CAJ | 학술논문

磁共振胰胆管造影(MRCP)能多方位、多角度显示胆道三维立体形态.腹腔镜经胆囊管处理肝外胆管结石优势明显,但胆囊管形态复杂多变,部分患者并不适宜经该途径手术.因此,如何筛选手术方式显得很重要.本文通过分析MRCP图像,将96例胆总管结石病例的胆囊管分成4类,前瞻性地选择手术方案.对照分析相关数据后我们认为,粗直型宜选择经胆囊管途径;细弯型选择胆管切开途径;变异型及显示不清型则根据具体形态,慎行腹腔镜手术.此方法可最大限度发挥腔镜的微创优势.
자공진이담관조영(MRCP)능다방위、다각도현시담도삼유입체형태.복강경경담낭관처리간외담관결석우세명현,단담낭관형태복잡다변,부분환자병불괄의경해도경수술.인차,여하사선수술방식현득흔중요.본문통과분석MRCP도상,장96례담총관결석병례적담낭관분성4류,전첨성지선택수술방안.대조분석상관수거후아문인위,조직형의선택경담낭관도경;세만형선택담관절개도경;변이형급현시불청형칙근거구체형태,신행복강경수술.차방법가최대한도발휘강경적미창우세.
MRCP can be applied to display three-dimensional morphology of the biliary tract clearly.Laparoscopic surgery via cystic duct for choledocholithiasis possesses obvious advantages, but it is not suitable for all cases because there are great variations in the cystic duct.So how to make proper choice of the therapeutic strategy becomes very important.In this prospective study, different surgeries were administrated in patients with common bile duct stone based on the 4 categories of cystic ducts in 96 cases judged by MRCP images.These findings demonstrated that according to the cystic duct morphological type,LCTBDE is suitable for thick-straight type, and LCBDE is fit for thin-crooked type.Be careful to choose laparoscopic surgery in the other two types considering their individual features.Thus, this classification will be propitious to maximize the advantage of laparoscopic operation as a minimally invasive treatment.