经胆囊管造影在胆道手术中的应用分析

目的探讨经胆囊管造影在胆道手术中的应用价值。方法1617例胆道手术患者有选择性地行胆囊管造影198例，其中发现胆总管结石44例，行胆总管探查；有2例造影假阴性，术后发现胆总管结石残留，行二期手术。随机抽取单纯胆囊切除术病人154例、胆切＋总探病人200例与造影组分别进行对照。结果造影组198例病人中，胆切154例，有2例术后残留结石，残石率1．3％，而对照组有14例之多，残余结石发生率为9．1％。在造影组中有44例行胆总管探查，均证实有胆总管结石，阴性探查率0％，对照组200例中有23例进行了不必要的胆总管探查，阴性探查率11．5％。结论有选择性地经胆囊管造影能降低残余结石发生率及胆总管阴性探查率。

Application of intra-operative cholangiography via cystic duct

Objective To investigate the value of cholangiography through cystic duct in biliary surgery. Methods 1617 cases of biliary tract surgery in our hospital from 2002 to 2005 were retrospectively analysed. Among them, 198 cases were performed intra-operative cholangiography via cystic duct selectively in which 44 choledocholithiasis were found and conducted common duct exploration, 2 false negative cases with residual stone were performed the secondary operations. 154 simple cholecystectomy patients and 200 common bile duct exploration patients were compared with the cholangiography group. Results Among the 198 cholangiography cases, 154 cases underwent cholecystectomy, 2 cases were found stones in the common duct after the operation with the residue stone rate of 1.3%; while among the 200 cases in contrast group, 14 cases were found residue stones in common duct with the residue stone rate of 9.1%. 44 cholangiography-positive cases all were confirmed having calculus; while in contrast group 23 cases were conducted unnecessary common duct exploration with the negative exploration rate of 11.5%. Conclusion Selective intra-operative cholangiography through cystic duct can reduce residual stone effectively and lessen negative rate of common bile duct exploration.