术中超声检查在急诊胆囊切除术中预防胆总管残余结石的临床价值

Value of intra-operative ultrasonography in prevention of retained calculus in common bile duct before emergency cholecysctomy

目的探讨急诊胆囊切除术患者手术前可疑胆总管结石术中超声检查的临床价值。方法对本院2006年12月～2010年10月32例术前可疑胆总管结石的急诊胆囊切除术患者行术中超声检查,对其结果进行分析。结果32例经术中超声检查,发现胆总管结石20例,均经手术胆总管切开探测证实。超声检查阴性者,均未行胆总管切开探测,术后1例出现疑似胆总管残余结石表现,经保守治疗而与愈。结论对急诊胆囊切除术患者手术前可疑胆总管结石者,行术中超声检查,有助于提高胆总管切开探测阳性率,减少不必要的胆总管切开探测。

Objective To evaluate the value of intra-operative ultrasonography for suspected choledocholithiasis before emergency cholecysctomy.Methods From December 2006 to October 2010,32 symptomatic gallstones patients underwent intra-operative ultrasonography for suspected choledocholithiasis before emergency cholecysctomy.The results were analyzed.Results Of the 32 symptomatic gallstones patients,occult common bile duct stone（CBDS） was found in 20 patients.The results were proved by exploratory choledochostomy.Those in whom no signs of occult CBDS were found did not undergo exploratory choledochostomy.One had symptoms and signs of retained calculus in common bile duct after the operation,but recovered after non-operative therapy.Conclusion For suspected choledocholithiasis before emergency cholecysctomy,intra-operative ultrasonography can increase the positive rate of exploratory choledochostomy,and avoid unnecessary exploratory choledochostomy.