腹腔镜联合术前超声保胆治疗胆囊结石和胆囊息肉的临床分析

目的探讨腹腔镜联合术前超声微创保胆治疗胆囊结石、胆囊息肉的临床价值。方法选择2009年3月-2012年9月74例胆囊结石患者、61胆囊息肉患者，回顾性分析其术前超声检查结果及手术资料。结果术前常规超声观察上述患者中有5例胆囊周围粘连，均为慢性胆囊炎合并胆囊结石患者；术中发现4例胆囊结石患者胆囊周围粘连严重而中转开腹，3例因合并胆囊管结石嵌顿无法取出，改腹腔镜胆囊切除，余均一次性取石成功，结石直径2-30mm，结石取净率100％；2例胆囊息肉患者术中冰冻结果为腺瘤性息肉，改腹腔镜下胆囊切除，余均一次性摘除息肉成功，取出息肉93个，息肉直径7～14mm；术后无胆瘘等严重并发症，恢复快。结论术前超声对腹腔镜保胆手术具有重要的临床指导价值；腹腔镜保胆治疗胆囊疾病创伤小，恢复快，并发症少，可明显提高患者生活质量。

CLINICAL ANALYSIS OF LAPAROSCOPY COMBINED WITH ULTRASOUND BEFORE OPERATION IN TREATMENT OF CHOLECYSTOLITHIASIS AND GALLBLADDER POLYPS

Objective To investigate the clinical value of minimally invasive endoscope in treating gallstone and gallbladder polyps with cholecyst retention by laparoscopy combined with preoperative ultrasound. Methods Preoperative ultrasonic findings and operation data of 74 cases of gallstone and 61 cases of cholecyst polypus in author＇s hospital from March 2009 to September 2012 were retrospectively analyzed. Results There were 5 cases of adhesion around gallbladder by observation of conventional ultrasound before operation, which were chronic eholecystitis with choleeystolithiasis patients. 4 cases of adhesion around gallbladder required to convert to open surgery, 3 cases were converted to laparoscopic cholecystectomy because of that complicated with calculus of cystic duct incarceration. The others performed successfully with Minimal Invasive Endoscope treat Gallstone with Gallbladder Sparing by laparoscope, successful removal of all stones, Stone＇s size was 2-30mm. There were 59 patients performed successfully with Minimal Invasive Endoscope treat Cholecyst Polypus with Cholecyst Retention by laparoscope, Successful removal of polyps in 93, Polyp size 7-14mm. The others 2 cases which were Adenomatous polyps with frozen pathology result in intraoperative converted to laparoscopic choleeystectomy. No postoperative biliary fistula or other serious complications. The cases were faster postoperative recovery postoperation. Conclusions Preoperative ultrasonography has an important clinical guiding value in laparoscopic with cholecyst retention. That minimal invasive endoscope in treating gallstone and gallbladder polyps with cholecyst retention by laparoscopy is trauma, rapid recovery, few complications and can significantly improve the life quality of the patients.