目的 探讨胆囊结石患者微创保胆取石术前彩超检查胆囊情况、脂餐后胆囊排空功能的临床体会.方法 患者术前空腹时详细记录胆囊大小、壁厚情况、结石数目及大小,有无皱襞及位置,并且对胆囊底的位置进行定位；脂餐后60min、120min测量胆囊大小,估测排空功能.结果 97例中68例胆囊排空功能≥30％,脂餐后60min胆囊排空功能(％)均数65.23±27.69,脂餐120min胆囊排空分数(％)均数64.5±28.12,P＞0.05,两者间无统计学意义；胆囊壁上息肉样病变28例,胆囊壁间结石3例,胆囊皱襞15例,1例胆囊皱襞只留有针孔样结构,均行微创保胆取石术,胆囊排空功能＜30％29例改行腹腔镜下胆囊切除术.结论 彩超显像观察胆囊结石患者胆囊情况、脂餐后胆囊排空功能的变化,保证了胆囊结石患者微创保胆取石术既保留具有排空功能的胆囊,又取尽结石的预期疗效.%Objective To explore the preoperative ultrasonographic status in patients with gallstone underwent minimally invasive gallbladder-preserving cholecystolithotomy and to present the clinical experience of postprandial emptying function of gallbladder. Methods A detailed record of the gallbladder size, wall thickness, the number and size of stones, the presence or absence of plica and position in patients with preoperative fasting was kept and the base of gallbladder location was positioned. The emptying function of gallbladder 60 min and 120 min after fat meal was measured and the size of gallbladder was estimated. Results In the 97 cases, the emptying function of gallbladder more than or equal to 30% was found in 68 cases. The average of gallbladder emptying function (%) 60 min after fat meal was 65. 23 ± 27. 69 and the average gallbladder emptying fraction (%)120 min after fat meal was 64. 5 ± 28. 12, which was not statistically significant ( P >0. 05). Polypoid lesions in gallbladder wall were found in in 28 cases, intramural calculus in 3 cases, gallbladder plica in 15 cases, 1 case of gallbladder plica leaving only the needle like structure, which were all subjected to minimally invasive gallbladder-preserving cholecystolithotomy. As for the 29 cases with gallbladder emptying function less than 30% , all underwent laparoscopic cholecystectomy. Conclusion The color Doppler ultrasound can observe the postprandial changes in gallbladder emptying function in patients with gallstones, ensure the gallbladder-preserving cholecystolithotomy as well as therapeutic efficacy for removing stones.
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