肝内胆管结石

Firstly,all patients have been excided the upper ductus choledochus,the liver gross duct,left right liver duct besides one centimeter of liver duct that lies upwards the hepatolith.Secondly, we have sutured the excided bile duct, which has been shaped acetabuliform,lifted one part of jejunums,intered non-port one subcuneously,and then inosculated gall with enteron by Roux-en-Y way.Lastly,we have partly excised the ill liver in regular way.Results 26 ones have been follow-up for 1～10 years.The rate is 81 percents,average for 6 years.

32例肝内胆管结石均接受皮下盲袢型胆肠吻合术，其中结石位于右肝7例（22%），左肝9例（28%），两肝均有16例（50%）；结石合并肝胆管狭窄24例（75%），全部病例均切开胆总管上部、肝总管、左右肝管，并切开肝内胆管狭窄部以上1cm肝管，将切开的胆管做必要的缝合，形成碟状，取一段空肠上提，盲袢埋置皮下，再做胆肠Roux-en-Y吻合，病肝做规则性肝部分切除术。

METHODS: A total of 52 cases with choledocholithiasis, hepatolithiasis, carcinoma of the pancreatic head, carcinoma of the choledoch, carcinoma of the gallbladder, hepatoblastoma and choledochocyst were examined by MRCP combined with MRI and the results of MRCP and MRI were compared with those of operation.

对52例胆道梗阻患者，包括胆总管结石、肝内胆管结石、胰头癌、胆管癌、胆囊癌、肝母细胞瘤、胆总管囊肿，术前行MRCP联合MRI检查。

Objective To study the effect of biliary tract e xpansion techniquecombined with electrohydraulic lithotripsy in treating intrahepatic biliary stricture and hepatolith iasis blockage or complex hepatolithiasis.

目的总结胆道镜胆道扩张技术和液电碎石对合并有肝内胆管狭窄、胆道嵌顿结石、巨大结石复杂性肝内胆管结石的治疗效果。

Methods: Sixty-three cases of left hepatolith underwent operations of left-half hepatectomy, Roux-en-Y cholangio-jejunostomy and removal of stones by cholangiotomy under the condition of hemihepatic blood flow occlusion at normal atmospheric temperature.

回顾性总结63例左肝内胆管结石患者在常温下阻断左半肝血流，行左肝叶切除、肝内含石胆管直视下切开取石和肝胆管Roux-en-Y胆肠吻合等手术后，患者术后并发症、肝内胆管结石的复发率、再手术率以及术后患者的肝功能恢复情况等。

Methods: Sixtythree cases of left hepatolith underwent operations of lefthalf hepatectomy, RouxenY cholangiojejunostomy and removal of stones by cholangiotomy under the condition of hemihepatic blood flow occlusion at normal atmospheric temperature.

回顾性总结63例左肝内胆管结石患者在常温下阻断左半肝血流，行左肝叶切除、肝内含石胆管直视下切开取石和肝胆管Roux-en-Y胆肠吻合等手术后，患者术后并发症、肝内胆管结石的复发率、再手术率以及术后患者的肝功能恢复情况等。

Methods the clinical data of 56 patients with hepatolithiasis and intrahepatic cholangiocarcinoma were retrospectively analyzed.

目的 探讨肝内胆管结石合并肝内胆管癌的临床特点、诊断和治疗方法。

Methods The clinical data of 56 patients with hepatolithiasis and intrahepatic cholangiocarcinoma were retrospectively analyzed.

目的 探索肝内胆管结石合并肝内胆管癌的临床特征、诊断和治疗方法。

RESULTS:① The demonstrating rate of intrahepatic bile duct calculus was 87.5% and that of other parts was 100%.② The rate of orientative diagnosis of choledocholithiasis was 94.7%, that of intrahepatic bile buct calculus was 75.0％ and that of other parts was

结果：①定位诊断：对肝内胆管结石梗阻部位显示率为87.5%，对其他梗阻部位显示率为100%；②定性诊断：术前诊断胆总管结石正确率为94.7%，肝内胆管结石正确率为75.0%，其他胆道梗阻正确率为90.9%～100%。

Results:In this group there were respectively 8 calculi of intrahepatic duct,9 calculi of extrahepatic duct,4 stenosis of bile duct,3 duodenal papillitis,2 excess residual cystic duct and 2 stubble cholecystitis,which were managed surgically.There were respectively 1 duodenal diverticulum,10 bile back flow gastritis,5 functional dyspepsia,1 chronic pancreatitis and 1 ulcer,which were cured via expectant treatment.

结果：本组肝内胆管结石8例，肝外胆管结石9例，胆管狭窄4例，十二指肠乳头炎3例，胆囊管残留过长2例，残株胆囊炎2例，分别采用外科手术治疗；十二指肠憩室1例，胆汁返流性胃炎10例，功能性消化不良5例，慢性胰腺炎1例，溃疡病1例，采用内科保守治疗好转。

Complete resection of lesions is the most effective way in the treatment of hepatolithiasis. The current hepatolithiasis treatment of liver resection has been the trend in hepatic segment or subsegment.

切除病灶是彻底治疗肝内胆管结石最有效的方法，目前肝内胆管结石肝切除治疗已趋向于肝段化和亚肝段化。

With Death guitarist Schuldiner adopting vocal duties, the band made a major impact on the scene.

随着死亡的吉他手Schuldiner接受主唱的职务，乐队在现实中树立了重要的影响。

But he could still end up breakfasting on Swiss-government issue muesli because all six are accused of nicking around 45 million pounds they should have paid to FIFA.

不过他最后仍有可能沦为瑞士政府&议事餐桌&上的一道早餐，因为这所有六个人都被指控把本应支付给国际足联的大约4500万英镑骗了个精光。