超声内镜诊断胆总管小结石的临床研究  

Clinical Study on Endoscopic Ultrasonography in Diagnosis of Common Bile Duct Microlith

作　　者：李焕喜[1] 王震宇[1] 张莉[1] 李伟志[1] LI Huan-xi;WANG Zhen-yu;ZHANG Li(Department of Endoscope Centre, Tianjin Nankai Hospital, Tianjin 300100 ,China)

机构地区：[1]天津市南开医院内镜中心,天津300100

出　　处：《中国中西医结合外科杂志》2017年第6期610-613,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:探讨超声内镜检查术(EUS)对于胆总管小结石的诊断率及临床价值。方法:回顾性分析行EUS检查患者159例,所有病人结合病史及临床体征考虑为胆总管结石,但影像学检查未发现结石。EUS发现胆总管结石者随即行ERCP取石术;ERCP失败者行手术取石。EUS未发现胆总管结石者,则不行ERCP,但随访至少三个月。结果 :159例患者中EUS发现结石者96例;89例ERCP取石成功,1例ERCP失败者手术取出结石,1例排石,5例为假阳性。63例EUS未发现结石者随访三个月未发现结石。无操作相关并发症发生。超声内镜诊断胆总管小结石的准确性、敏感性、特异性、阳性和阴性预测值分别为96.8%、100%、92.6%、94.8%和100%。结论:超声内镜诊断胆总管小结石安全、可靠。Objective To determine the diagnostic rate and clinical value of endoscopic ultrasonography(EUS)in patients with choledocholithiasis.Methods Patients with choledocholithiasis who underwent EUS(159cases)were retrospectively reviewed.All patients were considered as choledocholithiasis by clinical history and signs,but no stones were found in imaging examinations.The patients with choledocholithiasis diagnosed by EUS were treated with ERCP,and ERCP losers were treated with surgery.If EUS found no stones in common bile duct,no ERCP was performed,but the follow-up was continued for at least three months.Results In159patients,96patients were found common bile duct stone,by EUS,among which89cases were successfully removed stone with ERCP,one case was removed stones by surgery,one case sgowed natural stone discharge and five cases showed false positive stones in common bile duct.For those63patients without evidence of choledocholithiasis by EUS,no false-negative case was noted during the there-month follow-up period.No operation related complications occurred.The accuracy,sensitivity,specificity,positive and negative predicted values of EUS for the detection of choledocholithiasis were96.8%,100%,92.6%,94.8%and100%,respectively.Conclusion EUS is an accurate and safe diagnostic tool for the detection of choledocholithiasis.

关 键 词：超声内镜检查术 胆总管小结石 诊断价值 

分 类 号：R657.42[医药卫生—外科学] R445.1[医药卫生—临床医学]