Corbitt J D, Leonetti L A
JSLS. 1997 Jan-Mar;1(1):13-6.
Intraoperative cholangiography was successfully performed in 1,000 out of 1,006 attempts in 1019 consecutive cholecystectomies. There were 783 chronic, 95 acute, 61 fibrotic, 27 gangrenous and 40 cases of hydrops of the gallbladder in those laparoscopic cholecystectomies performed. unsuspected common duct stones were identified in 5% of the patients. There were no injuries resulting from intraoperative cholangiography performed via the cystic duct. In this large series, routine cholangiography was thought to be helpful in the prevention of common bile duct injuries and the establishment of abnormal anatomy. In non-acute cholecystitis, intraoperative cholangiography is necessary due to the importance of abnormal anatomy verification. The technique of laparoscopic cholecystectomy differs greatly from that of open technique, and, therefore, routine intraoperative cholangiography is strongly advised.
在连续1019例胆囊切除术中,1006次尝试中有1000次成功进行了术中胆管造影。在这些腹腔镜胆囊切除术中,有783例慢性胆囊炎、95例急性胆囊炎、61例纤维化、27例坏疽性胆囊炎和40例胆囊积水。5%的患者发现了意外的胆总管结石。通过胆囊管进行术中胆管造影未导致任何损伤。在这个大样本系列中,常规胆管造影被认为有助于预防胆总管损伤和确定异常解剖结构。在非急性胆囊炎中,由于验证异常解剖结构的重要性,术中胆管造影是必要的。腹腔镜胆囊切除术的技术与开放手术技术有很大不同,因此,强烈建议进行常规术中胆管造影。