术中胆道造影在腹腔镜胆囊切除术中应用价值

目的探讨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在切除胆囊前,常规在C型臂X线下行胆道造影,并及时采集、保存图像,以了解肝外胆管内有无结石存在。若发现结石,继而行中转开腹胆总管探查取石术。结果施行的76例术中胆道造影中,发现胆总管结石5例,其中胆总管下段多发结石2例,胆总管内单发结石2例,胆总管内一长柱状结石1例。5例胆总管结石取出术后均放置T型管,随访T管造影复查,未见结石残留。结论腹腔镜胆囊切除术常规行术中胆道造影可有效地防止胆道结石残留,避免了不必要的胆管探查,减少了胆管损伤和术后并发症的发生,减少了患者的住院费用和住院时间,且术中胆道造影操作简单、迅速、安全,除有禁忌证外,应常规应用术中胆道造影。

Value of intraoperative cholangiography in laparoscopic cholecystectomy

Objective Discussion the value of intraoperative cholangiography in laparoscopic cholecystectomy.Methods We make use of the intraoperative cholangiography and timely collection,preservation of images with C-arm X-ray system before laparoscopic cholecystectomy,in order to know whether the extrahepatic bile duct stones exist.If it is found stones,and then line conversion technique common bile duct exploration.Results Among the 76 cases of intraoperative cholangiography,five cases were found common bile duct stones,one of many hair common bile duct stones in 2 cases,common bile duct calculi in two cases of single,common bile duct with a stone pillar in 1case.Five cases of common bile duct stones were put out after "T"-tube,follow-up "T"-tube review angiography.Residual stone was found one case.Conclusions The intraoperative cholangiography in laparoscopic cholecystectomy can decrease residual calculus in the biliary tract,reduce the injury of biliary tract and avoid the unnecessary exploration in the common duct,reduced hospital costs and time of inhospital,and intraoperative cholangiography was simple,rapid,safe.Intraoperative cholangiography should be performed in all cases except those who suffer from contraindications.