100 例腹腔镜 Roux-en-Y 胃旁路术（LRYGBP）和腹腔镜袖状胃切除术（LSG）前的术前经腹超声检查（US）。在学习曲线期间，它是否有益且可靠？

Preoperative transabdominal ultrasonography (US) prior to laparoscopic Roux-en-Y gastric bypass (LRYGBP) and laparoscopic sleeve gastrectomy (LSG) in the first 100 operations. Was it beneficial and reliable during the learning curve?

机构信息

Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland.

出版信息

Obes Surg. 2012 Mar;22(3):416-21. doi: 10.1007/s11695-011-0416-z.

DOI:10.1007/s11695-011-0416-z

PMID:21660643

Abstract

BACKGROUND

Preoperative ultrasonography (US) prior to laparoscopic Roux-en-Y gastric bypass (LRYGBP) aimed to find possible gallstones. The aim of this study was to evaluate the reliability of the US in evaluating the size and consistency of the left lobe of the liver.

METHODS

One hundred LRYGBP and LSG were performed in our new bariatric surgery unit by two surgeons. All patients underwent preoperative US to evaluate the size and consistency of the left lobe of the liver. A consultant radiologist reviewed the US findings, which were then compared to the intraoperative findings.

RESULTS

The mean preoperative body mass index was 49. All patients had co-morbidities. The intraoperative evaluation showed an enlarged left lobe of the liver in 23 patients, whereas the US found enlargement only in eight patients, but revealed eight false positives. In the intraoperative evaluation, fatty liver was observed in five patients, only four of whom were shown in the US, but US revealed 77 false positives. In evaluating the size of the left lobe, US had 35% sensitivity, 90% specificity, 65% false negative rate (FNR) and 10% false positive rate (FPR). In evaluating the consistency, US had 80% sensitivity, 18% specificity, 20% FNR and 82% FPR.

CONCLUSION

Preoperative US is unreliable in evaluating the size and consistency of the left lobe of the liver prior to LRYGBP and LSG and has limited prognostic value for surgical complications and complexity of surgery.

摘要

背景

腹腔镜 Roux-en-Y 胃旁路术（LRYGBP）术前超声检查旨在发现可能存在的胆结石。本研究旨在评估超声检查评估左肝叶大小和质地的可靠性。

方法

由两位外科医生在我们新的减重外科手术单元中进行了 100 例 LRYGBP 和 LSG。所有患者均接受术前超声检查以评估左肝叶的大小和质地。一位顾问放射科医生对超声检查结果进行了回顾，并与术中发现进行了比较。

结果

术前平均体重指数为 49。所有患者均存在合并症。术中评估显示 23 例患者左肝叶增大，而超声检查仅发现 8 例增大，但发现 8 例假阳性。术中评估发现 5 例脂肪肝，其中仅 4 例在超声检查中显示，但超声检查显示 77 例假阳性。在评估左肝叶大小方面，超声检查的敏感性为 35%，特异性为 90%，假阴性率（FNR）为 65%，假阳性率（FPR）为 10%。在评估质地方面，超声检查的敏感性为 80%，特异性为 18%，FNR 为 20%，FPR 为 82%。