From the Departments of Radiology (N.M.H., S.K.) and Surgery (M.S.P.), NYU School of Medicine, 660 First Ave, New York, NY 10016.
Radiographics. 2014 Jan-Feb;34(1):119-38. doi: 10.1148/rg.341125181.
The interpretation of images obtained in patients who have recently undergone abdominal or pelvic surgery is challenging, in part because procedures that were previously performed with open surgical techniques are increasingly being performed with minimally invasive (laparoscopic) techniques. Thus, it is important to be familiar with the normal approach used for laparoscopic surgeries. The authors describe the indications for various laparoscopic surgical procedures (eg, cholecystectomy, appendectomy, hernia repair) as well as normal postoperative findings. For example, port site hernias are more commonly encountered in patients with trocar sites greater than 10 mm and occur at classic entry sites (eg, the periumbilical region). Similarly, preperitoneal air can be encountered postoperatively, often secondary to trocar dislodgement during difficult entry or positioning. In addition, intraperitoneal placement of mesh during commonly performed ventral or incisional hernia repairs typically leads to postoperative seroma formation. Familiarity with normal findings after commonly performed laparoscopic surgical procedures in the abdomen and pelvis allows accurate diagnosis of common complications and avoidance of diagnostic pitfalls.
对于近期接受过腹部或骨盆手术的患者，其图像的解读具有挑战性，部分原因是先前采用开放性手术技术进行的手术，现在越来越多地采用微创（腹腔镜）技术进行。因此，熟悉腹腔镜手术的常规入路非常重要。作者描述了各种腹腔镜手术的适应证（例如，胆囊切除术、阑尾切除术、疝修补术）以及术后正常发现。例如，在套管部位大于 10 毫米的患者中更常遇到套管部位疝，并且发生在经典的进入部位（例如，脐周区域）。同样，术后可能会遇到腹膜前积气，通常是由于在困难进入或定位时套管移位所致。此外，在常见的腹侧或切口疝修补术中，将网片置于腹膜内通常会导致术后血清肿形成。熟悉腹部和骨盆中常见腹腔镜手术的正常发现可准确诊断常见并发症并避免诊断陷阱。
