胆囊切除术中选择性胆道造影的应用价值  

The Applied Value of Selected Intraoperative Cholangiography in Cholecystectomy

作　　者：李瑞祥[1] 王红云[2] 吴茂喜 

机构地区：[1]西安交通大学第一医院老年外科,陕西西安710061 [2]西安交通大学第一医院西手术室,陕西西安710061 [3]陕西省渭南市妇幼保健院

出　　处：《实用放射学杂志》2004年第11期998-999,共2页Journal of Practical Radiology

摘　　要：目的　探讨胆囊切除术中选择性胆道造影的应用价值。方法　回顾分析胆囊切除时选择性经胆囊管行胆道造影 3 9例的临床资料 ,根据传统观念这些病例均有胆总管探查的指征。结果　造影阳性 19例 ,其中结石征象 16例 ,胆总管下段狭窄 3例 ,阳性率 48.72 % ;手术探查阳性者 14例 ,其中胆总管结石 12例 ,胆总管下段炎性狭窄 1例 ,胆总管下段肿瘤 1例 ,造影准确率73 .68% ;手术探查阴性 5例 ,造影假阳性率 2 6.3 2 % ;造影阴性的 2 0例病人 ,未行胆总管探查而随访未发现异常。结论　选择性术中胆道造影安全方便 ,效果确切 ,对预防术中残留结石及因盲目胆总管探查而损伤胆道 ,减少术后并发症 。Objective To evaluate the applied of selected intraoperative cholangiography(SIOCG) during cholecystectomy.Methods The SIOCG data of 39 patients who had indications for exploration of common bile duct were analysed retrospectively.Results Among 39 cases with SIOCG,abnormal findings were detected in 19 cases(48.72%),in which choledocholith in 16 cases;stenosis of common bile duct at the third part in 3 cases.Positive findings in exploration of common bile duct were 14 cases(73.68%),in which,choledocholith were 12 cases inflammatory stenosis 1 case and tumor of common bile duct at the third part 1 case.Negative patients in exploration of common bile duct were 5 cases(26.32%).Normal imaging in 20 patients who did not underwent exploration of common bile duct had no disorders in follow-up.Conclusion SIOCG is safe,convenient,and useful in preventing the remnant stones and biliary tract damage and improving the quality of cholecystectomy.

关 键 词：胆道造影 术中 胆总管探查 胆囊切除术 应用价值 狭窄 阴性 准确率 

分 类 号：R657[医药卫生—外科学] R735[医药卫生—临床医学]