超声与ERCP检查在腹腔镜胆囊切除术前对Calot三角区粘连的诊断价值  

Ultrasound Combined with Endoscopic Retrograde Cholangiopancreatographic Diagnosis of Accretion in Calot Triangular Area Before Laparoscopic Cholecystectomy

作　　者：宋玲[1] 龚明[1] 宋振才[2] 王清云 邹萌 

机构地区：[1]贵阳中医学院第一附属医院超声室,贵阳市550001 [2]贵阳中医学院第二附属医院超声室 [3]毕节地区中医院超声室

出　　处：《中国超声医学杂志》2006年第12期929-932,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨二维基波、自然组织谐波和彩色多普勒超声条件下,结合ERCP检查在腹腔镜胆囊切除(LC)术前诊断Calot三角区粘连的应用价值。方法对310例实施LC患者,术前经超声与内窥镜逆行胰胆管造影术(ERCP)检查,对Calot三角区粘连,进行手术病理对照,回顾性分析声像图特征,评估其诊断效果。结果310例LC患者,术前超声检查Calot三角区粘连,超声检出率86.5%(268/310)。ERCP检出率96.1%(298/310)。其中度粘连185例,占59.7%(185/310);度粘连者115例,占37.1%(115/310);度粘连者10例,占3.2%(10/310);全部病例均经手术病理证实。结论术前超声与ERCP检查Calot三角区粘连,对LC的适应证、禁忌证的选择,预测手术难易程度及防止手术中胆道损伤、出血、胆漏等并发症,具有重要临床应用价值。Objective To investigate the clinical value of two dimensional fundamental wave, native harmonic wave and colcr Doppler flow imaging （CDFI） combined with endoscopic retrograde cholangiopancreatography （ERCP） in the diagnosis of accretion in Calot triangular area （CTA） before laparoscopie eholeeysteetony （LC）. Methods The CTA in 310 patients was examined with ultrasound and ERCP before LC and were compared with pathology. The sonograms were analyzed retrospectively, The diagnosis indication was appraised. Results The detection rate of CTA on ultrasound was 86.5% （268/310） and that of ERCP was 96. 1% （298/310） . Patients with CTA degree Ⅰ were 185 cases, 59.7% （185/310）; Ⅱ was 115, 37.1% （115/310）; Ⅲ was 10, 3.2% （10/310） .All of the results were confirmed by pathology after operation. Conclusions Ultrasound and ERCP have important clinical value and advantages to inspect CTA before operation, so as to determine the indication and contraindication according to the operation difficult or easy to do, and to prevent compilations such as the injury of biliary tract, hemorrhage, biliary leakage, and so on.

关 键 词：内窥镜逆行胰胆管造影术 腹腔镜胆囊切除术 CALOT三角区 

分 类 号：R445[医药卫生—影像医学与核医学] R657.4[医药卫生—诊断学]