Carvajal A, Bandres D, Noel Monsalve J, Milano G
G E N. 1989 Jan-Mar;43(1):28-33.
ERCP and cholangiography during surgery (SC) are compared in regard to their usefulness in 100 patients in whom cholecystectomy was performed because of gallstones. The biliary tree was visualized in 73% of patients with ERCP and in 85% with SC 20 patients presented stones in the common bile duct (CBD), of these 19 had previous signs or symptoms clinical history, laboratory, ultrasonography) that suggested this diagnosis, of the rest of the patients (80) without CBD stones only 7 had signs or symptoms that suggested this diagnosis, 4 of these patients had normal cholangiograms and 3 had "odditis". So in 73 patients without symptoms suggestive of CBD stones, preoperative or intraoperative cholangiography was probably not necessary. We consider that it is convenient to perform ERCP only in those patients with gallstones who have clinical findings suggestive of CBD or pancreatic problems (history, laboratory, ultrasonography). Cholangiography during cholecystectomy would be indicated in patients with small gallstones, the finding during operation of a dialted CBD or palpation of stones in the CBD and when ERCP fails in a patient with suggestive symptoms or when there is doubts with the ERCP findings.
对100例因胆结石行胆囊切除术的患者，比较了术中内镜逆行胰胆管造影术（ERCP）和术中胆管造影术（SC）的效用。ERCP使73%的患者胆管显影，SC使85%的患者胆管显影。20例患者胆总管（CBD）有结石，其中19例有先前提示该诊断的体征或症状（临床病史、实验室检查、超声检查）。在其余无CBD结石的患者（80例）中，仅7例有提示该诊断的体征或症状，其中4例患者胆管造影正常，3例有“奥迪括约肌炎”。因此，在73例无提示CBD结石症状的患者中，术前或术中胆管造影可能没有必要。我们认为，仅对那些有提示CBD或胰腺问题临床发现（病史、实验室检查、超声检查）的胆结石患者进行ERCP是合适的。对于小胆结石患者、术中发现CBD扩张或触诊到CBD结石的患者，以及有提示症状的患者ERCP失败或对ERCP结果有疑问时，行胆囊切除术时的胆管造影是有必要的。
