Cudjoe E A, Edoga J K, Chattar D
Department of Surgery, Morristown Memorial Hospital, New Jersey, USA.
JSLS. 2001 Jul-Sep;5(3):245-8.
Despite the numerous and often cited benefits of routine cholangiography during laparoscopic cholecystectomy, universal application of this technique has not been realized. Surgeons who advocate selective cholangiography cite the extra cost, the low yield of unanticipated findings, and the marked increase in the duration of the operation when cholangiography is added to laparoscopic cholecystectomy. We present our experience with preview cholangiography and compare it with the transcystic-duct approach.
We attempted preview cholangiograms on 11 consecutive patients undergoing laparoscopic cholecystectomy. Successful cholangiography was determined by using established radiologic criteria.
Preview cholangiogram was successful in all 11 patients. No complications occurred. The average time required was 110 seconds. The mean operating time was 52 minutes. These times are far better than our best accomplishments using the cystic duct cannulation method for cholangiography (mean cholangiogram time, 22 minutes, and mean operative time, 75 minutes) following the first 100 cases.
Preview cholangiography is a safe, relatively easy, quick method for outlining the anatomy of the extrahepatic biliary tree prior to dissection necessary to remove the gallbladder with laparoscopic techniques. The ease of this approach should result in more widespread use of cholangiography during laparoscopic cholecystectomy.
尽管在腹腔镜胆囊切除术中常规胆管造影有诸多益处且常被提及，但该技术尚未得到普遍应用。主张选择性胆管造影的外科医生指出其额外成本、意外发现的低检出率以及将胆管造影添加到腹腔镜胆囊切除术中时手术时间显著增加。我们介绍我们在预视胆管造影方面的经验，并将其与经胆囊管途径进行比较。
我们对连续11例行腹腔镜胆囊切除术的患者尝试进行预视胆管造影。通过既定的放射学标准确定胆管造影是否成功。
11例患者的预视胆管造影均成功。未发生并发症。所需平均时间为110秒。平均手术时间为52分钟。这些时间远比我们在前100例病例中使用胆囊管插管法进行胆管造影时的最佳成绩要好（平均胆管造影时间为22分钟，平均手术时间为75分钟）。
预视胆管造影是一种安全、相对简便、快速的方法，可在采用腹腔镜技术切除胆囊所需的解剖操作之前勾勒出肝外胆管树的解剖结构。这种方法的简便性应会导致胆管造影在腹腔镜胆囊切除术中得到更广泛的应用。
