Kang E H, Middleton W D, Balfe D M, Soper N J
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110.
Radiology. 1991 Nov;181(2):439-42. doi: 10.1148/radiology.181.2.1833786.
To determine the normal postoperative appearance of gallstones in the common duct at ultrasound (US) examination, the significance of fluid collections after surgery, and the usefulness of routine postoperative scanning, US of the right upper quadrant was performed in 106 consecutive patients 24 hours after laparoscopic cholecystectomy. The location, volume, and appearance of fluid collections were recorded. The maximum diameter of the common duct was measured in all patients and compared with preoperative measurements in 58 patients. Small fluid collections were identified in the gallbladder fossa in 56 patients (53.0%). Fluid collections did not correlate with fever or white blood cell count. In 15 of 58 patients, the diameter of the common duct had increased on the postoperative scan. This did not correlate with alkaline phosphatase or bilirubin levels. One hundred one patients (95.3%) were discharged the day after surgery. Routine US performed the day after surgery did not alter management; the authors conclude that it is unwarranted in their group of patients.
为了确定超声（US）检查时胆总管内术后胆囊结石的正常表现、术后积液的意义以及术后常规扫描的作用，对106例连续行腹腔镜胆囊切除术的患者在术后24小时进行右上腹超声检查。记录积液的位置、体积和表现。测量所有患者胆总管的最大直径，并与58例患者的术前测量值进行比较。56例患者（53.0%）在胆囊窝发现少量积液。积液与发热或白细胞计数无关。58例患者中有15例术后扫描显示胆总管直径增大。这与碱性磷酸酶或胆红素水平无关。101例患者（95.3%）术后次日出院。术后次日进行的常规超声检查未改变治疗方案；作者得出结论，在他们的患者群体中，这种检查是不必要的。
