摘要
目的:比较术中胆道造影与术前影像检查的差异,分析胆道造影对胆管结石诊断的指导价值。方法:回顾分析2016~2019年完成的164例腹腔镜经胆囊管胆道造影患者的临床资料。结果:术中胆道造影对术前存在黄疸、转氨酶、谷氨酰转肽酶、碱性磷酸酶或胆红素升高,胆总管扩张的患者,胆总管结石的诊断率更高;术中胆道造影对胆总管结石的诊断准确性高于术前彩超(P<0.05),对胆管解剖异常诊断率高于CT(P<0.05),而与MRCP相比差异无统计学意义(P>0.05),但仅50.61%的患者进行了术前MRCP检查。结论:术中胆道造影能弥补术前影像检查的不足,及时发现可疑的胆总管结石及胆道解剖变异,降低胆总管残余结石发生率,避免胆道损伤的风险。
Objective:To compare the difference between intraoperative cholangiography(IOC)and preoperative imaging,and to analyze the guiding value of cholangiography in the diagnosis of cholangiolithiasis.Methods:The clinical data of 164 patients who underwent laparoscopic trans-bile duct IOC from 2016 to 2019 were retrospectively analyzed.Results:The IOC diagnostic rate of choledocholithiasis was higher in the patients with jaundice,with the increase of transaminase,glutamyl transpeptidase,alkaline phosphatase or bilirubin,or diagnosed with dilated common duct;the accuracy of IOC in the diagnosis of choledocholithiasis was significantly higher than that of preoperative color Doppler ultrasound(P<0.05),and the diagnostic rate of IOC in biliary anatomic variation was significantly higher than that of CT,while there was no significant difference between IOC and MRCP(P>0.05).However,only 50.61%patients underwent MRCP before operation.Conclusions:IOC can make up for the lack of preoperative image examination.It can timely detect suspected choledocholithiasis and biliary anatomic variation,reduce the incidence of residual choledocholithiasis,and avoid the risk of bile duct injury.
作者
黄龙
罗云
朱长康
周良弼
吴定泉
HUANG Long;LUO Yun;ZHU Chang-kang(Department of General Surgery,Beibei Traditional Chinese Medical Hospital,Chongqing 400711,China)
出处
《腹腔镜外科杂志》
2020年第10期748-752,共5页
Journal of Laparoscopic Surgery
基金
广州中医药大学附属北碚中医院院级课题(2020-01)。
关键词
胆总管结石
腹腔镜检查
术中胆道造影
胆道解剖变异
Choledocholithiasis
Laparoscopy
Intraoperative cholangiography
Anatomic variation of biliary tract
