胆道

Objective To discuss the diagnosis and management of biliary tract stone.

目的 总结胆道结石合并胆道感染的诊治经验。

Proper operation in combination with cholangioscopy is the best way to treat cholelithiasis.

合理的手术加上胆道镜的使用是目前治疗胆道结石的最佳方法。

Here, we present two cases of congenital choledochal cyst in which the patients were 9 weeks old and 7 weeks old respectively. Both of them presented with jaundice, acholic stools, and hepatomegaly. Combined use of sonography, computed tomography and hepatobiliary scintigraphy demonstrated the presence of choledocal cysts.

生这衷，我们提出了两个先天性胆道囊肿的病例，分别是九个月大与七个月大，他们均以黄疸，灰白公大便，和肝肿道的核医摄影证实了他们均有胆道囊肿的存在。

Methods:Fifty patients with common duct stones that underwent choledocholithotomy by laparoscopy and choledochoscopy with outward drawstring were researched.

于腹腔镜下外置胆总管牵引线胆总管切开纤维胆道镜取石，治疗胆总管结石50例。

Methods:Fifty patients with common duct stones that underwent choledocholithotomy by laparoscopy and choledochoscopy with outward draw string were researched.

于腹腔镜下外置胆总管牵引线胆总管切开纤维胆道镜取石，治疗胆总管结石50例。

Laparoscopic choledocholithotomy Ttube drainage was performed in 491 cases,all 11 cases of bile leakage were cured conservatively.173 cases were treated by transcystic duct exploration,and were cured conservatively,173 cases were treated by transcystic common bile duct exploration,and there were no complications.

完成491例腹腔镜胆总管切开纤维胆道镜取石，&T&管引流术（laparoscopic choledocholithotomy Ttube drainage，LCTD），出现胆漏11例，经保守治疗治愈。173例经过胆囊管取出胆总管结石，无并发症发生。

Methods In choledochotomy of 32 cases,make sure it is unabstructed after cleaning all the stones and ascaricls,then it is sewed up primarily and conformed by cholangiongraphy.

对32例患者行胆道探查，取尽结石或蛔虫，检查胆总管下段通畅，经胆囊管胆道造影后一期缝合胆管。

Methods:The clinical data of twenty nine patients with common bile duct calculi underwent laparoscopic choledochotomy and primary ductal submucosa closure without routine T tube drainage was retrospectively analyzed.

应用腹腔镜手术设备及纤维胆道镜为29例胆总管结石患者行腹腔镜胆总管切开取石术，不置T管引流，一期缝合胆总管壁。

Methods In cases of SAP with severe pancreatic and peripancreatic infection, open surgical debridement and drainage was done, and, about one week later, the drainage tubes were removed and a choledoscope was then used repeatedly to debride and wash out the necrotic and infected foci that were hard to drain out.

对于SAP已形成严重胰周感染的患者，在开腹手术清创、引流约1周后，拔除腹腔引流管，顺引流管窦道，插入胆道镜；应用胆道镜对感染灶内难以引流至体外的坏死组织及脓液进行反复冲洗及清除。

Result:the incidence of AP went up year by year;(2)bile tract disease is the major reason,but hyperlipdemic AP should be attach importance to for its higher and higher incidence;(3)mean age of biliary AP is higher than alcohlolic and hyperlipdemic AP;(4)the difference of sex is significant in biliary AP and alcohlolic AP;(5)the incidence of local omplications is lower than alcohlolic and hyperlipdemic AP,but the difference is of no significance in view of systemic complications;(6)lungis of the most liability for dysfunction,and renal dysfunction is most closely related to death ;(7)ESS is associated with AP and related to the severity and prognosis .

结果表明：(1)急性胰腺炎发病率呈逐年上升趋势；(2)胆道疾病仍是急性胰腺炎的首要病因，高脂血症性胰腺炎明显增多，应受到重视；(3)胆源性胰腺炎患者年龄高于酒精性和高血脂性等其它原因的胰腺炎；(4)性别差异在胆源性、酒精性胰腺炎中显著；(5)胆源性胰腺炎出现局部并发症几率少于酒精性和高血脂性胰腺炎，而在全身并发症上无明显差异；(6)重症急性胰腺炎中，肺脏最易发生功能障碍，肾功能障碍与死亡关系最密切；(7)急性胰腺炎易伴发正常甲状腺病态综合症，并与其严重程度和预后相关。

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。