腹腔镜下胆囊切除术中胆道造影的研究进展  

Research progress of intraoperative cholangiography in laparoscopic cholecystectomy

作　　者：温天富 戴灵波 徐洪根 华长星 Wen Tianfu;Dai Lingbo;Xu Honggen;Hua Changxing(Department of General External Hepatobiliary Surgery,the First People's Hospital of Wenling,Wenling 317500,China;Department of General Gastrointestinal Hernia Surgery,the Second Hospital of Harbin,Harbin 150056,China)

机构地区：[1]温岭市第一人民医院普外肝胆外科,温岭317500 [2]哈尔滨市第二医院普外胃肠疝外科,哈尔滨150056

出　　处：《国际外科学杂志》2023年第4期275-279,共5页International Journal of Surgery

摘　　要：随着腹腔镜下胆囊切除术在各级医疗机构的广泛开展,手术并发症也随之增多,其中,胆管损伤的发生率在复杂性腹腔镜下胆囊切除手术中居高不下。究其原因为外科医师不能精准地识别变异的胆道和胆囊管与胆总管的关系,从而误伤胆管,给患者造成了住院时间长、医疗费用增加、患者远期生活质量下降等问题。术中胆道造影作为一种时时可视化的胆道呈现方法,可有效降低医源性胆管损伤的发生率,然而,多数外科医师对于胆囊切除术中胆道造影技术并没有充分认识。本文就笔者团队术中胆道造影的临床经验结合近几年胆道造影在腹腔镜下胆囊切除术中的应用研究进行综述,旨在加深外科医师对术中胆道造影的认识,从而能将其更好地应用到临床之中,为患者造福。With the widespread implementation of laparoscopic cholecystectomy in various levels of medical institutions, surgical complications have also increased. Among them, the incidence of bile duct injury remains high in complex laparoscopic cholecystectomy. The reason for this is that surgeons cannot effectively and accurately identify the relationship between the aberrant bile duct and the cystic duct and the common bile duct, resulting in the accidental injury of the bile duct, resulting in long hospital stays, increased medical costs, and decreased long-term quality of life for patients. Intraoperative cholangiography, as a real-time visual method of biliary presentation, can effectively reduce the incidence of iatrogenic bile duct injury. However, most surgeons do not fully understand the technology of intraoperative cholangiography during cholecystectomy. This article reviews the application of intraoperative cholangiography in laparoscopic cholecystectomy based on the clinical experience of the author′s team and the literature in recent years, with the aim of deepening the understanding of surgeons about intraoperative cholangiography, so as to better apply it to clinical practice and benefit patients.

关 键 词：胆囊切除术 腹腔镜 胆道造影术 胆管疾病 胆管损伤 

分 类 号：R657.4[医药卫生—外科学]