Department of Ultrasonography, Gaochun County Hospital, Gaochun, Jiangsu province, People's Republic of China.
Cell Biochem Biophys. 2011 Nov;61(2):449-52. doi: 10.1007/s12013-011-9210-8.
To evaluate the application of intraoperative ultrasound (IOUS) during partial hepatectomy to accurately detect and remove intrahepatic bile duct stones. Intrahepatic bile duct stones were precisely localized during surgery by using IOUS. Furthermore, guiding stone extraction, and determining the scope of liver resection and choice of surgical procedures were also evaluated using this technique. Of the 25 patients used in this study, 16 patients received a left lateral liver resection, 7 patients received a left liver resection, 1 patient had a liver resection of segments V and VI, 9 patients had common bile duct stones, and 6 patients had bile duct stones that underwent jejunal Roux-en-y anastomosis. In addition, IOUS exploration after liver resection and post-operative T-tube cholangiography showed one case with residual stones. The use of IOUS showed high diagnostic accuracy, while also rectifying the misdiagnosis and missed diagnosis of bile stones in preoperative imaging. IOUS also assisted with positioning accuracy, which is very important in determining the extent of surgical resection and choice of surgical procedure. Thus, IOUS can dynamically monitor the surgical procedure, guide the operation, and inspect the outcome of operations, therefore, effectively improving the quality of operation.
为了评估术中超声(IOUS)在部分肝切除术中的应用,以准确检测和清除肝内胆管结石。术中超声(IOUS)可精确定位肝内胆管结石。此外,还评估了该技术在引导取石、确定肝切除范围和手术方式选择方面的应用。在本研究中,25 例患者中,16 例行左外侧肝切除术,7 例行左半肝切除术,1 例行 V 段和 VI 段切除术,9 例患者合并胆总管结石,6 例患者合并胆肠 Roux-en-y 吻合术后胆管结石。此外,肝切除术后 IOUS 探查和术后 T 管胆管造影显示 1 例有残余结石。IOUS 显示出较高的诊断准确性,同时纠正了术前影像学对胆管结石的误诊和漏诊。IOUS 还协助定位准确,这对于确定手术切除范围和手术方式的选择非常重要。因此,IOUS 可以动态监测手术过程,指导手术,并检查手术结果,从而有效提高手术质量。