摘要
目的 探讨腹腔镜超声(laparoscopic ultrasonography, LUS)在困难腹腔镜胆囊切除术(laparoscopic cholecystectomy, LC)中的应用价值及肝外胆道系统的扫描方法。方法 60例LC因急性、萎缩性、坏疽性胆囊炎以及疑合并有胆总管结石而被定义为困难LC患者,术中采用彩色多普勒腹腔镜超声仪进行扫描,根据扫描结果行LC或进一步治疗。结果 60例患者在LUS下顺利完成手术,其中急性胆囊炎52例、萎缩性胆囊炎6例、坏疽性胆囊炎2例;4例急性胆囊炎患者术中因发现合并胆总管结石而行LC联合腹腔镜下胆总管切开取石术,1例急性胆囊炎患者因胆囊三角区粘连严重行中转开腹手术。所有行LUS患者术中及术后无相关并发症发生,术中扫描可清晰显示肝内外胆道结构。结论 LUS技术在困难LC中具有良好的应用价值,在避免胆道损伤(bile duct injury, BDI)、降低结石残留率方面可起关键作用。
Objective To investigate the value of laparoscopic ultrasound(LUS)in difficult laparoscopic cholecystectomy(LC)and the scanning method of intra-and extra-hepatic biliary system.Methods Sixty patients with LC defined as difficult LC due to acute,atrophic,or gangrenous cholecystitis and suspected combined common bile duct stones were scanned intraoperatively using color Doppler laparoscopic ultrasonography,and LC or further treatment was performed according to the scan results.Results The operation of 60 patients were successfully performed by using LUS.Among them,52 had acute cholecystitis,6 had atrophic cholecystitis,and 2 had gangrenous cholecystitis.Four patients with acute cholecystitis underwent LC combined with laparoscopic choledochotomy and lithotripsy because of combined choledocholithiasis,and 1 patient with acute cholecystitis underwent intermediate open surgery because of serious adhesions in the gallbladder triangle.All patients underwent LUS without complications during and after the surgery,and intraoperative scans could clearly show the biliary structures inside and outside the liver.Conclusion The LUS technique has good application in difficult LC and can play a key role in avoiding bile duct injury and reducing the rate of stone retention.
作者
刘春龙
张健
吴盼盼
宋坤
崔涛
任魁梧
杨锐
于江涛
LIU Chunlong;ZHANG Jian;WU Panpan;SONG Kun;CUI Tao;REN Kuiwu;YANG Rui;YU Jiangtao(Department of Hepatobiliary and Pancreatic Surgery,Fuyang People s Hospital,Anhui Medical University,Fuyang 236000,China;Department of Neurosurgery,Seventh Clinical College of China Medical University,Fushun 113000,China)
出处
《邵阳学院学报（自然科学版）》
2023年第5期32-39,共8页
Journal of Shaoyang University：Natural Science Edition
基金
国家卫健委医院管理研究所项目(YLZLXZ22G026)
阜阳市自筹科技项目(FK202081016)。
关键词
腹腔镜超声
困难腹腔镜胆囊切除术
胆道损伤
laparoscopic ultrasound
difficult laparoscopic cholecystectomy
bile duct injury
