Ibáñez Aguirre J, Santoyo Santoyo J, Rico Selas P, Bercedo Martínez J, Gómez Sanz R, Mansilla Molina D, Hidalgo Pascual M, Moreno González E
Rev Esp Enferm Apar Dig. 1989 Mar;75(3):252-5.
The present study evaluates the benefits of systematic intraoperative cholangiography (CIO) in 144 patients without preoperative suspicion of choledocholithiasis. Eleven (7.6%) of the intraoperative cholangiographies were considered abnormal by the surgeon and the presence of choledocholithiasis (3/11, 27%) was confirmed in only three cases. Pathology of the main bile duct that had been unsuspected preoperatively was found in only 2% (3/144). We conclude that routine intraoperative cholangiography of patients without preoperative suspicion of choledocholithiasis increases the cost of surgery, prolongs operative time, exposes the patient to radiation and sometimes yields false positives (5%) that lead to unnecessary exploration of the choledochus, which is accompanied by a potential increase in morbidity and a real prolongation of the postoperative hospital stay.
本研究评估了144例术前未怀疑胆总管结石患者进行系统性术中胆管造影(CIO)的益处。外科医生认为11例(7.6%)术中胆管造影异常,仅3例(3/11,27%)确诊存在胆总管结石。术前未怀疑的胆总管主要病变仅在2%(3/144)的患者中发现。我们得出结论,对术前未怀疑胆总管结石的患者进行常规术中胆管造影会增加手术费用,延长手术时间,使患者暴露于辐射之下,且有时会产生假阳性结果(5%),导致对胆总管进行不必要的探查,这可能会增加发病率,并真正延长术后住院时间。