摘要：目的：探讨胆管结石术后残余结石的诊断手段。方法：总结142例胆管结石术后的T管造影、B超和胆镜对残余结石的诊断情况。结果：142例T管造影阳性例数37例，假阴性14例。B超诊断阳性44例，假阴性14例。胆镜诊断53例，假阴性5例。三种检查的诊断准确率分别是58.6%、72.4%、91.4%。结论：T管造影及B超虽然是胆管结石术后残余结石诊断的最常用方法，但由于受影响的因素较多而出现假阴性而造成漏诊，胆镜能发现T管造影及B超不能发现的结石，同时可同步处理。提出肝内外胆管结石术后应常规进行胆镜的检查治疗，以提高胆管结石手术的质量，降低残石率和再手术率方面有一定的价值。

    关键词：T管造影；B超；胆镜；残余结石

    Analysis on Diagnosis of Residual Gallstones

    CHE Si-yao,YE Guan-rui,PAN Si-bo,et al

    (Gaozhou People's Hospital, Guangdong Gaozhou 525200,China)

    Abstract： Objective： To explore an effective diagnostic. Method：Postoperative residual gallstones with guidance of T tube chilangiography (groupI),B-mode ultrasound(group II) and choledochoscopy (group III)in 142 patients were analyzed retrospectively. Result: Among the all 142 cases allocated into three groups, the numbers of positive cases were 37 (group I),44 (group II) and 53 (group III)respectively.The accurate rates of diagnoses of three methods were 58.6%,72.4% and 91.4% respectively.Conclusions： Although T tube cholangiograph and B-mode ultrasound are most frequently used to diagnose postoperative residual gallstones,which occur false negative results and cause diagnosis to be neglected with influence of many factors.Gallstones that the former two means cannot detect can be done by choledochoscopy and can be removed at the appropriate time.Patients with undergoing cholelithoitomy should be taken an examination with choledochscopy routinely,which presents some value in improving the quality of surgery treatment and decreasing incident of residual stones and reoperation. ......