胆囊结石术中经胆囊管胆道造影的临床分析

目的：探讨胆囊切除术中行胆囊管胆道造影的临床意义。方法：回顾性分析254例行胆囊切除术患者的临床资料，其中89例术中行胆囊管造影，165例未行造影。结果：89例术中行胆囊管造影，术中发现胆总管结石9例（10．11％）、胆总管隐匿性损伤2例（2．2％），术后随访3～6月发现胆道残余结石3例（3．37％）；165例术中未行胆囊管造影，术中发现胆总管结石4例（2．42％），术后出现胆道损伤3例（1．82％），术后随访3～6月发现胆道残余结石14例（8．5％）。结论：对既往有胰腺炎、黄疸病史及术前B超检查胆总管增粗等胆囊结石患者，术中行胆道造影可降低胆道残余结石发生率，减少和发现胆道损伤，避免不必要的阴性胆总管探查。

Clinical Analysis of Intraoperative Trans-Cystic Duct Cholangiography during Cholecystectomy

Objective： To discuss the clinical value of intraoperative traMs - cystic duct cholangiography during simple cholecystectomy. Methods ： The clinical data of 254 cases who had gone through cholecystectomy, including 89 patients （ experimental group） concurrently accepted cholangiography, other 165 cases （ control group） did not receive cholangiography, was analyzed retrospectively. Results：Nine （10.11% ） cases in the experimental group were found to have common duct stones, and 2 （2.2%） suffered from the insidious damages to the common bile ducts. However, in the control group, 4 （2.42 % ） cases were found to have com- mon duct stones, and 3 cases （ 3.37% ） have the injuries of biliary tracts. In the postoperative follow - up periods of 3- 6 months, 3 cases （3.37%）in the experimental group and 14 （8.5%）in the control group were found to have retained calculus in biliary tracts. Conclusions：The intraoperative cholangiography will be performed on the patients who have medical records of pancreatitis, yellow jaundice, and whose preoperative B - uhrasonography showed the thickening of choledochus, that could reduce the incidence of residual stones and injury to biliary tract, and could avoid unnecessary exploration of the common bile duct.