Blatner M E, Wittgen C M, Andrus C H, Kaminski D L
Department of Surgery, St. Louis University Medical Center, Mo.
Arch Surg. 1991 May;126(5):646-9. doi: 10.1001/archsurg.1991.01410290124025.
At present, there is no consensus regarding the routine use of intraoperative cholangiography during cholecystectomy. We describe a reliable technique for performing cystic duct cholangiography during laparoscopic cholecystectomy. Using this technique, we were able to cannulate the cystic duct in 97% of patients, completely visualize the biliary tree and duodenum in 93% of patients, and identify unsuspected choledocholithiasis in 3% of patients. Treatment options for the management of choledocholithiasis demonstrated by cholangiograms during laparoscopic cholecystectomy include conversion to an open cholecystectomy and common duct exploration, or endoscopic sphincterotomy and common duct stone extraction following laparoscopic cholecystectomy.
目前，关于在胆囊切除术中常规使用术中胆管造影术尚无共识。我们描述了一种在腹腔镜胆囊切除术中进行胆囊管胆管造影的可靠技术。使用该技术，我们能够在97%的患者中成功插管胆囊管，在93%的患者中完全可视化胆管树和十二指肠，并在3%的患者中发现意外的胆总管结石。腹腔镜胆囊切除术中胆管造影显示的胆总管结石的治疗选择包括转为开腹胆囊切除术并探查胆总管，或在腹腔镜胆囊切除术后进行内镜括约肌切开术和胆总管结石取出术。
