胆囊

Methods:Removal the fundus vesicae fellea, copus visicae fellea, majority of vesicae fellea anterior wall and vesicae fellea posterior wall,mucous membrane, normal method separate ligate ductus cysticus, only keep the all or part of vesicae fellea posterior wall on vesicae fellea bed.

其中，A组胆囊底部、体部及颈后壁的部分切除，仅胆囊床上胆囊后壁全部或部分保留，其残余黏膜给予剔除或破坏，胆囊管按常规方法分离后结扎。

No structural change was found in the 4th group. Conclusion The test prove that cholestasis would occure during TPN and become serious with time prolonging. Integrity and function of gallbladder-wall tissue cell could be defended and sustained by applying GLN, but there is no direct preventing action. There is apparent cholecy stokinetic and cholagogic fundations by applying CCK. But CCK would lose its function if gallbladder-wall was damaged. The test prove that TPN+GLN+CCK is the best way to prevent cholestasis during TPN.

TPN时间越长，胆汁淤积越重； GLN虽无直接收缩胆囊作用，但它可保护胆囊壁组织结构完整，而CCK虽有收缩胆囊、减轻胆汁瘀积作用，但晚期当胆囊壁组织结构破坏时，其作用减弱；联合应用GLN和CCK可能是预防TPN期间胆汁瘀积的一种方法。

We performed cholecystectomy in 10 cases, cholecystectomy and choledochotomy for common bile duct exploration and stone removal and T-tube drainage in 2, partial cholecystectomy in 3, cholecystostomy in 1. Pathological examination showed that it was AGC in all the patients.

该组行胆囊切除术10例，胆囊切除+胆总管切开取石+T管引流术2例，胆囊大部切除术3例，胆囊造瘘术1例，术后病理报告均为急性坏疽性胆囊炎。

Fourteen cases were converted to laparotomy (including 4 cases of type I Mirizzi syndrome, 4 cases of type II which all converted to laparotomy. 2 cases with the location of cystic duct into the common bile duct much lower than normal one, 2 cases with the confluence of cystic duct and cho ledoch locating in the posterior wall of choledoch. 1 case with a public wall shared for about 2 cm between the cystic duct and the choledoch).

结果 全组90例，术中中转开腹14例（包括Mirizzi综合征Ⅰ型4例Ⅱ型4例全部中转；胆囊管汇入胆总管过低2例；胆囊管开口于胆总管后壁2例；胆囊管与胆总管共同一侧壁，并并行约2 cm 1例；右肝管汇入胆囊管1例，开腹术中证实）。

Methods: Fifty-six cases of cholelith in residual gallbladder after cholecystectomy were analysed retrospectively. Among them, 18 patients under went conventional cholecystectomy, 16 patients underwent mini-lap cholecystectomy, 22 patients underwent laparoscopic cholecystectomy; 30 patients under went emergency operation and 26 patients under went selective operation; 42 patients' first operation was performed by under grade three hospital and 14 patients were performed by up gradethree hospital.

对56例残余胆囊结石再次手术的病例进行回顾性分析。56例中初次手术行经典胆囊切除术18例，小切口胆囊切除术16例，腹腔镜胆囊切除术22例；急诊手术30例，择期手术26例；初次手术在三级以下医院施行42例，在三级以上医院施行14例。

To prevent cholelith in residual gallbladder, it is important to choose the proper timing and mode of cholecystectomy, to anatomize cystic duct, common hepatic duct, common duct clearly and cut cystic duct 0.3~0.5cm apart from common duct.

合理掌握胆囊切除术的手术时机、和术式，在术中解剖清楚胆囊管、肝总管、胆总管三管关系，然后距胆总管0.3~0.5cm切断结扎胆囊管，是预防残余胆囊结石的关键。

The position of the primary carcinoma of unsuspected gallbladder carcinoma ofen located in the collum and body of the gallbladder, the position of the primary carcinoma of preoperative diagnosed gallbladder carcinoma ofen located in the body and fundus of the gallbladder. The incidence of Nevin I stage and II stage in unsuspected gallbladder carcinoma was significantly higher than that in preoperative diagnosed gallbladder carcinomaP.

意外胆囊癌的Nevin分期，在Ⅰ期和Ⅱ期的比例均高于术前确诊的胆囊癌，差异有显著意义(P＜0.05)；在Ⅳ期的比例低于术前确诊的胆囊癌，差异有显著意义(P＜0.05)；在Ⅴ期的比例低于术前确诊的胆囊癌，差异有非常显著意义(P＜0.01)。

Objective:To explore the feasibility of nonclosure and suture gallbladder stump after the subtotal laparoscopic cholecystectomy with residual gallbladder ampullae and cystic duct.

目的：探讨残留部分胆囊壶腹或困难胆囊行腹腔镜胆囊大部切除术不闭锁缝合胆囊残端的可行性。

CDRS and damage of biliary tract can be avoided after nonclosure and suture gallbladder stump in the subtotal laparoscopic cholecystectomy reserving gallbladder ampullae and cystic duct.Bile leakage can be cured after shorttime prophylactic drainage.

Calot三角解剖困难时残留部分胆囊壶腹或胆囊管的腹腔镜胆囊大部切除术，术中不闭锁缝合胆囊残端可以避免发生CDRS及误伤肝外胆管等，出现胆漏经过短期持续腹腔引流后可自愈。

The gall bladder is an organ that stores bile produced in the liver.this bile is released into the intestine to help the body digest and take in food.but tiny stones can form in the gall bladder.the stones can block the tube leading to the intestine,which can cause severe pain.in the traditional gall bladder operation doctors make a large cut across the person's abdomen to remove the gall bladder.patients must spend up to 10 days in the hospital and they often suffer pain for as long as six weeks while they recover from the operation.

胆囊是一个器官，储存的胆汁产生於肝脏。胆汁被释放到小肠，以帮助身体消化和食物的吸收，也可以形成微小结石的胆囊结石可以阻止膀胱。导致小肠引起严重的激痛，传统的胆囊手术医生作出一个大跨越的人类腹部移除胆囊膀胱，患者必须用10天时间在医院里，他们常常遭受的痛苦，只要6个星期，而他们的手术中恢复过来

Neither the killing of Mr Zarqawi nor any breakthrough on the political front will stop the insurgency and the fratricidal murders in their tracks.

在对危险的南部地区访问时，他斥责什叶派民兵领导人对中央集权的挑衅行为。

In fact,I've got him on the satellite mobile right now.

实际上 我们已接通卫星可视电话了