Cranley B, Logan H
Br J Surg. 1980 Dec;67(12):869-72. doi: 10.1002/bjs.1800671210.
A series of 500 cholecystectomies performed over a 7-year period was reviewed retrospectively. The reliability of preoperative clinical features such as jaundice and pancreatitis was assessed in determining the presence of choledocholithiasis, and was found to be of limited value. Investigations such as intravenous cholangiography and liver function tests were found also to be inaccurate in the detection of common duct stones as was the appearance of the duct at operation. The usefulness of the peroperative cholangiogram in the detection of common duct stones that would otherwise have been overlooked is emphasized. Common duct stones would have remained undetected in 25 per cent of patients with choledocholithiasis. Despite the use of routine peroperative cholangiography common duct stones were overlooked in 11.25 per cent of patients who underwent exploration.
回顾性分析了7年间进行的500例胆囊切除术。评估了术前黄疸和胰腺炎等临床特征在判断胆总管结石存在方面的可靠性，发现其价值有限。静脉胆管造影和肝功能检查等检查在检测胆总管结石方面也不准确，手术中胆管的外观也是如此。强调了术中胆管造影在检测否则会被忽视的胆总管结石方面的作用。25%的胆总管结石患者的结石会一直未被发现。尽管使用了常规术中胆管造影，但在接受探查的患者中，仍有11.25%的患者胆总管结石被忽视。
