腹腔镜胆囊切除术前行MRCP对肝外胆道变异诊断的临床意义

目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)术前行MRCP检查对肝外胆道变异诊断的临床意义。方法:回顾分析为1 200例LC患者术前行MRCP检查的临床资料。结果:LC术前通过MRCP检查发现肝外胆道变异96例,其中胆囊管冗长且扭曲51例、胆囊管低位汇合23例、胆囊管汇合于右肝管8例、迷走胆管5例、副胆管4例、胆总管囊肿2例、双胆囊2例、肝内胆囊1例。手术证实89例与术前MRCP检查结果一致,存在胆道变异。结论:通过MRCP检查可全面了解胆树图像,LC术前便可发现各种胆道变异及胆道的复杂性,具有一定的导航作用,克服了以往术中经验性、探索性解剖Calot三角的缺点,明显减少了医源性胆道损伤的发生。

The clinical significance of MRCP examination prior to laparoscopic cholecystectomy in the diagnosis of extrahepatic bile duct variations

Objective： To investigate the clinical significance of MRCP examination prior to laparoscopic cholecystectomy （LC） in the diagnosis of extrahepatic bile duct variations. Methods：The clinical data of 1 200 patients who accepted MRCP examination before LC were retrospectively analyzed. Results：Extrahepatic bile duct variations were detected in 96 cases by MRCP before LC, inclu- ding 51 cases of cystic duct redundancy and twist,23 cases of low choledochal joint,8 cases of cystic duct confluence of right hepatic duct,5 cases of aberrant bile duct,4 cases of accessory bile duct,2 cases of choledochal cyst,2 cases of double gallbladder and 1 case of intrabepatic gallbladder. Bile duct variations were confirmed by operation in 89 patients whose results were consistent with the MRCP examination. Conclusions ： Bile duct variations and the complexity can be detected by MRCP examination to reveal the biliary tree image before LC,which helps to overcome the shortcomings of experiential and exploratory dissecting the Calot triangle and decrease iatrogenic bile duct injuries.