腹腔镜胆囊切除术前MRCP与术中胆道造影的临床价值  

Clinical Value of Magnetic Resonance Cholangiopancreatography and Intraoperative Cholangiography before Laparoscopic Cholecystectomy

作　　者：季刚 黄文磊 曹华祥[2] JI Gang;HUANG Wen-lei;CAO Hua-xiang(Wuxi Xishan peoples Hospital,Wuxi,Jiangsu,214105)

机构地区：[1]无锡市锡山人民医院,江苏无锡214105 [2]江南大学附属医院,江苏无锡214062

出　　处：《医学临床研究》2020年第1期74-76,共3页Journal of Clinical Research

摘　　要：【目的】探讨腹腔镜胆囊切除术(LC)术前磁共振胰胆管造杉(MRCP)与术中胆道造影(IOC)的临床价值。【方法】选取2015年4月至2017年4月本院收治的70例胆囊结石患者,根据随机数表法将其分为观察组和对照组,各35例。两组患者均行LC,观察组于术前行MRCP,对照组于术中行IOCo比较两组患者Mirizzi综合征、副右肝管、胆囊管斜过肝总管、胆胰管汇合异常发生情况;比较两组围术期相关临床指标,包括手术时间、住院时间、胆道损伤、中转开腹;观察并记录两组患者术后并发症发生情况。【结果】观察组Mirizzi综合征、副右肝管、胆囊管斜过肝总管、胆胰管汇合异常所占比例与对照组比较,差异无统计学意义(P>0.05)。观察组手术时间、住院时间均短于对照组,差异有统计学意义(P<0.05);观察组胆道损伤、中转开腹所占比例与对照组比较,差异无统计学意义(P>0.05)。观察组术后并发症发生率为11.43%(4/35)低于对照组的25.71%(9/35),但差异无统计学意义(χ^2=2.362,P>0.05)。【结论】MRCP可于术前精确、无创地对患者进行诊断,降低手术对患者的创伤,缩短手术及住院时间,减少并发症的发生,值得临床推广应用。【Objective】To explore the clinical value of magnetic resonance cholangiopancreatography(MRCP)and intraoperative cholangiography(IOC)before laparoscopic cholecystectomy(LC).【Methods】A total of 70 patients with gallstones who underwent LC in our hospital from April 2015 to April 2017 were selected as the research objects.They were randomly divided into the observation group and the control group,with 35 cases in each group.LC was performed in both groups.Patients in the observation group received MRCP before operation,while patients in the control group received IOC during operation.After operation,the results of MRCP and IOC were compared between the two groups,including Mirizzi syndrome,right parahepatic duct,bile duct obliquely crossing the common hepatic duct and abnormal convergence of biliopancreatic duct.The perioperative clinical indexes including operation time,hospitalization time,biliary duct injury and conversion to laparotomy of the two groups were compared.The occurrence of postoperative complications in the two groups was recorded.【Results】There were no significant differences in terms of Mirizzi syndrome,right parahepatic duct,bile duct obliquely crossing the common hepatic duct and abnormal convergence of biliopancreatic duct between the observation group and the control group(P>0.05).The operation time and hospitalization time of the observation group were shorter than those of the control group(P<0.05).Compared to the control group,the proportion of biliary tract injury and conversion to laparotomy in the observation group was not significantly different from the control group(P>0.05).The incidence of postoperative complications was 11.43%(4/35)in the observation group and 25.71%(9/35)in the control group,however,the difference was not statistically significant(χ^2=2.362,P>0.05).【Conclusion】MRCP can diagnose patients accurately and noninvasively before operation,reduce the trauma of patients,shorten the time of operation and hospitalization,and avoid complications.It is worthy of

关 键 词：胆囊切除术 腹腔镜 磁共振成像 胆管造影术 

分 类 号：R605[医药卫生—外科学]