急性胆囊炎行腹腔镜胆囊切除时术中胆道造影35例分析

目的:探讨急诊腹腔镜胆囊切除术(LC)时行术中胆道造影对胆总管结石的诊断价值,了解IOC在急诊LC时的可行性和安全性。方法:37例术前B超或CT未发现胆总管结石的急性胆囊炎病例行LC,均行经胆囊管胆道造影。结果:35例胆道造影成功,发现3例胆总管结石病例,分别为4mm、3mm、3mm大小,于术后行内镜取石成功。该组病例中无胆道损伤,发生1例与胆道造影无关的轻微胆漏。结论:急性胆囊炎行LC时,并发隐匿性胆管结石的情况值得重视,IOC在急诊LC时对胆管结石的诊断是安全可行的。

Intraoperative cholangiography in acute cholecystitis patients underwent laparoscopic cholecystectomy-analysis of 35 cases

Objective：To study the diagnostic value of intraoperative cholangiography（IOC）for CBD stone in AC patient undergoing laparoscopic cholecystectomy（LC）.Safety and feasibility of IOC in emergency LC were also discussed.Method：LC were performed in 37AC patients who hadn＇t been detected CBD stone by ultrasonography or X-ray CT check.IOC were taken in these cases.Result：We successfully performed IOC in 35patients and found 3cases of CBD stone.The stones were 4mm,3mm and 3mm in diameter respectively and received no treatment during operation.Endoscopic sphincterotomy（EST）was taken to clear the CBD stones successfully after LC. There was no CBD injury case but one case of slight bile leakage unrelated to IOC.Conclusion：Occult CBD stones in AC patients underwent emergency LC should be identified.IOC is safe and feasible to diagnose CBD stone during emergency LC.