lc术前mrcp检查在预防术中胆道损伤的临床研究_祁军安

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1、LC术前MRCP检查在预防术中胆道损伤的临床研究*祁安S江奎1,李宗芳2巴朱海林S振S梁容瑞2"(1.宝鸡市中心医院肝胆胰脾外科，陕西宝鸡721008:2.西安交通大学医学院第二附丿曲医院普外科，陕曲西安710004;3.生物诊断治疗国家地方联合工程研究中心■陕西^710004:4.苏州大学附屈笫一医院肿瘤科.江苏苏州215006)【摘要】H的探复胆囊腹腔胆囊切除(LC)前行磁共振胆胰管成像(MRCP)的必要性及防中胆道的床意。方法分析1380例复胆囊行LC的床料，分MRCP和非MRCP各690例。结果前行M

2、RCP非MRCPLC中胆道生率、中开腹和平均住院天数明减少(P<0.05)。结论干复胆囊患者行LC前行MRCP是必要的，可有效防中胆道的生。【关键词】MRCP;腹腔胆囊切除；胆道【中图分类号】【文献标志码】：/R657.4Adoi10.3969j.issn.16723511.2-014.07.011TheclinicalstudyofpreoperativeMRCPexaminationinpreventionofintraoperativebileductinjuryinlaparoscopiccholec

3、ystectomyQUun-an1JIANGKui*ZHUHai-Iir/eta!(-1.•,•；I•DepartmentofHepatobiliarySurgeryBaojiCentralHospitalSao/7721008ShaanxiChina9♦•♦2.DepartmentofOncologyTheFirstAffiliatedHospitalofSoochowjUniversitySuzhou2A5006JiangsuChina3.DepartmentofGenera/SurgeryTheSeco

4、ndAffiliatedHospitalofXianJiaotongUniversityXiaril10004China,.)【Abstract】4.NationalLocalJointEngineeringResearchCenterofBiodiagnostics&BotherapyXiaril10004ChinaObjectiveToinvestigatethenecessityofMRCPexaminationbeforecomplicatedgalbladderLCanditsclinicalsig

5、nificanceofpreventingintraoperativebileductinjury.MethodsAretrospectiveanalysiswasexecutedbaseon1380casesunderwentcomplicateLCgalbladdersurgery・ThepatientswereseperatedintononMRCPgroupandMRCPgroup・Theclinicaldataswerecomparedbetweentwogroups・ResultsPreopera

6、tiveMRCPexaminationLCsurgerycouldreducetheincidenceofbileductinjurylaparotomyanddecreasetheaveragelengthofhospitalstay.ConclusionPreoperativeMRCPexaminationisnecessaryforLConcomplicatedgalbladderitcanbeeffectiveinpreventingtheoc—currenceofintraoperativebile

7、ductinjury.【Keywords】MRCP'LC'Bileductinjury腹腔镜胆既切除术(Laparoscopiccholecystecto—,)已成为治疗胆囊结石及胆囊良性疾病的“金myLC的“唤⑴LC术禁忌证的急性期胆囊(>79小吋)、综合征、萎缩胆囊、残余胆囊等，已逐/乙Mirrizi渐成为手术适应症，适应症的增宽，并发症也随之増加。磁共振胆胰管成像(MagneticResonanceCholangiopan—)是国内外近年来快速发展起来的creatographyMRCP一种非介入性胰皿

8、管成像技术，具有安全、无损伤、无痛苦、无并发症等特点。木文分析我院1380例复杂胆囊患者行LC手术的临床资料，发现术前行MRCP检杳能有效预防LC术中胆道损伤，报告如下。1资料与方法11--般资料例，年龄门〜85囊炎伴胆囊结石萎缩胆囊伴结右木组1380例患者，男岁，中位年龄为551282例；充满型胆囊结石例;胆囊管结石或2129例;伴继发性肝损害，总胆红索例。纳入标准:对丁-胆囊疾患首选例女470刃