腹腔镜超声检查在胆囊切除胆道探查术中的应用

目的：探讨腹腔镜超声检查在胆囊切除胆道探查术中的应用价值。方法：腹腔镜下对126例腹腔镜胆囊切除胆道探查术患者常规行腹腔镜超声检查，并选择其中30例行术中胆管造影。与腹腔镜超声检查行对比研究。结果：腹腔镜超声检查平均时间17min，对胆道系统和血管系统扫描结果显示：胆囊和门静脉100％显像，肝胆管，胆总管97％显像，胆总管未端85％显像，腹腔镜超声检查和术中胆管造影对比结果显未腹腔镜超声检查的胆总管检查成功率及胆管结石的敏感性，特异性及总诊断成功率均优于术中胆管造(影（分别为97％，82％，97％，98％和80％，75％，95％，95％）。结论：腹腔镜超声检查的应用有助于判断胆道系统的解剖结构，防止发生胆管损伤，有助于发现或排除肝内外胆管结石，为胆管造影及胆道探查术提供重要指标。降低了胆道残石和阴性胆道探查术的发生率。

APPLICATION OF LAPAROSCOPIC ULTRASONOGRAPHY IN LAPAROSCOPIC CHOLECYSTECTOMY AND COMMON BILE DUCT EXPLIRATION

Objective To study the value of laparoscopic ulrasonography(LUS)in laparoscopic cholecystectomy and common bole duct explortion(LCBDE).Methods LUS has been routinely applied in 126 laparoscopic cholecystectomy,with a comparison of LUS and intraoperative cholangiography(IOC) in 30 cases.Results The mean time taken for the examination of LUS was 17min.Accurate identification of the biliary anatomy and vascular structures was made possible by LUS including visualizations of gallbladder and portal vein(with 100%),hepatic and common bile ducts(98%),and the end of CBD(86%).LUS was shown to be superior to IOC for the succeed rate of common bile duct exploration and the detection of stones:the sensitivites,specificities,and accuracies(97%,82%,97%,98% and 80%,75%,95%,95%).Conclusion LUS when routinely performend during LC would be useful in preventing the bile duct injury by delineating biliary anatomy,and helping to detect the exclude bile duct stones,providing the important guideline for IOC and common bile duct exploration,and reducing the rates of retained stones and negative CBDE.