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| Clinical Value of Magnetic Resonance Cholangiopancreatography and Intraoperative Cholangiography before Laparoscopic Cholecystectomy |
| JI Gang, HUANG Wen-lei, CAO Hua-xiang |
| Wuxi Xishan people's Hospital, Wuxi, Jiangsu, 214105 |
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Abstract 【Objective】To explore the clinical value of magnetic resonance cholangiopancreatography (MRCP) and intraoperative cholangiography (IOC) before laparoscopic cholecystectomy (LC).【Methods】A total of 70 patients with gallstones who underwent LC in our hospital from April 2015 to April 2017 were selected as the research objects. They were randomly divided into the observation group and the control group, with 35 cases in each group.LC was performed in both groups. Patients in the observation group received MRCP before operation, while patients in the control group received IOC during operation. After operation, the results of MRCP and IOC were compared between the two groups, including Mirizzi syndrome, right parahepatic duct, bile duct obliquely crossing the common hepatic duct and abnormal convergence of biliopancreatic duct. The perioperative clinical indexes including operation time, hospitalization time, biliary duct injury and conversion to laparotomy of the two groups were compared. The occurrence of postoperative complications in the two groups was recorded.【Results】 There were no significant differences in terms of Mirizzi syndrome, right parahepatic duct, bile duct obliquely crossing the common hepatic duct and abnormal convergence of biliopancreatic duct between the observation group and the control group (P>0.05).The operation time and hospitalization time of the observation group were shorter than those of the control group (P<0.05). Compared to the control group, the proportion of biliary tract injury and conversion to laparotomy in the observation group was not significantly different from the control group (P>0.05). The incidence of postoperative complications was 11.43% (4/35) in the observation group and 25.71% (9/35) in the control group, however, the difference was not statistically significant (χ2=2.362, P>0.05).【Conclusion】MRCP can diagnose patients accurately and noninvasively before operation, reduce the trauma of patients, shorten the time of operation and hospitalization, and avoid complications. It is worthy of clinical promotion.
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Received: 03 July 2019
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[1] 闵志军. LRCL与 LC治疗胆囊结石的临床疗效观察[J].医学临床研究, 2016, 33(6):1213-1215.
[2] 陈智勇, 陈文有, 杨爱国,等. 腹腔镜胆囊切除术并发症发生的相关影响因素分析[J].中国普通外科杂志, 2016, 25(2):214-218.
[3] 李加洲, 吴先臣, 易滨. 不同双镜术式联合治疗胆囊结石并肝外胆管结石患者的临床效果及近期并发症比较[J].医学临床研究, 2018, 35(3):520-522.
[4] Pandey M, Sood BP, Shukla RC,et al. Carcinoma of the gallbladder: Role of sonography in diagnosis and staging[J].J Clin Ultrasound,2015, 28(5):227-232.
[5] 廖伟明, 温钦, 吴振声, 等. B超定位联合X线引导经皮经肝穿刺碎石取石术治疗肝内胆管结石[J].中国普通外科杂志, 2016, 25(8):1117-1122.
[6] Revzin MV, Scoutt L, Smitaman E,et al.The gallbladder: uncommon gallbladder conditions and unusual presentations of the common gallbladder pathological processes[J].Abdominal Imaging,2015, 40(2):385-399.
[7] 陈晨, 汪新天. 胆道术后胆囊管残余结石的诊断、治疗及预防[J].医学临床研究, 2014, 31(6):1235-1236.
[8] 杨星, 刘巍, 邓小明,等. 术前MRCP与LC术中胆道造影诊断胆囊结石合并可疑胆总管结石的临床价值比较[J].重庆医学, 2016, 45(15):2070-2072.
[9] 温哲,王哲,梁奇峰, 等.影像学检查在先天性胆总管囊肿切除术中的指导意义[J].临床小儿外科杂志,2013,12(2):138-140,164.
[10] 王超, 徐锋, 戴朝六. 超声内镜联合磁共振胰胆管造影对可疑胆总管结石的诊断价值[J].临床肝胆病杂志, 2019, 35(01):128-131.
[11] 邱钧, 马仁桂, 李志贵,等. 选择性MRCP在胆囊结石术前的应用价值分析[J].肝胆胰外科杂志, 2014, 26(4):327-329.
[12] 朱益民, 许傅英. 腹腔镜胆囊切除术前行MRCP检查的必要性探讨[J].肝胆胰外科杂志, 2016, 28(2):143-144. |
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2020, Vol. 37 
