术中B型超声在肝胆手术中的应用

Intraoperative B mode ultrasonography in hepatobiliary surgery

目的 :总结肝胆术中应用 B超的优越性 ,提高病变切除的准确性、彻底性及术后疗效。 方法 :对 12 5例肝病和 11例复杂胆道病的病例 ,采用 5～ 7.5 MHz术中 B超配套的高频探头及 3.5～ 5 .5 MHz的普通 B超探头 ,直接在脏器上按顺序对肝内结构及胆道系统进行全方位扫查。结果 :术中 B型超声在 12 5例肝病和 11例复杂胆道病的应用中 ,对找到或发现新病灶具有明显优越性 ,对 <3cm的肿瘤扫查阳性率达 96 % ,对 >3cm肿瘤达 10 0 % ;引导处理肝深部的小病灶具有独特的作用 ,并使本组手术 5 0 %的残留结石均及时发现并引导取尽 ;协助和指导 14.4%的肝癌病例改变原手术方案 ,采取了更合理的治疗方案和措施。 结论 :术中 B超扫查肝癌定位准确 ,提高了手术安全性、彻底性 ,可弥补术前影像检查的不足 。

Objective: To summarize the advantages of B mode ultrasonography in hepatobiliary operation. Methods: The high frequency prober (5 7.5 MHz) and general prober (3.5 5.5MHz) were used in operation to detect the liver in 125 patients with hepatic diseases and 11 patients with complex biliary diseases. Results: The intraoperative ultrasonography showed more obvious advantages. It could detect 96% tumors whose diameters were less than 3 cm and detect 100% tumors whose diameters were larger than 3 cm. About 50% leftover stones were detected and taken out clearly guided by the intraoperative ultrasonography, and it helped the surgeon to apply more reasonable treatment instead of the therapy designed preoperatively in 14.4% cases with liver cancer. Conclusion: Ultrasonography in operation can locate the focus accurately, improve surgical safety and make the operation more radical. It can overcome the weakness of the preoperative image examination.