术中超声在多镜联合微创保胆取石术中的应用价值  

Intraoperative ultrasonography in minimally invasive gallbladder-preserving surgery for cholelithiasis

作　　者：张欢[1] 李明[1] 尤理想 陈杰[1] 吴浩荣[1] 危少华[1] 

机构地区：[1]苏州大学附属第二医院普外科,215004

出　　处：《中华普通外科杂志》2016年第11期904-906,共3页Chinese Journal of General Surgery

摘　　要：目的探讨术中超声在多镜联合保胆取石术中的应用价值。方法回顾性分析2009年5月至2014年5月苏州大学附属第二医院对158例胆囊结石患者行多镜联合保胆取石术使用术中超声的治疗效果。结果多镜联合清除胆囊内结石后，术中行经皮腹部B超检查。158例患者中，151例（95．57％）成功行保胆手术，其中145例取石后胆囊内未见明确结石回声影，6例B超提示强回声影，经再次胆道镜取石成功；7例（4．43％）改行腹腔镜胆囊切除术，其中5例术中B超发现为胆囊壁间结石，2例为胆囊颈管结石。手术时间为（48．01±8．15）min。术后平均住院时间（3．50±1．34）d。术后随访1、3个月均未见结石复发。随访6个月，2例出现胆固醇结晶。随访12个月，4例出现胆固醇结晶。结论术中超声在多镜联合保胆取石术中的应用可以明确胆囊结石残留部位及数量，降低术后胆囊结石残留率。Objective To evaluate intraoperative ultrasound in minimally invasive gallbladder- preserving surgery for gall stone patients. Methods We retrospectively analyzed clinical data of 158 patients undergoing minimally invasive gallbladder-preserving cholelithotomy under intraoperative ultrasound monitoring in our department from May 2009 to April 2014. Results 151 out of 158 cases （95.57%） successfully underwent laparoscopic gallbladder-preserving cholelithotomy （ in 6 cases, residue stones were found and removed by guidance of intraoperative ultrasound ）, 7 case （4.43%） were converted to laparoscopic cholecystectomy （LC） because stones found in the gallbladder wall in 5 cases and cystic duct stones in 2 cases . The average operation time was （48. 01 ± 8. 15） min and the average hospital stay was （3.50 ± 1.34） days. 6 month follow-up showed 2 cases recurred cholesterol crystal, 12 month follow-up showed 4 cases of cholesterol crystal. Conclusions Use of intraoperative ultrasound in minimally invasive gallbladder-preserving cholelithotomy helps discover and locate the residual gallstones, effectively reducing the rate of postoperative residual gallstones.

关 键 词：超声外科手术 胆囊结石病 腹腔镜 

分 类 号：R657.42[医药卫生—外科学]