腹腔镜超声在困难腹腔镜胆囊切除术中的应用  

The application of laparoscopic ultrasonography in difficult laparoscopic cholecystectomy

作　　者：田虎[1] 刘竞芳[1] 

机构地区：[1]山东省千佛山医院,山东济南250014

出　　处：《腹腔镜外科杂志》2010年第3期207-209,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜超声(laparoscopic ultrasonography,LUS)用于困难腹腔镜胆囊切除术(laparoscopic cholecystecto-my,LC)的价值,及改良电子线阵式探头LUS对肝外胆道系统的扫描方法。方法:术前经影像学检查估计腹腔镜手术困难及术中探查发现胆囊周围粘连严重的30例胆囊结石患者于LC术中用LUS扫描肝外胆道系统。结果:LUS能清晰显示肝外主胆管的超声图像并发现胆囊管异常汇入,根据LUS的扫描结果决定LC的手术方法。结论:LUS能在LC术中为术者提供肝外胆管的超声图像,准确定位胆总管,既可避免医源性胆管损伤,判断肝外胆管内有无结石,又可指导手术,保证手术质量。Objective：To explore the value of laparoscopic ultrasonography （LUS） in difficult laparoscopic cholecystectomy （LC） , and the scanning way for extrahepatic biliary system with modified electronic linear array probe. Methods：LUS were applied in 30 cholecystolithiasis patients for scanning extrahepatic biliary system. Their operations were evaluated as difficult LC based on BUS, MRI and CT before operation, or severe adhesion around gallbladder was found during laparoscopic exploration. Results ： LUS could clearly indicate the major extrahepatic bile duct ultrasound image and find the cystic duct abnormal abouchemcnt. LC operative method was detcrmined according to LUS scanning results. Conclusions ： LUS in LC can provide surgeon with ultrasound images of extrahepatic bile duct, so that surgeon is able to precisely locate common bile duct, avoid iatrogenic bile duct injury, and judge whether or not there are stones in the extrahepatic bile duct. It plays an important guiding role of the operation quality.

关 键 词：超声检查 多普勒 彩色 胆囊切除术 腹腔镜 

分 类 号：R657.4[医药卫生—外科学]