Rosenthal R J, Steigerwald S D, Imig R, Bockhorn H
Department of Surgery, Krankenhaus Nordwest, Frankfurt, Germany.
Surg Laparosc Endosc. 1994 Jun;4(3):171-4.
Six hundred sixty-nine German hospitals participated in a survey on the use of intraoperative cholangiography (IOC) in its relationship to common bile duct injuries. Of these, 174 surgical departments are presently practicing IOC, 30 routinely. Only 16 injuries to the bile duct occurred in the 6,328 patients who underwent surgery in those 30 units. Approximately 80% of these injuries were discovered during surgery because of IOC and were treated immediately. A significant difference was found between these rates and those reported by units that performed IOC selectively. Only 58% of bile duct injuries were discovered at the time of surgery in units performing selective cholangiography. In addition, it appears that IOC helps to avoid bile duct injuries; the 30 units that performed routine IOC were defined as "learners," as they had performed fewer LCs, and yet they had a significant lower bile duct injury rate than "experienced" centers that did not perform IOC routinely.
669家德国医院参与了一项关于术中胆管造影（IOC）与胆总管损伤关系的调查。其中，174个外科科室目前开展IOC，30个科室常规开展。在这30个科室接受手术的6328例患者中，仅发生了16例胆管损伤。这些损伤中约80%在手术期间因IOC被发现并立即得到治疗。这些发生率与选择性开展IOC的科室所报告的发生率之间存在显著差异。在进行选择性胆管造影的科室中，仅58%的胆管损伤在手术时被发现。此外，似乎IOC有助于避免胆管损伤；30个常规开展IOC的科室被定义为“初学者”，因为它们进行的腹腔镜胆囊切除术（LC）较少，但它们的胆管损伤率明显低于不常规开展IOC的“经验丰富”的中心。
