【摘要】 目的评价磁共振胰胆管成像(MRCP)在预防腹腔镜胆囊切除(LC)手术并发症中的价值。方法回顾性分析2006年1月至2010年6月期间我院收治的1 079例拟行LC治疗的患者的临床资料。根据不同时期行MRCP与否分为非MRCP组(n=523)和MRCP组(n=556),对2组患者胆管损伤及胆总管结石残余情况进行比较。结果非MRCP组35例患者中转开腹,MRCP组41例患者中转开腹。非MRCP组患者术中及术后出现胆管损伤5例,胆总管结石残余27例;MRCP组患者术中未出现胆管损伤以及胆总管结石残余,2组患者在胆管损伤和胆总管结石残余方面比较的差异均有统计学意义(P=0.026和P=0.000)。对于非MRCP组患者,术中胆道造影55例,发现胆总管结石23例。MRCP组3例患者术前MRCP未发现而术中经过胆道造影发现胆总管结石,另3例患者术前MRCP提示而术中胆道造影未发现胆总管结石。MRCP组患者术前MRCP发现双胆囊1例,Mirizzi综合征8例,胆囊管变异34例,副肝管28例,胆总管结石27例,与术中结果相比,其诊断的准确性分别为100%、87.5%、94.1%、89.3%和88.9%。结论 LC患者术前行MRCP有利于预防胆管损伤及胆总管结石残余的发生。更多还原

【Abstract】 Objective To evaluate the value of magnetic resonance cholangiopancreatography(MRCP) on prevention of the complications in laparoscopic cholecystectomy(LC).Methods The clinical data of 1 079 patients underwent LC from January 2006 to June 2010 in this hospital were retrospectively analyzed.According to the use of MRCP or not in the different period,the patients were divided into non-MRCP group(n=523) and MRCP group(n=556).The occurrence of bile duct injuries(BDI) and retained common duct stone(RCDS) were compared between two groups.Results Conversion to open surgery was performed in 35 cases in non-MRCP group and in 41 cases in MRCP group.The intraoperative and postoperative BDI were found in five patients and RCDS were found in 27 patients in non-MRCP group,and those were not found in patients in MRCP group.The differences of BDI and RCDS of patients were significant between two groups(P=0.026 and P=0.000).In non-MRCP group,23 of 55 patients were found common bile duct stones by intraoperative cholangiography.Common bile duct stones were found by intraoperative cholangiography other than preoperative MRCP in three patients in MRCP group,while another three patients did not find common bile duct stones by intraoperative cholangiography although preoperative MRCP suggested.By MRCP,double gallbladders were found in one patient,Mirizzi syndrome in eight patients,variant cystic duct in 34 patients,accessory hepatic duct in 28 patients,and complicating common bile duct stones in 27 patients in MRCP group,the diagnostic accuracy of those were 100%,87.5%,94.1%,89.3% and 88.9%,respectively.Conclusion Preoperative MRCP is helpful to prevent BDI and RCDS for the patients with LC.更多还原