超声诊断在胆囊三角中的应用_West China Medical Journal

Authors：

 王硕华 , 郭峰 , 程景华

成都市第六人民医院超声科（成都，610051）;

Corresponding author：

Keywords：

B型超声诊断; 胆囊三角; 急性结石性胆囊炎; 胆囊壁厚度

DOI：

10.7507/1002-0179.20140470

Video：

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目的探讨B型超声测定术前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。方法将2011年7月－2012年12月42例急性结石性胆囊炎患者，按术前B型超声提示的胆囊壁厚情况分为壁厚≥4 mm组（n=17）和＜4 mm组（n=25），分析胆囊三角与胆囊壁厚之间的关系。结果 42例患者术中胆囊三角可显示率为52.4%，其中胆囊壁厚≥4 mm组显示率仅为17.6%，＜4 mm组显示率为76.0%，两组在术中胆囊三角分离显示率比较，差异有统计学意义（P＜0.05）。随着胆囊壁厚度的增加，胆囊三角显示清晰度减低。结论术前B型超声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。

Citation： 王硕华, 郭峰, 程景华. 超声诊断在胆囊三角中的应用. West China Medical Journal, 2014, 29(8): 1541-1542. doi: 10.7507/1002-0179.20140470 Copy

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1. 熊小兵, 李华. B型超声在腹腔镜胆囊切除术中的应用[J]. 当代医学, 2010, 16(9):147-148, 15.
2. Rebelo A, Ribeiro PM, Correia AP, et al. Endoscopic papillary large balloon dilation after limited sphincterotomy for difficult biliary stones[J]. World J Gastrointest Endosc, 2012, 4(5):180-184.
3. 张波, 周群, 吴宁, 等. B超影像对腹腔镜胆囊切除术难度评估的临床研究[J]. 西南国防医药, 2009, 19(3):299-300.
4. Wang BJ, Kim JH, Yu HC, et al. Fetal intrahepatic gallbladder and topographical anatomy of the liver hilar region and hepatocystic triangle[J]. Clini Anat, 2012, 25(5):619-627.
5. 王幼玲. 浅析B超预测腹腔镜胆囊切除术的价值[J]. 医学信息·中旬刊, 2011, 24(5):2154-2155.
6. Sanjay P, Kulli C, Polignano FM, et al. Optimal surgical technique, use of intra-operative cholangiography (IOC), and management of acute gallbladder disease:the results of a nation-wide survey in the UK and Ireland[J]. Ann R Coll Surg Engl, 2010, 92(4):302-306.
7. Abdalla S, Pierre S, Ellis H. Calot's triangle[J]. Clin Anat, 2013, 26(4):493-501.
8. Horisberger K, Grossen E, Schöb O. How to meet the challenge of flexible exposure of the Calot triangle in SILS cholecystectomy[J]. Surg Laparosc Endosc Percutan Tech, 2012, 22(2):e63-65.
9. Reibetanz J, Wierlemann A, Germer CT, et al. A novel technique for fundal retraction of the gallbladder in single-port cholecystectomy[J]. J Laparoendosc Adv Surg Tech A, 2011, 21(5):427-429.
10. Hubert C, Annet L, van Beers BE, et al. The "inside approach of the gallbladder" is an alternative to the classic Calot's triangle dissection for a safe operation in severe cholecystitis[J]. Surg Endosc, 2010, 24(10):2626-2632.

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