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Objective: To study the efficacy of endoscopic retrograde cholangiopan creato graphy and endoscopic nasobiliary drainage in the diagnosis and therapy of bile leakage after cholecystectomy.

目的:探讨经内镜逆行胰胆管造影和经内镜鼻胆管引流在胆囊切除术后胆漏诊治中的应用价值。

Result: all the 82 cases,15 were treated with right hemihepatectomy,26 with left hemihepatectomy,10 with quadrate lobectomy,7 with right posterior lobectomy,24 with localization lobectomy.postoperative pathdogic:75 were liver cell carcinoma,7 were carcinoma of bileduct.one case with postoperative hemorrhea,hemostated by reoperation.3 patients with biliary fistula,2 cases were cured by drainage,1 case was cured by ercp.no one died in operation.10(12.2%) died in half year,27(32.9%) died in one year.conclusion: control the indication and amount of heratectomy,contral hemorrhea,treat incised wound of liver correctly and prevent postoperative complications ,that can guarantee the effect of hepatectomy.

结果:右半肝切除15例、左半肝切除26例、肝中叶切除10例、肝右后叶切除7例、肝局部切除24例。术后病理诊断为肝细胞癌75例、胆管细胞癌7例。本组术后近期出血1例,再次手术止血;胆瘘3例,2例行腹腔引流治愈,1例行ercp置管引流治愈;无手术死亡。术后半年内死亡10例(12.2%),1年内死亡27例(32.9%),余45例现均存活。结论:掌握肝切除手术指征及肝切除量、严格控制术中肝出血、正确处理肝创面及术后并发症,才能保证手术治疗的效果。

Objective To evaluate the role of choledochoscopy in selecting operation procedure for hepatolithiasis.

摘 要:目的探讨胆道镜技术在肝胆管结石术式选择中的作用与地位。

Methods Experience in choledochoscopy applied in 618 cases of hepatolithiasis was summerised.

总结肝胆管结石618例应用胆道镜技术的经验。

Methods We analyzed 106 patients with hepatolithiasis intraoperatively and postoperatively used the choledochoscope to check and removed stones.

回顾性分析106例肝胆管结石病人术中、术后利用纤维胆道镜检查、取石治疗的临床资料。

Its pathologic characteristics of indiscoverable growth and poor differentiation leads to the clinical figures, such as the difficult diagnosis in early stage, lower rate of redical resection, and insensitive to chemotherapy or radiotherapy, and in the end, the treatment efficacy of PGC has not been markedly improved for many years.

原发性胆囊癌占我国胆道肿瘤发病的第一位,其发病隐匿,早期诊断困难,恶性程度高,根治性手术切除率低,对化疗和放疗均不敏感,多年来疗效未能明显改善。

Enhanced CT imaging features were distinguished, and isopycnic density and low-density tumors were all displayed. Among 26 cases, the tumor diameter of 3 ~ 6cm was 22 cases , 1 ~ 3cm 4 cases; arterial phase scans had uneven reinforced, also had signs of peripancreatic fat layer disappeared, pancreatic duct and bile duct dilatation, bile duct obstruction, combined pancreatic cyst, tumor invasion blood vessels, peritoneal and lymph node metastasis.

增强CT影像特点显著,等密度及低密度肿瘤均得到显示。26例中,肿块直径3~6cm 22例、1~3cm 4例;动脉期扫描有不均匀强化,另有胰周脂肪层消失、胰管和胆管扩张、胆总管阻塞、合并胰腺囊肿、肿瘤侵及血管、腹膜的淋巴结转移等征象。

Chronic experiments were performed on male rabbits provided with implanted brain cannula,through which acetylcholine was injected into the hypotha- lamus and the third ventricle.

二将乙酰胆硷0.7—1.4毫克注入下丘脑结节区,可引起血浆自由脂肪酸水平明显升高,在注射后的第10及20分钟分别较注射前升高78.5%及85.0%,60分钟时恢复原水平。

Lithogenous diet caused liver damage, then abnormality of metabolism of bile acids, and promoted gallstone formation.

致石食物首先引起肝脏病理损害,继而导致胆汁代谢紊乱,尤其是胆汁酸代谢紊乱,促使了胆结石的形成。

Methods: Tube method was adopted in litholytic experiment.

目的:观察中药复方JEYS的溶石和利胆作用。

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