Weimann A, Wagner S, Dralle H, Raab R
Klinik für Abdominal- und Transplantationschirurgie, Medizinische Hochschule Hannover, Germany.
Leber Magen Darm. 1995 May;25(3):128-30.
Successful use of laparoscopic cholecystectomy requires good cooperation between surgeon and gastroenterologist. Standard preoperative workup includes detailed history of the patient, blood chemistry of serum bilirubin and liver enzymes as well as sonography for the detection of common bile duct stones. Intravenous cholangiography can be performed to diagnose anatomic variations of the bile ducts. In case of common bile duct stones "therapeutic splitting" by endoscopic retrograde cholangiography with sphincterotomy and gallstone extraction preoperatively may help to avoid unnecessary conventional open cholecystectomy.
成功实施腹腔镜胆囊切除术需要外科医生和胃肠病学家之间良好的配合。标准的术前检查包括患者的详细病史、血清胆红素和肝酶的血液化学检查以及用于检测胆总管结石的超声检查。可进行静脉胆管造影以诊断胆管的解剖变异。对于胆总管结石,术前通过内镜逆行胆管造影进行“治疗性切开”并进行括约肌切开术和胆结石取出术,可能有助于避免不必要的传统开放性胆囊切除术。