Kwon A H, Uetsuji S, Boku T, Yamada O, Inoue T, Kamiyama Y
First Department of Surgery, Kansai Medical University, Moriguchi, Japan.
Nihon Geka Gakkai Zasshi. 1995 May;96(5):309-13.
We investigated the 58 cases of cholecystolithiasis including 8 cases of choledocholithiasis treated with laparoscopic cholecystectomy. All patients received spiral CT scanning with drip infusion cholangiography (DIC-SCT), and 1.6 patients received endoscopic retrograde cholangiography (ERC), and the detection rates of the gallbladder, the bile duct and the cystic duct were compared. The gallbladder could be seen in 86.2% of cases with DIC-SCT and in 63.8% of cases with conventional DIC. The junction between the cystic duct and the common bile duct could be seen in 18 of 58 cases with DIC and in 49 of 58 cases with DIC-SCT. The DIC-SCT showed significantly superior anatomical details compared with images with conventional DIC. A comparison of DIC, ERC and DIC-SCT revealed that the junction between the cystic duct and the common bile duct could be identified in 14 of 16 cases undergoing ERC, in 13 of 16 cases receiving DIC-SCT and in 4 of 16 cases receiving DIC. Significant differences were noted among DIC-SCT, ERC and conventional DIC. We concluded that DIC-SCT is easy, non-invasive and useful for the preoperative assessment of laparoscopic cholecystectomy and also helpful for avoiding damage to the bile duct.
我们对58例胆囊结石患者(包括8例胆总管结石患者)进行了腹腔镜胆囊切除术治疗。所有患者均接受了螺旋CT扫描及滴注式胆管造影(DIC-SCT),16例患者接受了内镜逆行胆管造影(ERC),并比较了胆囊、胆管和胆囊管的检出率。DIC-SCT检查中86.2%的病例可显示胆囊,传统DIC检查中63.8%的病例可显示胆囊。DIC检查中58例患者中有18例可显示胆囊管与胆总管的交界处,DIC-SCT检查中58例患者中有49例可显示。与传统DIC图像相比,DIC-SCT显示的解剖细节明显更优。DIC、ERC和DIC-SCT的比较显示,16例接受ERC的患者中有14例可识别胆囊管与胆总管的交界处,16例接受DIC-SCT的患者中有13例可识别,16例接受DIC的患者中有4例可识别。DIC-SCT、ERC和传统DIC之间存在显著差异。我们得出结论,DIC-SCT操作简便、无创,对腹腔镜胆囊切除术的术前评估有用,也有助于避免胆管损伤。