Division of General Surgery, Department of Surgery, Dalhousie University, Room 8-026 Centennial Building, Vitoria General Site, QEII HSC 1276 South Park St, Halifax, Nova Scotia, Canada, B3H 1C8.
J Gastrointest Surg. 2012 Dec;16(12):2220-4. doi: 10.1007/s11605-012-2041-0. Epub 2012 Oct 6.
Although gallstone pancreatitis is initiated by the presence of stones in the common bile duct, the benefit associated with routine intraoperative cholangiography at the time of cholecystectomy in these patients is unclear. The purpose of this study, using population-based data, was to determine the impact of cholangiography on clinical outcomes after cholecystectomy for gallstone pancreatitis.
All patients who were admitted to hospital from January 1, 1997 to December 31, 2001 in Nova Scotia, Canada with pancreatitis who underwent cholecystectomy during the same admission were identified. The rates of recurrent pancreatitis and biliary complications after surgery were compared between patients who underwent cholecystectomy with intraoperative cholangiography ± common bile duct exploration and those who underwent cholecystectomy alone, using three linked administrative databases.
Three hundred thirty-two patients were identified, 119 had cholangiography at the time of cholecystectomy and 213 did not. After a median follow-up of after 3.8 years, there was no difference in the rate of recurrent pancreatitis or biliary complications between those who had cholangiography ± common bile duct exploration at the time of surgery and those who did not; 13.4 versus 10.8 %, respectively (p = 0.55).
These data suggest that intraoperative cholangiography does not improve outcomes after cholecystectomy for gallstone pancreatitis.
尽管胆石性胰腺炎是由胆总管内存在结石引起的，但在这些患者中胆囊切除术中常规进行术中胆管造影的获益尚不清楚。本研究旨在使用基于人群的数据，确定在胆石性胰腺炎患者中胆囊切除术后胆管造影对临床结局的影响。
确定 1997 年 1 月 1 日至 2001 年 12 月 31 日期间在加拿大新斯科舍省住院并在同一住院期间接受胆囊切除术的所有胰腺炎患者。使用三个相关的行政数据库，比较在胆囊切除术中进行胆管造影术±胆总管探查术与仅进行胆囊切除术的患者手术后复发性胰腺炎和胆道并发症的发生率。
共确定了 332 名患者，119 名患者在胆囊切除术中进行了胆管造影术，213 名患者未进行胆管造影术。中位随访 3.8 年后，在手术中进行胆管造影术±胆总管探查术与未进行胆管造影术的患者中，复发性胰腺炎或胆道并发症的发生率没有差异；分别为 13.4%和 10.8%（p=0.55）。
这些数据表明，在胆石性胰腺炎患者中，术中胆管造影术并不能改善胆囊切除术后的结局。
