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首页> 外文期刊>Surgical Endoscopy >Does routine intraoperative cholangiography prevent bile duct transection?
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Does routine intraoperative cholangiography prevent bile duct transection?

机译：常规术中胆道造影术是否可以防止胆管横切？

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BACKGROUND: The role of routine intraoperative cholangiography is controversial. The aim of this study was to assess the impact of routine intraoperative cholangiography on the incidence of common bile duct injuries, and to evaluate the operative outcome of laparoscopic cholecystectomy carried out in a major teaching hospital and review the literature. METHODS: Prospectively collected data on 3,145 laparoscopic cholecystectomies performed mainly by surgical trainees in the period 1990 to 2002 using routine intraoperative cholangiography with fluoroscopy were reviewed. RESULTS: The mean age of the study sample (65.6% male, 34.4% female) was 54 years, and 16.9% of the patients had clinical acute cholecystitis. The conversion rate to open cholecystectomy was 4.3%. Intraoperative cholangiography was attempted for 90.7% of the patients with a 95.9% success rate. Five patients (0.16%) had common bile duct injuries. Four injuries had occurred in the first 5 years. One injury (0.06%) had occurred after 1995. This injury was identified intraoperatively and repaired laparoscopically. Routine intraoperative cholangiography prevented one definite common bile duct transection. CONCLUSIONS: In this series using routine intraoperative cholangiography, there was a low rate and severity of common bile duct injuries, with a high intraoperative recognition rate. There was no bile duct transection or major injury requiring common bile duct reconstruction. Although intraoperative cholangiography helped in the immediate identification of injuries and the institution of appropriate therapy, injury was not completely prevented.
机译：背景：常规术中胆道造影的作用是有争议的。这项研究的目的是评估常规术中胆道造影术对胆总管损伤发生率的影响，并评估在一家主要教学医院进行的腹腔镜胆囊切除术的手术效果并回顾文献。方法：回顾性收集1990年至2002年期间主要由外科手术学员进行的3,145例腹腔镜胆囊切除术的数据，并采用常规的术中胆管造影术和透视检查。结果：研究样本的平均年龄（男性65.6％，女性34.4％）为54岁，其中16.9％的患者患有临床急性胆囊炎。开腹胆囊切除术的转化率为4.3％。 90.7％的患者尝试了术中胆道造影，成功率为95.9％。 5例（0.16％）胆总管损伤。在头5年中发生了四次伤害。 1995年后发生了1处损伤（0.06％）。该损伤在术中被确认并通过腹腔镜修复。常规术中胆管造影术可防止明确的一条胆总管横切术。结论：在本系列常规术中胆道造影中，胆总管损伤的发生率和严重性较低，术中识别率较高。没有胆管横切或需要胆总管重建的重大损伤。尽管术中胆道造影有助于立即确定受伤情况并采取适当的治疗方法，但并未完全防止受伤。

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