肝内结石手术中B超检查的价值  

The value of intraoperative ultrasound scanning in surgical treatment of intrahepatic stones

作　　者：胡宗泽[1] 张清泉[1] 王兴国[1] 刘竟芳[1] 李兆亭[1] 

机构地区：[1]山东省千佛山医院

出　　处：《肝胆外科杂志》1994年第2期83-86,共4页Journal of Hepatobiliary Surgery

摘　　要：１５３例肝内结石病人行术中Ｂ超检查（ＩＯＵＳ），以确定结石部位、分布．显示狭窄与扩张的部位．决定手术方式。待认为结石取净后再行ＩＯＵＳ．了解有无残石，如发现结石．再行Ｂ超引导下取石．直到结石取净或小残石无法取净．本组不同方式肝叶切除６７例．肝肠吻合５４例．单纯“Ｔ”管引流８６例，术毕残石率２２．２２％，术后胆镜取净结石１１例．自行排净５例．出院时残石率１１．７６％．ＩＯＵＳ显示肝内结石清晰．定位准确．无损伤．术中可反复使用，可显示隐蔽的结石、异位结石和易被忽视的尾叶结石．Intraoperative ultrasongrdphy(IOUS) was performed in 153 patients with intrahepatic stones and bile duct strictures to localize and quantify the stones as well as to select the operative procedures accordingly. When complete removal of stones was assumed, IOUS was reperformed to verify the completeness.Once residual stones were detected, fruther attempts to remove the stones were committed under the guidance of IOUS until complete removal xas achieved. Fine stones fixed in fine bile ducts were remained unavoidablely.In this group of patients, different forms of hepatic lobectomy were performed in 67 cases, choledocho-cholangioenterostomy in o4 cases, 'T' tube drainage in 86 cases. Incidence of residual stones was 22. 22%. Complete stone removal was achieved in 11 patients with residual stones lithotrpsized postoperatively by fibroscopy.Spontaneous complete evacuation of stones in 5cases resulting in 11. 76% of the patients with retained stones on discharge from the hospital.IOUS gives distinct imaging of intrahepatic calculi and is noninvasive, reptoducible and accurate. Hidden and cetopic intrahepetic calculi difficult to be found by fibrocholangioscope can also be detected by IOUS.

关 键 词：肝内结石 外科手术 超声波诊断 

分 类 号：R657.305[医药卫生—外科学]