胆管

T tube drainage was able to decrease bile viscosity effectively.The number of bacteria decreased significantly until 21 postoperative days.The time that T tube is drawn out is on 14 postoperative days.Bacteria may exist in bile continuously and play a role on relapse of choledochitis and bile duct stone.

胆汁中的细菌和粘度升高在胆管结石形成中起协同作用。T管引流能有效地降低胆汁粘度，而胆汁中细菌量在引流术后第3周才有显著减少，临床2周时拨除T管细菌可潜伏下来，对胆管炎和胆管结石的复发可能起作用。

Patients of peripheral cholangiocarcinoma without clonorchiasis and 27 patients of cholangiocarcinoma in 167patients with clonorchiasis on CT scan were reviewed.

肝内周围型胆管癌与肝吸虫病CT研究梁长虹摘要：本文分析了24例单纯肝内周围型胆管癌及167例肝吸虫病并发胆管癌27例的CT扫描资料。

Microscopically, this bile duct in a case of sclerosing cholangitis is surrounded by marked collagenous connective tissue deposition.

显微镜下可见硬化性胆管炎的胆管被大量的纤维组织包绕而形成了胆管阻塞。

If it is mainly extrahepatic biliary diffuse stenosis, it will gradually expand upward and downward along bile duct by Bakes biliary duct dilater after the bile duct is cut in surgery ( Including the sphincter of Oddi expansion,the dilatation should be gradual and slow. Too much strength will result in biliary rupture with vascular hemorrhage). T-tube is then placed to support drainage.

若主要是肝外胆管弥漫性狭窄，手术时在切开胆总管之后，以 Bakes 胆道扩张器沿胆管向上、下方向逐步扩张（包括对 Oddi 括约肌的扩张，扩张时应渐次、缓慢的进行，不能过分用力以致胆管破裂及伴行血管出血），然后放置 T 型管支撑引流。

PSC is a kind of rare and unknown disease due to stenosis cholangitis.Its main symptoms is diffuse fibrotic incrassation and duct stenosis in intrahepatic and extrahepatic bile duct system..

原发性硬化性胆管炎原发性硬化性胆管炎（primary sclerosing cholangitisPSC）是一种少见的、原因未明的胆管炎症性狭窄性疾病。

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。

The role of gall, retroflux of intestinal fluid and foreign-body reaction resulted from suture with silk thread during reconstruction of traumatic bile duct are probably crucial factors resulted in lasted infiltration of macrophage in bile duct wall, which strengthen formation of the benign biliary stricture.

胆汁的作用、肠液返流以及胆管损伤修复采用丝线缝合引起的异物反应可能是导致胆管局部组织MΦ过度沉着的重要因素，从而加剧胆管瘢痕形成。

Results Classifying according to configuration as below widespread type (n=16), Tubercular type (n=4), nipple type (n=2). Hilar madd, dilatation of intrahepatic ducts and discontinuity of hilar biliary ducts occurred in all cases. The imaging of MRCP displayed obstmction, stenosis, and filling defects. Portal vein was invaded in 3 cases and presented as infiltration, stegnosis or occlusion of the vein.

结果 按肿瘤形态分：弥漫型16例，结节型4例，乳头型2例，22例肝门胆管癌均可见肝门肿块、肝内胆管扩张、肝门胆管中断，MRCP表现为阻塞、狭窄或充盈缺损；肿瘤侵及门静脉3例，表现为门脉侧壁浸润、门脉缩窄或闭塞。

Results: The main reasons of re-operation in congenital choledochus cyst were calculogenesis, refluxing cholangeitis, stenostomia, endo-, ectobile duct residual cyst, stenosis of bile duct in hepatic hilum, residual cyst canceration, which accounts for 24 cases (63%), 21 cases (55%), 12 cases (31.6%), 11 cases (29%), 8 cases (21%), 2 cases (5%), respectively.

结果：先天性胆总管囊肿再次手术的主要原因是结石形成24例(63%)；其次为反流性胆管炎21例(55%)；再次为吻合口狭窄12例(31.6%)；肝内外胆管残余囊肿11例(29%)；肝门部胆管狭窄8例(21%)；残余囊肿癌变2例(5%)。

Dilatation of the bile duct supporting drainage : Due to a longer section of the bile duct stenosis and unremovable lesion part, biel duct tube or U-shaped tube drainage could be employed.

胆管扩张支撑引流术：对于较长节段胆管狭窄、又不能切除病变部位者，可行胆管内置管支撑或 U 形管引流。

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。