胆囊结石合并胆囊炎患者腹腔镜胆囊切除术前采用多层螺旋CT检查的临床应用价值

Clinical Application Value of Multi-slice Spiral CT in Patients Undergoing Laparoscopic Cholecystectomy for Cholecystolithiasis Complicated with Cholecystitis

目的探究多层螺旋CT检查在胆囊结石合并胆囊炎患者腹腔镜胆囊切除术前的应用价值。方法选取2016年1月—2018年6月广西壮族自治区南溪山医院收治的经CT或B超等各种影像学诊断确诊为胆囊结石合并胆囊炎的患者47例作为观察组,并选取同期经过上腹增强扫描诊断为非胆囊疾病的患者47例作为对照组,比较两组胆囊管与胆囊动脉显示率、显示评分,并对患者解剖结构与临床变异情况进行观察分析。结果对照组胆囊管均可以显示,观察组有2例胆囊管无法显示,两组胆囊管显示率、平均显示评分比较,差异无统计学意义(P>0.05);94例患者中,胆囊管可显示91例,正常走行80例,走行变异11例,包括高位胆囊管6例,右迷走胆管形成与胆囊管同时汇入肝总管各2例,低位胆囊管1例;观察组有3例胆囊管走行变异,对照组6例胆囊管走行变异,两组比较差异无统计学意义(P>0.05)。两组胆囊动脉均可显示,观察组胆囊动脉平均显示评分高于对照组(P<0.05)。结论在胆囊结石合并胆囊炎患者腹腔镜胆囊切除术前应用多层螺旋CT检查具有重要价值,其能够实现胆囊管与胆囊动脉及周围解剖关系的清晰显示,能够及时发现其行走变异情况,从而为腹腔镜胆囊切除术前评估提供可靠的依据。

Objective To investigate the value of multi-slice spiral CT in the preoperative laparoscopic cholecystectomy for cholecystolithiasis and cholecystitis.Methods Forty-seven patients who underwent CT or B-ultrasound and other imaging diagnosis diagnosed as gallbladder stones with cholecystitis in Nanxi Mountain Hospital from January 2016 to June 2018 were selected as the observation group.Forty-seven patients with gallbladder disease were used as the control group.The specific display rate and display score of the cystic duct and gallbladder artery were compared,and the anatomy and clinical variation of the patient were observed and analyzed.Results The cystic ducts of the control group could be displayed.There were 2 cases of gallbladder stones complicated with cholecystitis in the observation group.There was no significant difference between the two groups(P>0.05).94 patients among them,there were 91 cases of cystic ducts,80 cases of normal walking,11 cases of variability,including 6 cases of high cystic duct,2 cases of right vagus bile duct formation and cystic duct simultaneously into the common hepatic duct,1 case of low cystic duct.There were 3 cases of cystic ducts in the observation group,and 6 cases of cystic ducts in the control group.The gallbladder artery showed in both groups.The average score of gallbladder artery showed in the observation group was higher than that in the control group(P<0.05).Conclusion Multi-slice spiral CT is a valuable tool for laparoscopic cholecystectomy in patients with cholecystolithiasis and cholecystitis.It can clearly show the relationship between the cystic duct and the gallbladder artery and its surrounding anatomy.To provide a reliable basis for preoperative evaluation of LC.