目的 探讨术中胆道造影在腹腔镜胆囊切除术(LC)中的临床应用价值.方法 分析2006年9月至2010年12月北京丰台长辛店医院及东城区第一人民医院180例慢性结石性胆囊炎、急性结石性胆囊炎、胆源性胰腺炎患者行LC患者的临床资料,统计分析其中20患者在术中经胆囊管插管行胆管造影(IOC)的临床数据.结果 20例LC术中胆管造影18例成功,成功率90.0%,术中发现胆总管结石2例,经中转开腹行胆总管切开取石,胆管变异1例;平均造影时间15±10.50 min.结论 LC中胆管造影操作较为简单方便、显影清晰、成功率高,既能发现术前未能发现的胆总管结石,又能发现胆管解剖变异;并能够有效地降低胆管残石率,及时发现术中胆管损伤,提高了LC的手术质量和安全性.%Objective To evaluate the clinical significance of intraoperative cholangiography ( IOC ) during laparoscopic cholecystectomy ( LC ). Methods The clinical data of 20 patients with IOC were selected from 180 IX patients with chronic gallstone cholecystitis, acute gallstone cholecytitis, and biliary pancreatitis in Changxindian Hospital and the First People Hospital of Dongcheng District in where the author worked from September, 2006 to December, 2010. Results IOC in 18 of 20 patients was successfully performed in this study and the successful rate was 90. 0%. The stones in common bile duct were detected in two patients by IOC and they were converted to common stone extraction by an open surgery. The abnormal cystic duct was found in one patient by IOC. The average duration for IOC was 15 ± 10. 50 minutes. Conclusion Intraoperative cholangiography during LC exhibits more simple and convenient, clear imaging, and high successful rate. It can not only find the stones in common bile duct which were failed to find before the operation, but also find the anatomic variation of bile duct, and it may reduce the residual rate of stones in bile duct and timely detect surgical damage in bile duct. Intraoperative cholangiography will improve the quality and safety of laparoscopic cholecystectomy.
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