术中胆道造影52例临床分析

目的：探讨在胆道手术中选择性胆道造影的应用价值。方法：回顾性分析2004年4月～2006年9月52例术中胆道造影（IOC）患者的临床资料。其中经胆囊管或经胆总管穿刺行选择性IOC 36例、直接经T管造影16例，选择性IOC阳性者再行经T管IOC者10例。结果：对胆囊切除术中36例具有胆总管相对探查指征患者经胆囊管或经肝胆管穿刺IOC，发现胆道结石10例（27．78％），假阳性2例（5．56％），阴性24例（66．67％）。26例胆总管结石病例经“T”管术中造影，胆道结石残余2例（7．69％），假阳性1例（3．85％）。结论：IOC可预防术后残余结石，避免不必要的胆总管切开探查，降低术后并发症；并能直接了解胆道系统解剖，提高手术安全性，在临床手术中有着广泛的应用价值。

Clinical Evaluation of Intraoperative Cholangiography on 52 Patients

Objective： To investigate the applied values of selective intraoperative cholangiography （IOC） in operation on biliary duct. Methods-Clinical data of 52 cases of intraoperative cholangiography from April 2004 to December 2006 in our hospital were retrospectively analyzed. Selective IOC through cystic duct or common bile duct was performed on 36 patients, forthright through T duct was performed on 16 cases and positive in Selective IOC was performed again through T duct in 10 cases. Results.36 patients who had indication of bile duct exploration in bile-cystic exairesis underwent transcystic or transhepatic IOC. Ten were found to have bile duct stones（27.78% ）, two false-positive（5.56% ） and twenty four negative （66.67%）. 26 patients with choledocholithiasis underwent intraoperative T-tube cholangiography, two of them were found to have some residual stones in bileduct （7.69%）, one were false-positive（3.85% ）. Conclusions： IOC could prevent ignoring stones in bile duct, avoid unnecessary bile duct exploration, and decrease postoperative complications. Otherwise, IOC can help to understand straightly systematic anatomy of biliary duct to increase operative safety. So it had general applied values in clinical operation.