Alinder G, Nilsson U, Lunderquist A, Herlin P, Holmin T
Br J Surg. 1986 May;73(5):383-7. doi: 10.1002/bjs.1800730524.
Routine operative cholangiography (group 1) was compared with pre-operative intravenous infusion cholangiography and selective operative cholangiography (group 2) in 200 patients subjected to elective cholecystectomy. All patients were examined with pre-operative intravenous infusion cholangiography. In group 1 patients, this examination was not made available to the surgeon and not used in any way except for a later analysis. Thirteen patients had to be excluded for different reasons. In group 1, normal operative cholangiograms were obtained in 82/94 cases. Choledocholithotomy was performed in 7/12 cases, choledochotomy in 2/12 and no exploration in 3/12 cases. In group 2, pathological or inconclusive infusion cholangiograms were demonstrated in 17/91 cases. Choledocholithotomy was performed in 11/17 cases. One of 17 patients was subjected to choledochotomy only. In 5/17 patients, no exploration was carried out because of normal operative cholangiography. No residual or retained stone/s have been revealed during a follow-up period of 1 year. The general clinical outcome in the two groups of patients was similar. Significantly shorter operative time was an important advantage of the strategy in group 2 patients.
在200例行择期胆囊切除术的患者中，对常规术中胆管造影（第1组）与术前静脉滴注胆管造影及选择性术中胆管造影（第2组）进行了比较。所有患者均接受了术前静脉滴注胆管造影检查。在第1组患者中，外科医生无法获取该检查结果，且除了后期分析外未以任何方式使用。13例患者因不同原因被排除。在第1组中，94例中有82例获得了正常的术中胆管造影结果。12例中有7例进行了胆总管切开取石术，2例进行了胆总管切开术，3例未进行探查。在第2组中，91例中有17例显示病理或不确定的滴注胆管造影结果。17例中有11例进行了胆总管切开取石术。17例患者中有1例仅进行了胆总管切开术。17例患者中有5例因术中胆管造影正常未进行探查。在1年的随访期内未发现残留或留存结石。两组患者的总体临床结果相似。手术时间显著缩短是第2组患者策略的一个重要优势。
