胆道

BACKGROUND: The biliary stents commonly used in clinic are made of plastics and metal, both of which have some irresolvable defects.

背景：临床上使用的胆道塑料支架和金属支架存在胆泥形成、支架嵌入胆道壁等难以克服的缺陷。

ABSTRACT Objective To discuss the importance of the study of conformation and variation of extrahepatic bile duct before gallbladder operationMethods The images of 100 cases having normal structure of gallbladder and extrahepatic bile duct were studied;the conformations and confluence sites were analyzedResults Among the 100 cases,97 cases had clear images of extrahepatic bile duct (97%),3 cases with large amount of air bulbs in bile duct because of the laxation of the lower common bile duct still had clear images of the general conformation of extrahepatic bile duct,87 cases had clear images of gallbladder and cystic duct (87%),13 cases (13%) had partial images of gallbladder or cystic ductConclusions ERCP can clearly show out the conformation and variation of extrahepatic bile duct and cystic duct and it is of important value before gallbladder operation

目的 通过对100例胆囊及肝外胆管正常结构尚存在的患者ERCP图像资料进行归纳和分析，探讨胆囊手术术前了解肝外胆道系统形态及变异的重要性。方法选出100例胆囊及肝外胆管正常结构尚存在的患者图像，对其形态、汇合位置进行分析。结果 100例患者图像中肝外胆管显示清晰者97例(97%)，3例因胆总管下端开口松弛导致大量气泡进入胆道，但肝外胆管大体形态显示尚清晰，胆囊及胆囊管显示清晰者87例(87%)，13例(13%)仅部分显示胆囊或胆囊管。结论 ERCP可以清晰显示肝外胆管及胆囊管的形态及变异情况，对于胆囊手术术前了解肝外胆道系统形态及变异有重要价值。 ERCP；胆囊管；肝外胆管

In neonates and infants, choledochal cysts are congenital, may be associated with distal biliary atresia and typically presents with cholestatic jaundice and acholic stools characteristic of biliary obstruction.

新生儿和婴儿期之胆道囊肿是先天性的且常合并远端的胆道闭锁，所以常以胆道阻塞的特徵如胆汁郁滞和灰白色大便为主要徵候。

Some patients had suffered from obstructive jaundice, pancreatitis, bilirubinemia, alkaline phosphatase raise,γ-glutamyl transpeptidase raise and/or diameter of common bile duct exceeded 0.8 cm; and for these cases intraoperative cholangiography must be carried out. 405 cases needed T-tube insertion. The common bile duct of 105 cases was sutured without T tube. Results All cases were operated successfully.

术前确诊者，术中直接行胆总管切开胆道镜取石；术前有黄疸史、胰腺炎史和直接胆红素增高、胆系酶增高者，或胆总管在0.8 cm以上者行术中造影，明确有胆总管结石的切开胆总管胆道镜取石。405例置T管引流，105例行胆总管Ⅰ期缝合。

We report a 67-year-old female admitted to our hospital with intermittent fever and upper abdominal pain. She had undergone cholecystectomy and choledocholithotomy 20 years previously. More recently, she had recurrent intrahepatic stones and underwent repeated choledocoscopic lithotiomy and endoscopic lithotripsy.

我们报告一位六十七岁女性因间歇性的发烧及上腹痛而住院，患者曾因胆及胆道结石在二十年前接受了胆囊切除术、胆道取石术，近几年又因复发的瞻道结石及胆管炎接受多次的胆道镜取石术及内视镜取石术。

Laparoscopic choledochotomy with endobiliary catheter and primary closure of CBD is a safe, effective and feasible procedure for the management of choledocholithiasis.

腹腔镜胆总管切开探查后放置胆道内置管引流胆总管一期缝合是一种安全、有效、可行的胆道引流方法。

Objective To probe the effect of treatment and operative means of choledocoscopy.Methods 34choledocholithasis patients were treated by cholecystectomy and choledochotomy under laparoscopy combined with fibro-optic choledocoscopy,and one-stage suture or T-shaped-tube drainage.

目的 探讨腹腔镜联合纤维胆道镜治疗胆总管结石的治疗效果及手术方式方法对34例胆总管结石患者在腹腔镜下行胆囊切除、胆总管切开、纤维胆道镜取石后行期缝合或T管引流。

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。

The other causes included stenosis of the sphincter of Oddi, focalized pancreatitis of the head of pancreas, traumatic stricture of bile duct and stricture of bilioenteric anastomosis (25％), and bile duct obstruction due to tumor (5％).

分析1996—2006年收治的100例多次胆道手术病人的临床资料，对其原因进行分析。结果 65％的胆道再手术原因是结石复发或残留，括约肌狭窄、胰头部肿块型胰腺炎、胆道损伤后狭窄和胆肠吻合口狭窄占26％，胆道系统肿瘤占5％。

Results 32 cases were primarily sewed up after all the stone and ascarids were cleaned,conformed by cholangiongraphy that there is nothing abnormal in operation.4 case which leaked bile after operation received conservative therapy and all cases were healed 9 days~12 days later.

结果：26例胆总管结石，1例胆道蛔虫，5例探查结果阴性。全部一期缝合，术中胆道造影肝内外胆管无异常。术后4例少量漏胆，进行保守治疗，全组术后9 d~12 d治愈出院。

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。