Patel J C, McInnes G C, Bagley J S, Needham G, Krukowski Z H
Department of Diagnostic Radiology, Aberdeen Royal Infirmary, Foresterhill, UK.
Br J Radiol. 1993 Dec;66(792):1125-7. doi: 10.1259/0007-1285-66-792-1125.
With the advent of laparoscopic cholecystectomy, pre-operative identification of calculi in the common bile duct has become increasingly important. In patients without clinical or biochemical evidence of common bile duct calculi, debate continues as to the value of intravenous cholangiography (IVC) as a screening modality for the detection of unsuspected choledocholithiasis. In a prospective series of 180 patients, IVC was used to assess the common bile duct in 113 patients at low risk of choledocholithiasis, 51 patients at high risk underwent endoscopic retrograde cholangiography (ERC) and sphincterotomy if indicated, and in 16 patients, for a variety of reasons, no pre-operative cholangiography was performed. 31% of those who had ERC and two (1.8%) of those who had IVC had duct calculi. These data do not support the routine use of IVC in patients with no evidence of common bile duct calculi and its routine use has been discontinued.
随着腹腔镜胆囊切除术的出现，术前识别胆总管结石变得越来越重要。对于没有胆总管结石临床或生化证据的患者，关于静脉胆管造影（IVC）作为检测隐匿性胆总管结石筛查方式的价值仍存在争议。在一项对180例患者的前瞻性研究中，113例胆总管结石低风险患者接受了IVC以评估胆总管，51例高风险患者在必要时接受了内镜逆行胆管造影（ERC）及括约肌切开术，另有16例患者因各种原因未进行术前胆管造影。接受ERC的患者中有31%发现胆管结石，接受IVC的患者中有2例（1.8%）发现胆管结石。这些数据不支持在无胆总管结石证据的患者中常规使用IVC，目前已停止其常规应用。
