经腹超声及术中超声在胰腺结石诊断、治疗中的应用

目的:探讨经腹超声及术中超声在胰腺结石诊断、治疗中的价值。材料和方法:对25例胰腺结石患者行经腹和术中超声检查。经腹超声主要观察胰管扩张程度,胰腺结石大小、位置,是否合并胆囊及胆道结石、胰腺假性囊肿等。术中超声观察是否有结石残留。结果:经腹超声显示25例患者主胰管扩张,胰腺实质增粗、增强。结石位于头部9例,位于全胰腺16例,伴有胆道梗阻征象13例,其中合并胆囊及胆道结石8例,并发胰腺假性囊肿3例,合并胰腺癌2例;术中超声形式显示6例未见残留结石,19例有残留结石,手术取出残留结石24枚。结论:经腹超声诊断主胰腺管结石敏感性较高,术中超声在判断残留结石及鉴别胰小管结石与胰腺实质钙化灶方面具有重要价值。

Evalue of Transabdominal Ultrasound and Intraoperative Ultrasound in the Management of Pancreatic Stone

Purpose:The aim of the study was to explore the clinical value and image characteristics of transabdominal and intraoperative ultrasound in the detection and treatment of pancreatic stone.Materials and Methods:25 patients of pancreatic stone underwent transabdominal and intraoperative ultrasound.In transabdominal examination,evidenced as dilation of pancreatic duct,size and location of the pancreatic stone,and possible complications such as gallstones and pancreatic pseudocyst were assessed.During operation,additional ultrasound were undertaken to detect if any more stones existed.Results:The dilation of pancreatic duct,thickening and coarsening of pancreatic parenchyma were found in all cases.In 9 cases(36%) stones were located in the head,while in the rest 16 cases(64%) stones were found in the entire pancreas.Obstruction of biliary tract presented in 13 cases,gallstones and bile duct stone in 8,pancreatic pseudocysts in 3,and pancreatic cancer in 2.With the intraoperative ultrasound 24 more stones were detected in 19 cases.Conclusion:The transabdominal ultrasound was sensitive in detecting pancreatic stones,while intraoperative ultrasound provided complementary information.