Carroll B J, Friedman R L, Liberman M A, Phillips E H
Division of Surgery, Cedars-Sinai Medical Center, 8635 W. 3rd Street, Suite 795W, Los Angeles, CA 90048, USA.
Surg Endosc. 1996 Dec;10(12):1194-7. doi: 10.1007/s004649900277.
An effort was made to determine whether a policy of routine cholangiography affects the incidence, morbidity, and cost of bile duct injuries.
A retrospective review of consecutive 3,242 laparoscopic cholecystectomies was performed. Most patients had routine intraoperative cholangiography.
There were 12 bile duct injuries (0.37%). All injuries were Bismuth levels 1 and 2. Eleven of 12 injuries were recognized intraoperatively. Ten were repaired primarily and one required hepaticojejunostomy. All repairs were successful. Average hospital charges were $26,669. One of 12 patients had delayed recognition of a bile duct injury and underwent primary repair over a T-tube on postoperative day 7. Hospital charges were $43,957.
Routine cholangiography did not appear to decrease the absolute incidence of bile duct injuries compared to previously published reports. Injury severity, morbidity, late sequelae, and costs were reduced by a policy of routine cholangiography.
开展一项研究以确定常规胆管造影术政策是否会影响胆管损伤的发生率、发病率及成本。
对连续3242例腹腔镜胆囊切除术进行回顾性研究。大多数患者接受了术中常规胆管造影。
发生12例胆管损伤（0.37%）。所有损伤均为毕氏1级和2级。12例损伤中有11例在术中被识别。10例进行了一期修复，1例需要肝空肠吻合术。所有修复均成功。平均住院费用为26,669美元。12例患者中有1例胆管损伤识别延迟，术后第7天在T管上进行了一期修复。住院费用为43,957美元。
与既往发表的报告相比，常规胆管造影术似乎并未降低胆管损伤的绝对发生率。常规胆管造影术政策降低了损伤严重程度、发病率、晚期后遗症及成本。
