未进行术中胆管造影的胆囊切除术结果
Results of cholecystectomy without intraoperative cholangiography.
作者信息
Lorimer John W
机构信息
Department of Surgery, University of Ottawa, Ottawa Hospital - General Site, 501 Smyth Rd, Room K-11, Ottawa, ON K1H 8L6.
出版信息
Can J Surg. 2004 Oct;47(5):343-6.
BACKGROUND
To determine if cholecystectomy can be performed satisfactorily without the use of adjunctive intraoperative cholangiography (IOC), we planned a retrospective analysis at a Canadian university teaching hospital.
METHODS
General operative morbidity and mortality (in particular, occurrences and complications of missed choledocholithiasis and reoperations for same, and occurrences of bile duct injuries and bile leaks) were noted and analyzed for a consecutive series of cholecystectomies from a single practice, carried out without IOC.
MAIN RESULTS
In general, choledocholithiasis could be identified and treated before the operation; missed cases were infrequent and were treatable without reoperation. No major injuries to the bile duct were encountered.
CONCLUSIONS
IOC appears to be optional with cholecystectomy; cholecystectomy can be performed without IOC safely in the defined setting, without related major complications from missed choledocholithiasis or excess occurrence of bile-duct injury.
背景
为了确定在不使用术中辅助胆管造影（IOC）的情况下能否令人满意地进行胆囊切除术，我们在一家加拿大大学教学医院计划了一项回顾性分析。
方法
记录并分析了来自单一术者连续进行的一系列未行IOC的胆囊切除术的总体手术发病率和死亡率（特别是漏诊胆总管结石及其再次手术的发生率和并发症，以及胆管损伤和胆漏的发生率）。
主要结果
一般来说，胆总管结石在手术前可以被识别和治疗；漏诊病例很少见，且无需再次手术即可治疗。未发生重大胆管损伤。
结论
IOC似乎不是胆囊切除术的必需操作；在特定情况下，不进行IOC也能安全地进行胆囊切除术，不会因漏诊胆总管结石或胆管损伤发生率过高而出现相关重大并发症。
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