目的 分析逆行胰膽管造影術(shù)(ERCP)在診斷膽囊管異常匯合的價值及其在預防腹腔鏡膽囊切除術(shù)(LC)膽管損傷等并發(fā)癥中的作用。
方法 我院從1992年7月至1999年6月共行LC 4 500余例，其中對780例LC患者術(shù)前行ERCP檢查。選擇膽囊管、肝總管和膽總管三者解剖關(guān)系均清楚的772例ERCP片，觀測其膽囊管異常匯合情況，測量其長度和直徑，并與100例胰膽管無異常的ERCP片對比。
結(jié)果 在780例ERCP檢查者中，發(fā)現(xiàn)膽囊管異常匯合者125例(16.03%)。該780例行LC中，中轉(zhuǎn)開腹膽囊切除術(shù)35例(4.49%)，發(fā)生各種并發(fā)癥6例(0.77%)，但無膽管損傷等嚴重并發(fā)癥發(fā)生。
結(jié)論 ERCP能準確診斷膽囊管的各種異常匯合，在預防LC膽管損傷等膽道并發(fā)癥的發(fā)生中起重要作用。
引用本文： 龔建平,韓本立,周永碧,周曉宏. 膽囊管異常匯合的診斷及其在腹腔鏡膽囊切除術(shù)中的意義. 中國普外基礎(chǔ)與臨床雜志, 2001, 8(2): 85-87. doi: 復制
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| 3. | 巫北海，王其源.54例膽囊管與肝外膽管低位匯合的ERCP觀察 [J].內(nèi)鏡，1993； 10(2)∶82. |
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| 6. | 龔建平，周永碧，韓本立.腹腔鏡膽囊切除術(shù)嚴重手術(shù)并發(fā)癥的預防 [J].華人消化雜志，1998； 6(4)∶307. |
| 7. | Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy [J]. J Am Coll Surg, 1995; 180(1)∶101. |
| 8. | Gigot J, Etienne J, Aerts R, et al. The dramatic reality of biliary tract injury during laparoscopic cholecystectomy. An anonymous multicenter Belgian survey of 65 patients [J]. Surg Endosc, 1997; 11(12)∶1171. |
| 9. | Kwon A, Uetsuji S, Yamada O, et al. Threedimensional reconstruction of the biliary tract using spiral computed tomography [J]. Br J Surg, 1995; 82∶260. |
| 10. | Prat F, Pelletier G, Ponchon T, et al. What role can endoscopy play in the management of biliary complications after laparoscopic cholecystectomy [J]. Endoscopy, 1997; 29(5)∶341. |
- 1. 周永碧，龔建平，王曙光.腹腔鏡膽囊切除術(shù)前對合并癥的診斷及術(shù)中膽管損傷的預防 [J].中華消化內(nèi)鏡雜志，1997； 14(2)∶135.
- 2. Kwon A, Uetsuji S， Ogura T, et al. Spiral computed tomography scaning after intravenous infusion cholangiography for biliary duct anomalies [J]. Am J Surg, 1997; 396.
- 3. 巫北海，王其源.54例膽囊管與肝外膽管低位匯合的ERCP觀察 [J].內(nèi)鏡，1993； 10(2)∶82.
- 4. 施維錦.膽道外科學 [M]. 第1版.上海： 上?？茖W技術(shù)出版社， 1993∶14～17.
- 5. 任旭，唐秀芳，孔慶云等.膽囊管低位匯合臨床意義的探討 [J].內(nèi)鏡，1996； 13(2)∶79.
- 6. 龔建平，周永碧，韓本立.腹腔鏡膽囊切除術(shù)嚴重手術(shù)并發(fā)癥的預防 [J].華人消化雜志，1998； 6(4)∶307.
- 7. Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy [J]. J Am Coll Surg, 1995; 180(1)∶101.
- 8. Gigot J, Etienne J, Aerts R, et al. The dramatic reality of biliary tract injury during laparoscopic cholecystectomy. An anonymous multicenter Belgian survey of 65 patients [J]. Surg Endosc, 1997; 11(12)∶1171.
- 9. Kwon A, Uetsuji S, Yamada O, et al. Threedimensional reconstruction of the biliary tract using spiral computed tomography [J]. Br J Surg, 1995; 82∶260.
- 10. Prat F, Pelletier G, Ponchon T, et al. What role can endoscopy play in the management of biliary complications after laparoscopic cholecystectomy [J]. Endoscopy, 1997; 29(5)∶341.