摘要
目的比较术中胆道造影与术前影像检查的差异,分析其对胆道疾病的诊断及术式选择的指导价值。方法 118例胆囊结石和胆道疾病患者,术前24例行B超检查,发现正常胆管22例,胆总管结石1例,胆管扩张1例;69例行CT检查,发现正常胆管49例,泥沙样胆管结石16例,胆管扩张4例;25例行MRCP检查,发现正常胆管17例,胆总管结石6例,胆管扩张2例。术中行胆道造影,根据造影结果确定相应术式。结果术前行B超检查的24例中造影发现正常胆管15例,胆总管结石6例,胆管癌1例,胆囊管变异1例,Caroli氏病1例;术前行CT检查的69例术中造影发现正常胆管51例,胆总管结石10例,胆管癌1例,胆囊扩张2例,胆囊管变异1例,Mirizzi综合征2例,胆管损伤2例;术前行MRCP检查的25例,术中造影发现正常胆管14例,结石5例,胆管扩张4例,胆囊管变异1例,M irizzi综合征1例。术中胆道造影对正常胆管的识别能力优于术前B超(P<0.05)。结论术中胆道造影具有操作简单、创伤小、结果可靠等优点,对胆道早期肿瘤、解剖畸形、术中胆道损伤的诊断及术式选择具有指导意义。
Objective To compare the difference between the intraoperative cholangiography（IOC） and preoperative image examinations,and evaluate the instructive value of IOC for diagnosis of biliary diseases and the choice of operation methods.Methods 118 patients with cholecystolithiasis or biliary diseases were enrolled.There were 24 subjects examined by B-mode ultrasonic scanner.The results demonstrated 22 normal,1 choledocholith and 1 cholangiectasis.69 subjects undertaken CT scan showed 49 normal bile ducts,16 sand-like bile duct stones and 4 cholangiectasis.25 subjects undertaken MRCP showed 17 normal bile ducts,6 choledocholith and 2 cholangiectasis.Intraoperative cholangiographies were conducted and the methods of operation were chosen according to the results of cholangiography.Results The IOC of 24 subjects examined by B-scan preoperation showed 15 normal bile ducts,6 choledocholith,1 cholangiocarcinoma,1 cystic duct variation and 1 Caroli＇s disease.The IOC of 69 subjects examined by CT scan preoperation showed 51 normal bile ducts,10 choledocholith,1 cholangiocarcinoma,2 cholangiectasis,1 cystic duct variation,2 Mirizzi syndrome and 2 bile ducts injures.The IOC of 25 subjects examined by MRCP preoperation showed 14 normal bile ducts,5 choledocholith,4 cholangiectasis,1 cystic duct variation and 1 Mirizzi syndrome.The effect of IOC was superior to B-mode ultrasonic scanner preoperation in detection of normal bile duct（P〈0.05）.Conclusion IOC is a simple,safe and accurate procedure.It is of instructive value in both the diagnosis of early biliary tract neoplasms,anatomical distortion,intraoperative bile duct injure and the choice of operation methods.
出处
《中国现代手术学杂志》
2010年第3期168-170,共3页
Chinese Journal of Modern Operative Surgery
关键词
胆管造影术
胆石
胆道外科手术
cholangiography
gallstones
biliary tract surgery
