Journal of Practical Hepatology ›› 2024, Vol. 27 ›› Issue (3): 466-469.doi: 10.3969/j.issn.1672-5069.2024.03.037

• Cholelithiasis • Previous Articles     Next Articles

Choice of open orlaparoscopic cholecystectomy under guidance of preoperative multi-slice spiral CT scan in patients with gallstones and cholecystitis

Chen Ai’e, Peng Xiangqian, Chen Lina   

  1. Department of Radiology, People's Hospital, Affiliated to Three Gorges University, Jianli 433300, Hubei Province, China
  • Received:2023-12-26 Online:2024-05-10 Published:2024-06-11

Abstract: Objective This study was conducted to explore application of preoperative multi-slice spiral CT (MSCT) scan for selection of surgical Methods in patients with gallstones and cholecystitis (GCS). Methods A total of 104 patients with GCS were enrolled in our hospital between April 2021 and April 2023, and all patients underwent MSCT examination to observe display of gallbladder artery and gallbladder ducts. Base on the imaging manifestations, open or laparoscopic cholecystectomy (LC) were performed. Results Of the 104 patients with GCS, display rate and display score of gallbladder ducts were 90.4% and (1.5±0.2) points, with duct course variation in 11 cases, including low-level gallbladder ducts in 2 cases, right vagus duct formation in 3 cases and high-level gallbladder ducts in 6 cases, and the display rate and display score of gallbladder artery were 94.2% and (1.8±0.2) points, with vessel course variation in 13 cases, including type Ib in 4 cases, type IIa in 2 cases and type IIb in 7 cases; open cholecystectomy was conducted in 16 patients because of gallbladder trigonum undefined pre-operationally, and LC was performed in left 88 patients; intraoperative blood loss, operation time and hospital stay in LC-treated patients were (36.4±7.8)mL, (46.7±8.3)min and (6.3±1.1)d, all much less or shorter than [(50.6±8.4)mL, (73.5±9.6)min and (8.9±1.5)d, respectively, P<0.05] in open operation-treated patients; incidence of post-operational complications, such as infection, bleeding and bile leakage in LC group was 8.0%, significantly lower than 25.0% (P<0.05) in open surgery group. Conclusion The preoperative MSCT scan could clearly display gallbladder ducts and gallbladder artery in patients with GCS, which might help precisely select operation mode and get a best outcomes.

Key words: Gallstone, Cholecystitis, Multi-slice spiral CT scan, Cholecystectomy, Diagnosis