Objective To evaluate the role of endoscopic retrograde cholangio-pancreatography(ERCP)in diagnosis of anomalous converge of the cystic duct and prevention of bile duct injuries during laparoscopic cholecystectomy(LC).
Methods From July, 1992 to June, 1999, LCs were performed in 4 500 patients with gallbladder stone or cholecystitis at our center. Preoperative ERCPs were performed in 780 of all patients (14.50%). Anomalous junctions of the cystic duct with common hepatic duct were investigated and the length and caliber of these cystic duct were measured and compared with 100 control cases.
Results An overall anomalous converges of the cystic duct were found in 125(16.03%) of the 780 patients undergoing ERCP. Of 780 patients undergoing LC, 35 cases were converted to open cholecystectomy(4.5%), and various complications occurred in 6 cases (0.77%), but no death and biliary duct injuries occurred.
Conclusion Various types of anomalous junctions of the cystic duct could be diagnosed precisely by ERCP before LC and the preoperative examination of ERCP may be helpful in prevention of bile duct injuries and other biliary complications in the laparoscopic time.
Citation：
GONG Jianping,HAN Benli,ZHOU Yongbi,et al.. DIAGNOSIS OF ANOMALOUS CONVERGE OF THE CYSTIC DUCT AND IT’S SIGNIFICANCE IN PREVENTION OF BILIARY DUCT INJURIES DURING LAPAROSCOPIC CHOLECYSTECTOMY. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2001, 8(2): 85-87. doi:
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周永碧，龚建平，王曙光.腹腔镜胆囊切除术前对合并症的诊断及术中胆管损伤的预防 [J].中华消化内镜杂志，1997； 14(2)∶135.
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Kwon A, Uetsuji S， Ogura T, et al. Spiral computed tomography scaning after intravenous infusion cholangiography for biliary duct anomalies [J]. Am J Surg, 1997; 396.
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巫北海，王其源.54例胆囊管与肝外胆管低位汇合的ERCP观察 [J].内镜，1993； 10(2)∶82.
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任旭，唐秀芳，孔庆云等.胆囊管低位汇合临床意义的探讨 [J].内镜，1996； 13(2)∶79.
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龚建平，周永碧，韩本立.腹腔镜胆囊切除术严重手术并发症的预防 [J].华人消化杂志，1998； 6(4)∶307.
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Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy [J]. J Am Coll Surg, 1995; 180(1)∶101.
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Gigot J, Etienne J, Aerts R, et al. The dramatic reality of biliary tract injury during laparoscopic cholecystectomy. An anonymous multicenter Belgian survey of 65 patients [J]. Surg Endosc, 1997; 11(12)∶1171.
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Kwon A, Uetsuji S, Yamada O, et al. Threedimensional reconstruction of the biliary tract using spiral computed tomography [J]. Br J Surg, 1995; 82∶260.
|
| 10. |
Prat F, Pelletier G, Ponchon T, et al. What role can endoscopy play in the management of biliary complications after laparoscopic cholecystectomy [J]. Endoscopy, 1997; 29(5)∶341.
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- 1. 周永碧，龚建平，王曙光.腹腔镜胆囊切除术前对合并症的诊断及术中胆管损伤的预防 [J].中华消化内镜杂志，1997； 14(2)∶135.
- 2. Kwon A, Uetsuji S， Ogura T, et al. Spiral computed tomography scaning after intravenous infusion cholangiography for biliary duct anomalies [J]. Am J Surg, 1997; 396.
- 3. 巫北海，王其源.54例胆囊管与肝外胆管低位汇合的ERCP观察 [J].内镜，1993； 10(2)∶82.
- 4. 施维锦.胆道外科学 [M]. 第1版.上海： 上海科学技术出版社， 1993∶14～17.
- 5. 任旭，唐秀芳，孔庆云等.胆囊管低位汇合临床意义的探讨 [J].内镜，1996； 13(2)∶79.
- 6. 龚建平，周永碧，韩本立.腹腔镜胆囊切除术严重手术并发症的预防 [J].华人消化杂志，1998； 6(4)∶307.
- 7. Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy [J]. J Am Coll Surg, 1995; 180(1)∶101.
- 8. Gigot J, Etienne J, Aerts R, et al. The dramatic reality of biliary tract injury during laparoscopic cholecystectomy. An anonymous multicenter Belgian survey of 65 patients [J]. Surg Endosc, 1997; 11(12)∶1171.
- 9. Kwon A, Uetsuji S, Yamada O, et al. Threedimensional reconstruction of the biliary tract using spiral computed tomography [J]. Br J Surg, 1995; 82∶260.
- 10. Prat F, Pelletier G, Ponchon T, et al. What role can endoscopy play in the management of biliary complications after laparoscopic cholecystectomy [J]. Endoscopy, 1997; 29(5)∶341.
