Stark M E, Loughry C W
Surg Gynecol Obstet. 1980 Nov;151(5):657-8.
Four hundred and forty patients who underwent cholecystectomy and routine operative cholangiography were reviewed. False-positive and false-negative examination were 3.8 and 0.2 per cent, respectively. Unsuspected common duct stones were found 0.9 per cent of the time by cholangiography. The yield of common duct exploration was 63.8 per cent. Operative cholangiography spares at least two-thirds of the patients with clinical indications of choledocholithiasis unnecessary common duct explorations. The yield of operative cholangiography in patients with no clinical indication of choledocholithiasis is extremely low, and the cost-to-benefit ratio of routine operative cholangiography is high. Operative cholangiography should be used prior to common duct exploration for any clinical suspicion of common duct pathology. Routine operative cholangiography is not indicated for those patients with no clinical indication of common duct pathology.
对440例行胆囊切除术并进行常规术中胆管造影的患者进行了回顾性研究。假阳性和假阴性检查率分别为3.8%和0.2%。胆管造影发现意外胆总管结石的概率为0.9%。胆总管探查的成功率为63.8%。术中胆管造影使至少三分之二有胆总管结石临床指征的患者避免了不必要的胆总管探查。对于无胆总管结石临床指征的患者，术中胆管造影的检出率极低，常规术中胆管造影的成本效益比很高。对于任何临床怀疑有胆总管病变的患者，应在胆总管探查前进行术中胆管造影。对于无胆总管病变临床指征的患者，不建议进行常规术中胆管造影。
