腹腔镜C臂下选择性胆道造影在腹腔镜胆囊切除术中应用和评价.docVIP

腹腔镜C臂下选择性胆道造影在腹腔镜胆囊切除术中应用和评价 　　【摘要】 目的：?u价腹腔镜C臂下选择性胆道造影在腹腔镜胆囊切除术中的应用效果。方法：选取2012年1月-2016年1月收治入院的胆囊结石合并胆囊炎，术前胆总管扩张（1 cm），胆红素增高怀疑有胆总管结石患者200例作为研究对象，按照随机数字表法将其分为观察组与对照组，每组100例，观察组先采用腹腔镜C臂下选择性胆道造影检查，如有结石行腹腔镜下胆总管切开胆道镜探查取石T管引流术，如无结石则不手术，对照组不进行腹腔镜C臂下选择性胆道造影检查，直接采用腹腔镜胆囊切除胆总管切开探查、T管引流术。观察两组术后恢复情况，比较两组胆管结石、损伤程度及术后并发症如胆屡、胆道出血、膈下脓肿、胆道狭窄及胆道感染等发生情况。结果：观察组胆管损伤率、术后残石率、术后胆结石复发率与住院时间均显著低于对照组，差异均有统计学意义（P1 cm），胆红素增高怀疑有胆总管结石患者，若术中腹腔镜C臂下选择性胆道造影显示无结石，可避免胆总管切开留置T管，有效改善患者生活质量，减轻痛苦，减少并发症，缩短住院时间，减少医疗费用且安全有效，值得临床推广。 　　【关键词】 腹腔镜； 胆道造影； 胆囊切除术； 胆结石； 急性发作 　　Application and Evaluation of Laparoscopic Selective Cholangiography in Laparoscopic Cholecystectomy/YIN Zhao-cheng，YIN Yao-hua，PENG Yan，et al.//Medical Innovation of China，2017，14（14）：035-038 　　【Abstract】 Objective：To evaluate the effect of laparoscopic selective cholangiography under C-arm in laparoscopic cholecystectomy.Method：A total of 200 patients with cholecystolithiasis and cholecystitis，common bile duct stones suspected of having common bile duct dilatation（1 cm） were enrolled in the study from January 2012 to January 2016.All of them were divided into the observation group and the control group according to random number table method，100 cases in each group.The observation group was first taken with laparoscopic selective cholangiography under C-arm.Then，patients with gallbladder gallstone were taken with common bileduct exploration，removing the stone and T tube drainage under laparoscope combined with choledochoscope，and people without gallbladder gallstone were not taken with such operation.The control group was directly taken with laparoscopic cholecystectomy，common bile duct exploration and T tube drainage.Incidence of bile duct stones，bile duct injury，biliary stricture and biliary tract infection of two groups were compared.Incidence of postoperative complications such as bile leakage，biliary tract bleeding，subphrenic abscess，biliary stricture and biliary infection were compared.Result：Bile duct injury rate，postoperative res