剑突下穿刺胆管造影术

目的　报告剑突下穿刺胆管造影术的临床应用经验。方法　在B超定位下于剑突下穿刺左肝管行PTC检查 ,拔针后压迫穿刺点 5～ 10分钟。结果　 86例行剑突下穿刺胆管造影术 ,75例穿刺成功 ,成功率 87.2 1% ,手术证实无出血及胆漏并发症 ;11例中转右侧径路PTC或经皮肝穿刺胆囊造影术 ,中转率 12 .79% ,其中 10例成功 ,术中发现不同程度出血和胆漏。总成功率 98.84%。结论　剑突下穿刺胆管造影术可作为PTC的首选方法。

Cholangiography by Puncturing below Xiphoid

Objective To report the clinical experience of cholangiography by puncturing below xiphoid.Method Percutaneous transhepatic cholangiography was performed by puncturing the left hepatic duct below xiphoid under the guidance of ultrasound.The puncturing spot should be oppressed for 5～10 minutes after the needle was pulled out.Results Cholangiography was performed in 86 patients with juandice,75 cases of the patients successfully punctured below xiphoid,the successful rate of puncture was 87.21%,and none of 75 patients occured bleeding or biliary leak during sequent laparotomy;11 cases of the patients were transfered to cholangiography by puncturing the right hepatic duct or cholecystography,10 cases of 11 patients succeeded and all occurred bleeding or biliary leak at different extend.In our study the whole rate of success was 98.84%.Conclusions Percutaneous transhepatic puncturing the left hepatic duct below xiphoid is probably the first choice of cholangiography.