超声在腹腔镜胆囊切除术前的诊断价值

目的 评价超声在腹腔镜胆囊切除术（LC）前的诊断价值，为LC提供全面选择依据，减少避免了LC的困难及并发症及中转开腹率。方法 回顾性分析了LC患者术前超声检查结果，综合五个方面情况将LC分为适合组，不适合组，相对适合组。结果834例行LC者，其中适合组650例LC均成功。相对适合组中163例中1例因术中发现胆总管结石而中转开腹，不适合组21例8例中转开腹，3例为胆囊明显水肿且与周围组织粘连，5例术中发现胆总管结石而中转开腹。结论 LC成功与否，手术适应症的选择是关键，术前超声检查不仅可以明确胆囊大小、囊壁情况．且可明确肝内外胆管有无结石或梗阻，能预先估计LC术中难易程度，为手术方式和病例选择提供可靠依据。

The diagnostic evaluation of ultrasound before laparoscopic cholecystectomy

Objective To evaluate the significance of ultrasound before laparoscopic cholecystectomy(LC), provide the reason to choose LC and decrease the complications and rate of conversion to open cholecystectomy during LC. Methods ultrasound records in LC patients were analyzed. They were divided into easy, difficult, very difficult classes. 834 LC patients, 650 cases which in easy class do LC successfully. 163 cases which in difficult class do the LC successfully except 1 case convert to open cholecystectomy because of common bile duct stone. 21 cases were divided into very difficult class. 8 cases of them convert to open cholecystectomy, 3 cases were because of gallbladder wall gets too thick and stick to the surrounding issues. 5 cases were because of common bile duct stone. Conclusions The LC is successful or not, choose the suitable case is important. The examination with ultrasound before the operation can not only know the length and outline of gallbladder, the wall's thickness but also know the common bile duct has stone or not. The preoperative ultrasound can predict the technical difficulties of LC, provide the foundation to choose the suitable cases and the intraoperative steps.