术中胆道造影在腹腔镜胆囊切除术中的应用价值

目的：研究对于有胆总管探查指征的病人行腹腔镜下胆囊切除术（laparoscopic cholecystectomy,LC)时手术中胆道造影（intraoperative cholangiography,IOC)的应用价值。方法：收集我院外科1991－1999年2395例腹腔镜胆囊切除术病人中有选择性行手术中胆道造影的201例病人资料。分析术前术中存在的胆总管探查原因，手术中通过经胆囊管插管造影的结果对比，评估腹腔镜胆囊切除术术中胆道造影的应用价值。结果：在所有201例手术前或手术中有总管探查指征的病人行LC手术时，术中经胆囊造影，共有65例病人有阳性发现，其中只有21例行中转开腹手术，结论：腹腔镜胆囊切除术术中胆道造影有很好的实用价值，正确使用可扩大腹腔镜胆囊切除术的手术适应症。

Value of intraoperative cholangiography for laparoscopic cholecystectomy

Objective To study the value of intraoperative cholangiography (IOC) for laparoscopic cholecystectomy (LC). Methods From 1991 to 1999, 2395 patients were treated with LC in our hospital. Amongst these patients, 201 with the evidence of common bile duct exploration were selected to receive IOC using C arm X ray machine. IOC was conducted by using a tube inserted through the cystic duct into the common bile duct. Results Of the 201 suspected patients, only 65 were found to be positive by IOC and the positive rate was 22 3%. Amongst these 65 patients, only 21 underwent open cholecystectomy (OC). Conclusions The selective IOC is of great value in LC and has potential effectiveness in expansion of LC if it is correctly used.