给予口服硫酸镁利胆治疗,复查B超未发现结石及梗阻,随访3个月无异常。16例病人随访至21个月,无复发。作者对病人术中胆道造影的指征进行了探讨,对造影发现胆囊结石合并胆总管结石的病人的处理方法作了讨论。 相似文献
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目的:评价选择性术中胆道造影在腹腔镜胆囊切除术中的应用价值。方法:腹腔镜胆囊切除术中经胆囊管插管行胆道造影21例,成功21例。结果:术中胆道造影排除胆道结石17例,排除胆道损伤3例,辩认胆道畸形1例。结论:术中胆道造影简单易行,安全可靠,显影清晰,成功率高,能降低胆道损伤及胆道残石的发生率,提高腹腔镜胆囊切除术的质量,值得推广应用。 相似文献
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腹腔镜胆囊切除术 (LC)后胆道残留结石及胆道损伤的并发症日益受到重视[1 ,2 ] 。我院自1 998年 3月以来 ,有选择地为 1 7例LC者作经胆囊管的术中胆道造影 (IOC) ,现报告如下。1 临床资料本组 1 7例入院诊断均为胆囊结石。男 3例 ,女 1 4例 ;年龄 2 4~ 68岁。术前近期内有胆囊炎急性发作且B超下结石细小 (直径 <0 3cm) 8例 ,曾有胆源性胰腺炎史 2例 ;B超下胆总管直径 >0 6cm 2例 ;术中胆囊管短粗疑胆总管继发结石 3例 ;calot’s三角解剖不清 ,排除胆道损伤 2例。LC术中解剖calot’s三角 ,显露胆囊管 ,于近胆… 相似文献
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目的 探讨评价术中胆道造影在腹腔镜胆囊切除术的应用价值。方法 206例慢性胆囊炎并结石有黄疸史行LC者,术中经胆囊插管行胆总管造影。结果 203例成功,成功率99%。术中造影发现胆总管结石23例。结论 术中造影操作迅速、安全、成功率高,能提高腹腔镜胆囊切除术的质量,降低中转开腹率,值得推广。 相似文献
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目的:探讨经胆囊管造影在单纯性胆囊切除术中的价值。方法:对1997年1月-2000年12月,232例单纯性胆囊切除术中,经胆囊管造影的临床资料进行回顾性分析。结果:43例有胆总探查相对指针的病人,术中胆道造影有阳性发现11例,占25.58%,189例无胆总管探查相对指针的病人,术中胆道造影有阳性发现的21例,占11.1%。结论:单纯性胆囊切除术中,经胆囊管造影是种简单而有效降低胆管残余结石方法。可避免不必要的阴性胆总管探查。 相似文献
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Objective To discuss the advantages and disadvantages of several biliary imaging method during laparoscopic cholecystectomy. Methods Review and analyse the clinical data of 153 cases of selective intraoperative cholangiography. Results 152 cases of intubation succeed. And found that choledocholith in 13 cases,injury of common bile duct in 1 case, accessory hepatic duct in 2 cases. The shortest time required for in-tubation is to puncture by epidural needle puncture(2~5 min) ,and the time required for the other two methods is closed (8~20 min). Conclusion The apphcation of epidural needle puncture as a tool of intraoperative cholangiography is more advantaged, and could easily applied in clinical practice. 相似文献
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腹腔镜胆囊切除术中几种胆道造影方法的临床应用价值 总被引:1,自引:0,他引:1
Objective To discuss the advantages and disadvantages of several biliary imaging method during laparoscopic cholecystectomy. Methods Review and analyse the clinical data of 153 cases of selective intraoperative cholangiography. Results 152 cases of intubation succeed. And found that choledocholith in 13 cases,injury of common bile duct in 1 case, accessory hepatic duct in 2 cases. The shortest time required for in-tubation is to puncture by epidural needle puncture(2~5 min) ,and the time required for the other two methods is closed (8~20 min). Conclusion The apphcation of epidural needle puncture as a tool of intraoperative cholangiography is more advantaged, and could easily applied in clinical practice. 相似文献
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Objective To discuss the advantages and disadvantages of several biliary imaging method during laparoscopic cholecystectomy. Methods Review and analyse the clinical data of 153 cases of selective intraoperative cholangiography. Results 152 cases of intubation succeed. And found that choledocholith in 13 cases,injury of common bile duct in 1 case, accessory hepatic duct in 2 cases. The shortest time required for in-tubation is to puncture by epidural needle puncture(2~5 min) ,and the time required for the other two methods is closed (8~20 min). Conclusion The apphcation of epidural needle puncture as a tool of intraoperative cholangiography is more advantaged, and could easily applied in clinical practice. 相似文献
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目的:探讨超声刀结合术中胆道造影行腹腔镜胆囊大部切除术的手术适应症和安全性.方法:回顾性分析我院2010年1月~2011年3月行超声刀结合术中胆道造影腹腔镜胆囊大部切除术23例患者的临床资料.结果:全组病例均于术后第2天拔出腹腔引流管,术后第3天出院,随访至少3个月,无胆漏、出血或胆管损伤等围手术期并发症发生.结论:超声刀结合术中胆道造影行胆囊大部切除术对Calot三角解剖困难的手术安全性高. 相似文献
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腹腔镜胆囊切除术前静脉胆道造影的价值 总被引:2,自引:0,他引:2
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、胆囊积液积浓脓、胆囊萎缩等病理改变的发生率均明显低于胆囊不显影、显影浅谈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59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,应作为LC术前的常规性检查。 相似文献