Pavlović Tomislav, Trtica Sanja, Troskot Perić Rosana
Tomislav Pavlović, J.J. Strossmayer University of Osijek, Faculty of Medicine, Josipa Huttlera 4, 31000 Osijek, Croatia,
Croat Med J. 2020 Jul 5;61(3):239-245. doi: 10.3325/cmj.2020.61.239.
To assess the intrahepatic and extrahepatic bile duct diameter dilatation after laparoscopic cholecystectomy with magnetic resonance cholangiopancreatography.
Forty-eight patients (35 women, mean age 54.58±11.83 years) underwent laparoscopic cholecystectomy because of gallstones. The intrahepatic and extrahepatic bile ducts were measured before and three and six months after cholecystectomy. The diameter was measured in the anteroposterior and laterolateral direction at 14 points.
When compared with the preoperative diameter, the common bile duct diameter at the proximal part was significantly wider three months (P=0.006) and six months (P=0.0001) after cholecystectomy; the common hepatic duct was significantly wider three months (P=0.001) and six months (P=0.003) after cholecystectomy; the right and left hepatic bile ducts were significantly wider six months after cholecystectomy (P<0.0001, P=0.01, respectively); and the segmental intrahepatic bile ducts in both hepatic lobes were significantly wider three months (P<0.0001) and six months after cholecystectomy (P<0.0001).
This study showed that significant post-cholecystectomy dilatation occurred only at certain points and not along the whole extrahepatic bile duct. We also found a significant dilatation of the main intrahepatic and segmental intrahepatic bile ducts.
通过磁共振胰胆管造影评估腹腔镜胆囊切除术后肝内和肝外胆管直径扩张情况。
48例患者（35例女性，平均年龄54.58±11.83岁）因胆结石接受腹腔镜胆囊切除术。在胆囊切除术前以及术后3个月和6个月测量肝内和肝外胆管。在14个点测量前后径和左右径。
与术前直径相比，胆囊切除术后3个月（P=0.006）和6个月（P=0.0001）胆总管近端直径显著增宽；胆囊切除术后3个月（P=0.001）和6个月（P=0.003）肝总管显著增宽；胆囊切除术后6个月左右肝管显著增宽（分别为P<0.0001，P=0.01）；两个肝叶的节段性肝内胆管在胆囊切除术后3个月（P<0.0001）和6个月（P<0.0001）均显著增宽。
本研究表明，胆囊切除术后显著扩张仅发生在某些部位，而非整个肝外胆管。我们还发现肝内主要胆管和节段性肝内胆管有显著扩张。
