Chen R C, Liu M H, Tu H Y, Chen W T, Wang C S, Chiang L C, Chen P H
Department of Radiology, Taipei Municipal Jen-Ai Hospital, Taiwan, ROC.
Clin Radiol. 1995 Aug;50(8):570-2. doi: 10.1016/s0009-9260(05)83195-2.
We prospectively analysed 51 consecutive cases who underwent laparoscopic cholecystectomy from June 1992 to February 1993. There were 35 cases of chronic cholecystitis and 16 cases of acute cholecystitis. All underwent pre-operative ultrasonography, complete blood cell count, liver function test and endoscopic retrograde cholangiopancreatography. Of those 44 had post-operative ultrasound within the first 2 d and again on the seventh day. In 35 cases of chronic cholecystitis, 31 of 32 cases with a pre-operative gallbladder (GB) wall thickness of less than 6 mm were successfully resected laparoscopically. All three cases with a GB wall thicker than 6 mm were converted to open cholecystectomy. In acute cholecystitis, the wall thickness of the laparoscopic cholecystectomy group ranged from 2 to 9 mm (average 4 mm) and the wall thickness of the conversion group was 4-7 mm (average 6 mm). Post-operative fluid accumulation was noted in 28 (63.6%) cases. There was no correlation between post-operative pyrexia, duration of post-operative pain, clinical complications and the presence of fluid accumulation in the GB fossa. However, of four cases with increasing fluid on the seventh day, three developed complications. We conclude that ultrasonography is valuable in chronic cholecystitis for selecting cases for laparoscopic cholecystectomy.
我们前瞻性分析了1992年6月至1993年2月连续接受腹腔镜胆囊切除术的51例患者。其中慢性胆囊炎35例，急性胆囊炎16例。所有患者均接受了术前超声检查、全血细胞计数、肝功能检查和内镜逆行胰胆管造影。其中44例在术后第1天和第7天进行了超声检查。在35例慢性胆囊炎患者中，术前胆囊壁厚度小于6mm的32例中有31例成功进行了腹腔镜切除。胆囊壁厚度大于6mm的3例均改行开腹胆囊切除术。急性胆囊炎患者中，腹腔镜胆囊切除术组胆囊壁厚度为2～9mm（平均4mm），改行开腹手术组为4～7mm（平均6mm）。28例（63.6%）患者术后出现积液。术后发热、术后疼痛持续时间、临床并发症与胆囊窝积液之间无相关性。然而，在术后第7天积液增多的4例患者中，3例出现了并发症。我们得出结论，超声检查在慢性胆囊炎患者选择腹腔镜胆囊切除术病例时具有重要价值。
