| Objective: To evalue the method of contrast-enhanced ultrasound guiding NS injection to the bile duct in detecting residual stones in the common bile duct after biliary surgery.Methods: This research include 41 patients with T-tube and 10 patients with PTCD dilated tube from August 2016 to October 2017,these patients received the su rgery in our hospital.All of them signed the informed consent and conform the rule of ethics.They completed contrast-enhanced ultrasound guiding NS injection and X-ray cholangiography,then they received choledochoscopy detection.We record the length and diameter before and after contrast-enhanced ultrasound guiding NS injection,then use paired t-test to detect the difference between them.Then the detection results of residual stones were recorded and compared with the results of choledochoscopy,we used Kappa value and Youden index to identify if they had consistent with each other.Results:All the patients completed contrast-enhanced ultrasound guiding normal saline injection test,X-ray cholangiography and choledochoscopy.When using the contrast-enhance ultrasound guiding saline injection test,the full display rate of common bile duct is 92.2%.The results have a higher Kappa value compared with choledochoscopy,accuracy is 88.2% and Youden index is 0.73,which are much high compared with cholangiograhy.If combine the results of these two tests,the final accuracy can reach 94.3% and Kappa value can be 0.885,which has a great consistency with choledoscopy.Conclusion: Contrast-enhanced ultrasound guiding normal saline injection into the bile duct can help us to detect common bile duct and the residual stone and improve possible rate.And the result can be combined with cholangiopraphy,which can have nearly the same results with choledoscopy.This method of contrast-enhanced ultrasound can be an important examination before the removing of T-tube or PTCD tube. |
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