四种胆管造影法在腹腔镜胆囊切除术中预防胆管损伤作用的比较

目的 为了减少胆管损伤的发生，比较在腹腔镜胆囊切除术中四种胆管造影法对预防胆管损伤所起的作用。方法 分别用光亮胆管造影法(cold light cholangiography，CLCP)、美蓝胆管造影法(methylenum coeruleum cholangioguaphy，MCCP)、术中X线胆管造影法(intraoperative cholan—giography，IOCP)、术中逆行胰胆管造影法(intraoperative endoscopic retrogarde cholangiopancreatography，IERCP)进行比较。结果 四种胆管造影法均能在腹腔镜胆囊切除术(1aparoscopic cholecystectomy，LC)中提供胆管图像。前两种为直接图像，有助于术者术中进行解剖，效果以CLCP为佳。后两种为间接图像，对术中解剖无直接帮助。结论 CLCP能清楚、直接地显示胆管走向。在解剖不清的LC中，能有效帮助术者进行解剖，提高手术安全性，与其他3种方法相比，实用价值更高。

Comparison of four kinds of cholangiographies in the prevention of bile duct injury during laparoscopic cholecystectomy

Objective The efficacies of four cholangiogrphies were compaired with each other in preventing bile duct injury during the procedure of LC. Methods Four cholangiogrphies were used in LC:1. Cold light cholangiography (CLCP); 2. Methylenum coeruleum cholangioguaphy (MCCP); 3. Intraoperative cholangiography (IOCP); 4. Intraoperative endoscopic retrogarde cholangiopancreatography (IERCP). Results The images of CLCP and MCCP were direct and could help operator to identify bile duct structure in LC. The images of IPCP and IERCP were indirect and could not be so helpful. Conclusions CLCP is the only technique that clearly and directly shows the location of the extra hepatic biliary system and may be useful in selected cases with abnormal or uncertain anatomy for the prevention of bile duct injury.