Section of Minimally Invasive Surgery, Department of Surgery, Washington University School of Medicine, 660 S Euclid Avenue, St. Louis, MO 63110, USA.
Adv Surg. 2022 Sep;56(1):37-48. doi: 10.1016/j.yasu.2022.02.002.
Intraoperative cholangiography (IOC) is an essential skill that surgeons need for the safe performance of cholecystectomy and intraoperative diagnosis and management of bile duct stones. Whether it should be performed routinely or selectively is an ongoing debate that goes back to the early days of laparoscopic cholecystectomy (LC). Benefits of IOC include ability to detect bile duct stones, recognition of aberrant anatomy, and, in some circumstances, mitigation of the risk of bile duct injury. In this review, key aspects of this debate, technical aspects of performing IOC, evidence regarding its benefits, and imaging alternatives to IOC during LC are presented.
术中胆管造影(IOC)是外科医生安全进行胆囊切除术以及术中诊断和处理胆管结石所需的一项重要技能。IOC 是否应该常规或选择性进行,这是一个自腹腔镜胆囊切除术(LC)早期以来就一直存在的争论。IOC 的益处包括能够检测胆管结石、识别异常解剖结构,以及在某些情况下降低胆管损伤的风险。在这篇综述中,介绍了该争论的关键方面、进行 IOC 的技术方面、其益处的证据以及在 LC 期间替代 IOC 的影像学方法。
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