超声诊断充满型胆囊结石208例手术结果分析

目的探讨超声诊断的充满型胆囊结石的手术方法及可能遇到的困难。方法 分析2000年1月至2008年8月超声诊断的208例充满型胆囊结石的手术所见。结果慢性结石性胆囊炎79例，胆囊内充满结石33例，胆囊萎缩80例，急性炎症16例；其中合并胆囊颈管结石嵌顿22例（含Mirizzi综合征Ⅱ型2例）、胆总管结石12例、胆囊-胃肠内瘘3例；合并施行胆总管手术19例。结论B超诊断的充满型胆囊结石多数病理解剖并不复杂，可首选腹腔镜胆囊切除术，少数病例确实存在复杂的病理改变，易导致治疗失误，需高度警惕。

Clinical analysis of the surgical management for turgid type of cholecystolithiasis diagnosed by ultrasound

Objective To discuss the surgical operations and possible difficulties for turgid type of cholecystolithiasis diagnosed by ultrasound. Methods 208 patients from Janurary 2000 to August 2008 were retrospectively studied. Result There were chronic choleeystitis in 79 patients, fulfill with gallstones in 33 patients, atrophy of gallbladder in 80 patients, acute inflammation in 16 patients. Special circumstances in 37 patients： cystic ductal stone incarceration in 22 patients（ including Mirizzi syndrome II in 2 cases）, eholedocholithiasis in 12 patients, gallbladder - gastrointestinal fistula in 3 cases. 19 patients had exploration of the common bile duct at the same time. Conclustion most pathological anatomy of cholecystolithiasis diagnosed by ultrasound is not complicated; laparoscopic cholecystectomy is preferred; complex circumstances exit on a few cases in which specific precaution is needed.