十二指肠切开术

Their ages at operation were between 5 hours and 8.5 years, with a median of 4 days. Surgical treatment included duodenojejunostomy in nine, duodenoduodenostomy in five and duodenotomy with duodenoplasty in one.

病人手术时的年龄介於5小时大与8岁半之间，9个人接受十二指肠空肠造口吻合术，5个人接受十二指肠与十二指肠吻合术，1个人接受十二指肠切开术和十二指肠造形术。

Oversewn suture ligation of the bleeder by duodenotomy successfully treated the patient.

所以，病人接受紧急开腹手术，做十二指肠切开术，在出血点处做缝合结扎手术而成功的治疗。

Fifteen patients underwent operation, including gastrostomy (6 cases), gastrotomy (4 cases), partial gastric fundus resection (2 cases), others operations (2 case), and laparotomy exploration (1 case); among them four patient died.

手术治疗15例，包括胃切开减压、胃造口术（6例），胃切开减压后再缝合创口（3例），胃切开减压、胃造口、空肠造口术（1例），胃底部分切除术（2例），十二指肠空肠吻合术（1例），空肠造口术（1例），开腹探查术未切开胃壁（1例），死亡4例(26.7%)。

Objective:To observe the clinical results of LC combined with EST in treating cholecystolithiasis and choledocholithiasis.

目的： 总结腹腔镜胆囊切除术＋十二指肠乳头括约肌切开术治疗胆囊、胆总管结石的体会。

Methods:The clinical data of 6 cases that received LC combined with EST herapy for cholecystolithiasis and choledocholithiasis were analyzed retrospectively.

目的：总结腹腔镜胆囊切除术＋十二指肠乳头括约肌切开术治疗胆囊、胆总管结石的体会。方法：为6例患者行LC＋EST。

Results: Among 80 cases of ACST, 76 cases were successfully implemented LC, gallbladder puncture and decompression choledocholithotomy T-tube drainage were performed in 11 cases, choledocholithotomy T-tube drainage in 15 cases, common bile duct gall bladder fistula Toishi T-tube drainage in 14 cases, gallbladder removal choledocholithotomy T-tube drainage in 36 cases, operative time 15-120 min, bleeding 10-80 ml; 4 cases transitted laparotomy, 1 case of gallbladder and surrounding tissue adhesion serious, ampulla signs disappear, and the hepatoduodenal ligament ill-defined, 2 cases of gallbladder contraction deep within the liver, gallbladder triangle scar adhesions, and 1 case of duct stone impaction and severe adhesions; postoperative hospital stay was 8-11 d, all were well recovered; pathological diagnosis, acute cholecystitis in 41 cases （51.2％）, acute suppurative cholecystitis in 24 cases （30.0％）, acute gangrenous cholecystitis in 15 cases （18.8％）.

结果：重症急性胆囊炎80例，76例成功实施LC，其中，胆囊穿刺减压胆总管切开取石T管引流11例，胆总管切开取石T管引流15例，胆囊造瘘胆总管切开取石T管引流14例，胆囊切除胆总管切开取石T管引流36例，手术时间15～120 min，术中出血10～85 ml；4例中转开腹，其中，1例胆囊与周围组织粘连严重，壶腹部标志消失，与肝十二指肠韧带界限不清，2例胆囊萎缩深陷肝脏内，胆囊三角区瘢痕粘连，1例胆囊管结石嵌顿且严重粘连，术后住院时间8～11 d，术后恢复均良好，治愈出院；80例术后病理诊断，急性单纯性胆囊炎41例（51.2％），急性化脓性胆囊炎24例（30.0％），急性坏疽性胆囊炎15例（18.8％）。

After preoperative treatment, 12 patients (26%) were considered to have clinically resectable tumors, and nine (19% of the total number of patients) had Whipple pancreatoduodenectomy one month after completion of radiation.

化疗治疗后，12例(26%)病人被认定有临床可切除肿瘤，9例(19%)完全放疗一个月后进行Whipple 胰腺十二指肠切开术。

Medical School of Xian Jiaotong University, Xian 710061, ChinaABSTRACT: Objective To evaluate the efficacy and safety of endoscopic sphincterotomy in treating common bile duct stone or strictive papillitis, and then analyze possible related risk factors for longterm complications after EST.

目的 探讨内窥镜下十二指肠乳头括约肌切开术(endoscopic sphincterotomy， EST)对胆总管结石、十二指肠乳头狭窄等疾病的治疗效果，并对术后出现的远期并发症的可能危险因素进行分析。

Objective To compare the effects of endoscopic sphincterotomy vs endoscopic papillary balloon dilation in the treatment of choledocholith and to explore the indications for these two techniques.

目的 比较内镜下十二指肠乳头切开术与十二指肠乳头球囊扩张术两种方法治疗胆总管结石的优点和缺点，探讨两种方法的适应证。

Methods Sixtyeight patients were randomly allocated to two groups, and then received endoscopic sphincterotomy during 24 h or conventional treatment.

68例随机分为内镜组和传统组各34例（重症患者分别有9、8例），所有患者入院后即给予内科综合治疗，内镜组患者入院24 h内行十二指肠乳头括约肌切开术，传统组患者待病情稳定后择期手术。

This one mode pays close attention to network credence foundation of the businessman very much.

这一模式非常关注商人的网络信用基础。

Cell morphology of bacterial ghost of Pasteurella multocida was observed by scanning electron microscopy and inactivation ratio was estimated by CFU analysi.

扫描电镜观察多杀性巴氏杆菌细菌幽灵和菌落形成单位评价遗传灭活率。