术中胆道造影384例分析  

Analysis of intraoperative cholangiography in 384 cases

作　　者：史坚强[1] 刘静[1] 刘杨[1] 周景华[1] 

机构地区：[1]中国人民解放军第359医院普外科,江苏镇江212001

出　　处：《海南医学院学报》2010年第7期929-930,933,共3页Journal of Hainan Medical University

基　　金：海南医学院科研基金资助学报项目(0020100263)~~

摘　　要：目的:探讨胆道手术术中胆道造影的临床价值。方法:回顾性分析384例胆道手术患者术中胆道造影的临床资料。分为甲组(258例):胆囊切除经胆囊管插管造影246例,胆总管穿剌造影12例;乙组126例:胆囊切除、胆总管切开探查、取石术手行术中T管造影。结果:甲组中具有相对胆总管探查指征者183例,造影阳性者22例,其中胆总管结石16例,肝内胆管结石3例,胆总管下端狭窄1例,假阳性2例;另75例无明确胆总管探查指征,胆道造影,阳性1例。乙组胆道结石104例,其中5例肝内胆管结石因病情不允许作进一步处理,明确有结石残留;其余99例取石后且认为结石已取尽,再行T管造影仍有结石残留25例;126例中假阴性3例,假阳性1例。结论:胆道手术术中胆道造影可即时发现胆管残石,有利于提高治愈率,具有较好的临床应用价值。Objective：To probe the clinical value of intraoperative cholangiography in cholangio-operation.Methods：The clinical data of 384 cases that suffered intraoperative cholangiography in cholangio-operation were retrospectively analyzed.A total of 258 cases were divided into group A.Cholecystectomy by intraoperative cholangiography was performed on 246 patients,and 12 patients had choledoch radiography.Other 126 cases were divided into group B receving cholecystectomy with exploration as well as T-tube cholangiography in lithotomy operation.Results：Relative indications for bilt duct exploration showed in 183 cases.A total of 22 cases showed positive response in radiology,including 16 cases with choledocholithiasis,and 3 with hepatolithiasis.One of the 22 cases had stricture of down common bile duct.There were 2 false positive cases,and other 75 cases without any relative indications for bilt duct exploration.One case showed positive response in radiology.There were 104 cases with biliary Ca...更多lculi.The stones were cleared off in 99 cases.Other 5 cases had residual stones because of their poor physical condition.Residual stones still showed by T-tube cholangiography in 25 cases.There were 3 false negative cases and 1 false positive case among the 126 cases.Conclusions：Intraoperative cholangiography can find residual stones immediately,increase recovery rate and is worth clinic application.

关 键 词：胆总管探查术 胆道造影 治疗 

分 类 号：R657.4[医药卫生—外科学]