磁共振胰胆管成像联合腹部超声检查在经腹腔镜胆囊切除术前的应用价值

To explore the value of MRCP combined with abdominal ultrasonography before laparoscopic cholecystectomy.

目的:探讨联合应用磁共振胰胆管成像(MRCP)和腹部超声(TUS)检查,避免在经腹腔镜胆囊切除(LC)术后并发症的应用价值。方法:收集我院2009年4月—2016年10月期间我院拟行LC术胆石症患者228例,术前随机平均分为TUS组、MRCP组和MRCP联合TUS组,每组76例,以LC术中探查情况为金标准,比较三组术中胆道变异检出率和胆总管结石诊断率。结果:TUS检查诊断胆道变异11例,准确率(68.7%),胆总管结石20例,准确率(64.5%);MRCP检查诊断胆道变异13例,准确率(81.2%);胆总管结石22例,准确率(70.9%);MRCP联合TUS诊断胆道变异14例,准确率(87.5%);胆总管结石27例,准确率(87.1%)。除MRCP组和MRCP联合TUS组在诊断胆道解剖变异方面无统计学差异(P>0.05)外,其余各组在胆道解剖变异和胆总管结石比较中差异均有统计学意义(P<0.05)。结论:LC术前选择MRCP联合TUS检查有利于防止胆道损伤,避免胆总管结石遗漏,从而优化手术方案、降低术后风险。

Objectivee To explore the clinical value of combined application of magnetic resonance cholangiopancreatography(MRCP) and abdominal ultrasound(TUS) before laparoscopic cholecystectomy(LC).) and abdominal ultrasound(TUS) before laparoscopic cholecystectomy(LC). Methods Methods In this study, 228 cases of cholelithiasis in our hospital from April 2009 to October 2016 were prospectively studied. The patients were divided into 3 groups TUS, MRCP and MRCP combined with TUS randomly. The detection rate of biliary tract variation and the diagnostic rate of common duct stones were compared in the three groups. e of common duct stones were compared in the three groups. Results Results TUS group,diagnosis of 11 cases of biliary tract variation, accuracy rate(68.7%), choledocholithiasis 20 cases, accurate rate(64.5%); MRCP group, diagnosis of 13 cases of biliary tract variation, accuracy rate(81.2%); choledocholithiasis 22 cases, accurate rate(70.9%); MRCP combined with TUS group,diagnosis of biliary tract mutation, accuracy rate(87.5%); choledocholithiasis 27 cases, The accuracy(87.1%). Except for the diagnosis of biliary tract variation, there was no significant difference between group MRCP and MRCP combined with TUS(P>0.05), the difference between the other groups was statistically significant(P < 0.05). Conclusion:. Selection of MRCP combined with TUS before LC is helpful to prevent biliary tract injury and avoid common bile duct stone leakage, so as to optimize operation plan and reduce postoperative risk.