术前肝胆囊静态显像胆囊未显影行微创保胆取石术33例临床分析  

Minimally-invasive operation with gallbladder preserved by choledochoscopy in 33 cases of cholecystolithiasis with nonvisualization of gall bladder in preoperative ECT

作　　者：李晋忠[1] 刘京山[1] 赵期康[1] 姜雅聪[1] 孔德志[1] 胡子文[1] 

机构地区：[1]北京大学首钢医院普外科,北京100041

出　　处：《中国内镜杂志》2009年第12期1271-1273,1276,共4页China Journal of Endoscopy

摘　　要：目的评价术前肝胆囊静态显像(ECT)胆囊未显影患者行保胆取石术的成功原因及概率。方法2006年8月～2009年4月在该院行微创保胆手术的患者术前常规行肝胆囊静态显像(ECT)检查,将胆囊未显影的患者纳入研究组,统计成功完成微创保胆手术例数并分析原因。结果术前有80例患者肝脏显影良好,但胆囊未显影,均为胆囊结石患者,其中有33例患者成功地完成微创保胆取石术,占40.1%,成功原因主要是结石能全部取出等。结论术前肝胆囊静态显像(ECT)胆囊显影表明胆囊有功能,是微创保胆术的适应证,未显影表明胆囊功能不良,均为胆囊结石患者,在术中若发现胆囊无萎缩,无明显积脓或急性炎症水肿,结石无严重嵌顿且能全部取出者可行微创保胆取石术,丰富了微创保胆手术的适应证。[ Objective ] To evaluate the successful reasons and probability of minimally invasive operation with gallbladder preserved in patients with cholecystohthiasis whose cholecysts were not visualized in preoperative ECT examination （static liver and gallbladder imaging）. [Methods] Eighty cases with invisible cholecyst in preoperative ECT examination （static hver and gallbladder imaging） were enrolled from August 2006 to April 2009, among which 33 cases successfully received of minimally invasive operation with gallbladder preserved by choledochoscopy. The successful reasons and probability were analyzed. [Results] Thirty-three cases with cholecyst invisualized in preoperative ECT examination （static hver and gallbladder imaging） successfully received minimally invasive operation with gallbladder preserved by choledochoscopy. The probability was 40.1%. The gallbladder stones could be completely taken out is an important reason for success. [ Conclusion ] Visualization of cholecyst in preoperative ECT （static gallbladder imaging） examination indicated the fine function of cholecyst. It is the indication of minimally invasive operation with gallbladder preserved by choledochoscopy. But nonvisuahzation of cholecyst indicated the poor function of cholecyst. These patients all had cholecystolithiasis. In the operation, ff there is no eholecyst atrophy, no significant empyema or acute inflammatory edema; if stones are not seriously incarcerated and could be completely removed, the operation could be successfully finished. We have enriched the indications of minimally invasive operation with gallbladder preserved by choledochoscopy.

关 键 词：肝胆囊静态显像(ECT) 胆囊未显影 微创保胆取石 

分 类 号：R657.4[医药卫生—外科学]