| Objective:In this study,we observed the application of magnetic resonance cholangiopancreatography in laparoscopic cholecystectomy and summarized the MRCP results before laparoscopic cholecystectomy.Observed and compared the operative time,postoperative complications,conversion to laparotomy,postoperative hospital stay,total hospitalization time,and total hospitalization expenses of patients with MRCP and MRCP before laparoscopic cholecystectomy.To investigate the recognition of the changes of cystic duct variability in laparoscopic cholecystectomy by magnetic resonance cholangiopancreatography and its influence on the surgical procedure and hospitalization economic indicators.Methods:The clinical data of patients undergoing laparoscopic cholecystectomy in hepatobiliary surgery from January 2018 to December 2018 in our hospital were retrospectively collected.The preoperative MRCP examination was performed.According to the preoperative MRCP examination group,the MRCP group and the MRCP group were not classified.The MRCP results of the MRCP group were analyzed and summarized.The relevant indicators of the two groups of patients were collected:gender,age;operation time,whether or not to convert to open surgery and postoperative complications;postoperative hospital stay,total hospital stay and total hospitalization expenses.After collecting and collating the data,SPSS 20 statistical software was used for statistical analysis.The comparison between the MRCP group and the MRCP group was compared.The operation time,conversion rate,complication rate and postoperative hospitalization were further explored.There is a difference between time,total hospital stay,and hospitalization expenses.Results:A total of 3282 patients with laparoscopic cholecystectomy were enrolled,of which 2897(88.27%)improved preoperative MRCP,and 385(11.73%)did not undergo MRCP.There were 162 males and 223 females in the group without MRCP,aged 16-79 years,mean age(51.26±14.20)years old;1108 males and 1789 females,aged 10-103 years,mean age in the MRCP group(49.66±14.17 years old,there was no statistical difference between the two groups.MRCP examination in the MRCP group found 173 cases of cystic duct variants with a mutation rate of 5.97%.The mutation rates of each type were as follows:1.90%of the type? cystic duct(n=55);0.8%of the type? cystic duct(n=23);the left side of the type ? cystic duct was 0.24%(n)=7);? type cystic duct high infusion was 0.24%(n=7);V-shaped parahepatic duct was 2.14%(n=62);Type VI choledochal cyst was 0%(n=0);Type VII The vagus hepatic duct was 0%(n=0).?+? type is 0.38%(n=11);?+? type is 0.03%(n=1);?+? type is 0.07%(n=2);?+? type is 0.13%(n=4));?+? type is 0.03%(n=1).There was no significant difference between the two groups in total cost and postoperative hospital stay.The total length of hospital stay in MRCP group was shorter than that in MRCP group(P<0.05),The operation time in MRCP group was longer than that in MRCP group(P<0.05).There were 4 cases of postoperative bile leakage,1 case of hemorrhage,0 case of biliary tract injury in MRCP group,l case of hemorrhage,0 case of biliary tract injury,O case of bile leakage in group without MRCP.12 cases of MRCP group converted to open surgery,There were 2 cases of open surgery in group without MRCP.There was no significant difference in postoperative complications and conversion rate between the two groups.Conclusions:MRCP can accurately and effectively identify cystic duct variants,which is helpful for the development of reasonable surgical procedures to avoid iatrogenic bile duct injury.In patients with laparoscopic cholecystectomy,the preoperative MRCP examination showed a cystic duct mutation rate of 5.97%.The variation was mainly due to the low-level inflow of the cystic duct and the concomitant cystic duct in the lower part.MRCP examination before LC shortened the operation time,did not increase the total cost of hospitalization,and brought more benefits to patients.It should be used as a routine examination before LC. |
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