超声诊断在胆囊切除术中胆囊三角显示的指导意义

Ultrasound diagnosis of Calot's triangle in cholecystectomy

目的探讨术前B超测定急性结石性胆囊炎胆囊壁厚度与术中胆囊三角显示之间的关系,指导手术时机与方法的选择,减少手术并发症。方法 44例急性结石性胆囊炎患者以术前B超提示胆囊壁厚情况分为壁厚大于或等于4 mm组和小于4mm组,分析术中胆囊三角显示情况与胆囊壁厚之间的关系。结果 44例术中胆囊三角可显示率为54.54%,但其中术前B显示囊壁厚大于或等于4 mm显示率仅为12.5%,胆囊壁厚小于4 mm显示率为78.57%,2组在术中胆囊三角分离显示率比较,P<0.05,差异有统计学意义。结论术前B超测定急性结石性胆囊炎胆囊壁厚,可间接提示胆囊三角显露难易程度,指导临床急性结石性胆囊炎患者手术时机与方法的选择,避免因胆囊三角显示不清而造成胆道损伤。

Objective To analyze the relationship between gallbladder wall thickness of acute cholecystitis determined by preoperative ultrasound diagnosis and intraoperative gallbladder triangle, the surgery opportunity and method were selected to reduce complications. Methods All of 44 patients with acute cholecystitis are divided into two groups according to if the gallbladder wall thickness less than 4 mm or not, and the relationship between gallbladder wall thickness and Calot＇ s triangle was analyzed. Results Calot＇ s triangle of all patients could be shown 54.54% ,but gallbladder wall thickness which was greater than or equal to 4 mm could only be 12.5% ,which was less than 4 mm could be shown 78.57%. There was statistical significance in Calot＇ s triangle （ P 〈 0.05 ）. Conclusion Acute cholecystitis with gallbladder wall thickness determined by ultrasound diagnosis preoperatively can indicate the exposure condition of gallbladder triangle of stone, which can guide the operation time and method for patients with acute cholecystitis. Meanwhile, unexpected injuries of biliary tract can be avoided by unclear appearance of gallbladder triangle of stone.