腹腔镜胆囊术前彩色超声定位肝中静脉的临床意义
肝中静脉；胆囊切除术,腹腔镜；出血,,肝中静脉；胆囊切除术，腹腔镜；出血,1资料与方法,2结果,3讨论,参考文献：
【摘要】 目的：探讨腹腔镜胆囊切除术(LC)前彩色多普勒超声波检查在避免术中损伤胆囊床肝中静脉大出血的临床意义。方法：2003年1月～2005年1月行LC的1 100例患者术前经彩色多普勒超声波检查常规对胆囊床肝中静脉及属枝的解剖关系进行分析。结果：对于术前经彩色多普勒超声波检查明确的肝中静脉直接和胆囊床相贴的非萎缩性胆囊炎胆囊结石的102例患者，采用紧靠胆囊壁的浆肌层直接进行剥离；而慢性萎缩性胆囊炎胆囊结石的24例患者，采用胆囊粘膜切除，或者直接开腹手术切除，未发生因损伤胆囊床肝中静脉而大出血。结论：术前常规彩色多普勒超声波检查，明确胆囊床肝中静脉及属枝位置关系，对于肝中静脉与胆囊床相贴的病例，采用紧靠胆囊壁的浆肌层剥离，或采用胆囊粘膜切除，或直接开腹手术切除，可以避免因损伤胆囊床肝中静脉而导致大出血。【关键词】 肝中静脉；胆囊切除术，腹腔镜；出血
LC plans directed by preoperative chromatic color ultrasound locatization of venae hepaticae intermediate
CUI Jianchun,LI Li,RONG Daqing,et al.
General Surgery of Liaoning Province People's Hospital,Shenyang 110032,China
【Abstract】 Objective:To investigate the direction role of preoperative chromatic color ultrasound locatization of venae hepaticae intermediae on laparoscopic cholecystecyomy(LC).Methods:All the 1 300 cases from 2003.1 to 2006.1 treated with LC were detected by the chromatic color ultrasound preoperatively.The anatomy relationship of venae hepaticae intermediae and its branches on gallbladder bed were analysed,which could be the reference during the LC.Results:For 112 patients suffered from inatrophic cholecystitis and cholecystolithiasis,whose gallbladders were decoherence directdly from ectoptygmamuscular coat close to the gallbladder wall.Gallbladder endoscopicmucosalresection(EMR)or open cholecystectomy were applied in 28 cases developed with chronic atrophic cholecystitis and cholecystolithiasis.No hemorrhoea resulted from venae hepaticae intermediae on gallbladder bed injury were occured in all the cases.Conclusions:Preoperative chromatic color ultrasoud locatization of venae hepaticae intermediae routinely can be helpful to choose LC methods. ......
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