彩色多普勒超声在确定微创保胆手术禁忌证中的应用价值

目的探讨彩色多普勒超声在确定腹腔镜（或小切口）、胆道镜联合微创行保留胆囊切除息肉或取出结石手术方法禁忌证的应用价值。方法回顾性分析2007年1月至2009年12月来我院拟行微创保胆手术患者1476例，术前均常规进行肝脏、胆囊、胆管、胰腺彩色多普勒超声检查。结果1476例患者中1461例实施手术，其中行腹腔镜（或小切口）、胆道镜联合微创保留胆囊切除息肉和／或取出结石手术1185例；行胆囊切除手术276例。彩色多普勒超声术前诊断微创保胆手术适应证准确率为95．27％，禁忌证准确率为93．48％，总准确率为94．93％。15例未实施手术，其彩色多普勒超声诊断结果与CT／MRI诊断结果一致。结论彩色多普勒超声能够在微创保胆手术术前充分显示患者胆囊及胆管情况，检出具有微创保胆手术禁忌证病例，以其简便、安全无害、准确性高而成为微创保胆手术术前必选的检查方法。

The value of color Doppler ultrasound in identification for contraindication of endoscopic gallbladder-preserving operation

Objective To investigate the value of the color Doppler ultrasound in identification for contraindication of gallbladder-preserving operation using laparoscope combined with choledochoscope. Methods The clinical data of 1476 cases of acute mushroom poisoning were retrospectively analyzed. Results A total of 1461 patients suffered from cholecystolithiasis and gallbladder polyps. Of all, 1185 took endoscopic gallbladder-preserving operation, and 276 cases received laparoscopic cholecystectomy. The accuracy of ultrasonographie diagnosis was 95.27% and the accuracy of contraindication was 93.48 % , the accuracy of total was 94.93 %. Fifteen cases were not performed with operations, and the diagnosis results of color Doppler ultrasound were consistent with those of CT and MRI. Conclusion The color Doppler ultrasound, as a convenient, safe means with high accuracy, can indicate the condition of gallbladder and bile duct and determine the operative contraindication.