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首页> 外文期刊>Surgical Endoscopy >Contribution of intraoperative cholangiography to incidence and outcome of common bile duct injuries during laparoscopic cholecystectomy.
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Contribution of intraoperative cholangiography to incidence and outcome of common bile duct injuries during laparoscopic cholecystectomy.

机译：术中胆道造影对腹腔镜胆囊切除术中胆总管发生率和结局的影响。

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摘要

BACKGROUND: In the present study we examined, in a meta-analysis of the literature, the contribution of intraoperative cholangiography (IOC) to incidence, type, and time of diagnosis of common bile duct (CBD) injuries during laparoscopic cholecystectomy (LC). MATERIALS AND METHODS: Forty of 2104 reports were enrolled for analysis. In 26 reports we found exact information on type, location and repair of 405 major injuries and in a subgroup examination we selected 103 major injuries with detailed information as to the event and size of CBD injury in association with IOC. RESULTS: The main incidence of CBD injuries was 0.36%. Using the method of routine IOC the incidence was 0.21% and the rate of diagnosis at the time of cholecystectomy 87% in contrast to selective use of IOC with 0.43% and 44.5%. In 405 cases of major CBD injuries, severe injuries predominated in 83.9% of the cases. Reconstruction with the help of a bilio-digestive anastomosis was necessary in 45.7% of all patients. In 34.8% of the cases a second intervention had to be made in the follow-up of 4 years after LC. The analysis of type, severity, recognition, and follow-up of CBD injuries during LC w/wo IOC showed significant advantages for doing routine IOC. CONCLUSIONS: The use of IOC can avoid severe types of CBD injuries during LC, increase the recognition at the time operation, and influence the success of repair and outcome of the patients.
机译：背景：在本研究中，我们在文献的荟萃分析中检查了术中胆道造影（IOC）对腹腔镜胆囊切除术（LC）期间胆总管（CBD）损伤的发生率，类型和诊断时间的贡献。材料与方法：2104份报告中有40份进行了分析。在26份报告中，我们找到了405例重伤的类型，位置和修复的确切信息，在亚组检查中，我们选择了103例重伤，并详细说明了与IOC相关的CBD损伤的事件和大小。结果：CBD损伤的主要发生率为0.36％。与常规使用IOC的发生率分别为0.43％和44.5％相比，使用常规IOC的发生率为0.21％，在进行胆囊切除术时的诊断率为87％。在405例严重的CBD伤害案例中，严重伤害占83.9％。在所有患者中，有45.7％的患者需要借助小肠消化吻合术进行重建。在34.8％的病例中，LC后4年的随访中必须进行第二次干预。对LC w / wo IOC期间CBD损伤的类型，严重性，识别性和随访情况的分析显示，进行常规IOC具有明显的优势。结论：使用IOC可以避免LC期间严重的CBD损伤类型，增加手术时的识别度，并影响修复的成功率和患者预后。

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