超声在胆囊管解剖变异诊断中的价值及其临床意义

目的探讨超声诊断胆囊管解剖变异的价值及其在胆囊切除术中的指导作用.方法收集行胆囊切除术证实为胆囊管解剖变异的患者74例,将超声检查借助胆囊颈长轴与胆总管夹角及胆囊颈与肝总管的位置关系诊断的胆囊管解剖变异者的超声表现与胆囊切除术中所见进行对照分析.结果超声断胆囊管解剖变异与手术证实的胆囊管解剖变异有高度的一致性(Kappa为0.547,P＜0.01);超声诊断胆囊管解剖变异的患者术中医源性胆道损伤的发生率显著低于超声检查未诊断胆囊管解剖变异者(P＜0.01).结论术前超查诊断胆囊管解剖变异有较高的准确性,并可降低术中医源性胆道损伤的生率.

Clinical significance of ultrasound diagnosing anatomic variation of gallbladder duct

Objective To approach the value of ultrasound diagnosing anatomic variation of gallbladder duct for the guidance in cholecystectomy. Methods A total of 74 patients with gallbladder duct anatomic variation confirmed with cholecystectomy were collected. The anatomic variation of gallbladder duct on cholecystectomy and ultrasound, the angle between the long axis of gallbladder neck and bile common duct and the position relation of the neck to common hepatic duct were comparatively analysed.Results There was high concordance between anatomy variation of the duct on ultrasonic inspection and the cholecystectomy (Kappa 0.547,P<0.01). The incidence rate of biliary tract iatrogenic trauma on operation in the patients diagnosed anatomic variation of gallbladder duct by ultrasound preoperatively was lower than that without diagnosed variation on ultrasound (P<0.01). Conclusions The diagnostic accuracy rate of the duct anatomic variation on preoperative ultrasound was very high, which may decrease the incidence of iatrogenic biliary tract injury during operation.