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21.
目的探讨预防小切口胆囊切除术(MC)中胆道损伤的方法。方法对本组15131例MC中发生的18例胆道损伤进行回顾分析。结果1994年12月前施行MC2321例,发生胆道损伤9例(0.39%),1995年以来实施MC12810例,发生胆道损伤9例(0.07%)。结论思想上高度重视、规范手术适应证、规范手术操作是预防MC中胆道损伤的关键。 相似文献
22.
Yoshinori Igarashi Naoki Okano Ken Ito Takahiko Mimura Kazumasa Miki 《Digestive endoscopy》2007,19(Z1):S109-S114
A 69‐year‐old man was admitted to Toho University Omori Medical Center complaining of icterus. Abdominal computed tomography, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography were suspicious of cholangioma of inferior bile duct. Peroral cholangioscopy using narrow band imaging (NBI) was performed and it was possible to diagnose the mucosal spread lesions of cholangioma. Histological findings reflected the endoscopic findings. Mucosal spread lesions of cholangiocarcinoma were successfully diagnosed using the CHF‐B260 for NBI. 相似文献
23.
Yoshinobu Okabe Osamu Tsuruta Yoshiki Naito Hideya Suga Michio Sata 《Digestive endoscopy》2007,19(Z1):S121-S125
Regarding peroral cholangioscopy (POCS) for biliary disease, due to the recent appearance of a video cholangioscope that can obtain high‐quality images, it is possible to observe subtle changes of the biliary mucosa. In addition to the conventional observation method using POCS, the biliary mucosa with also observed with narrow band imaging (NBI) in one case of chronic cholangitis and four cases of extra hepatic bile duct tumor (three surgical cases). In the conventional observation method, the vessels in the surface layer of the biliary mucosa could be observed more clearly using NBI. In one case in which a tumor was observed, the irregularity of the biliary mucosa became clear on NBI, and the vessels inside a papillary tumor could also be easily observed. In another case of bile duct tumor, the conventional observation method showed a region in the proximity of the tumor where the vessels could not be seen clearly, but they could be seen clearly on NBI. In all of the cases, the bile juice was seen as red on NBI, which disturbed the observation. With POCS using NBI, it was possible to observe the vessels and irregularities in the surface layer of the biliary mucosa more clearly than with conventional observation methods. 相似文献
24.
Müllerian duct regression is first apparent in male pouch young of the tammar wallaby (Macropus eugenii) 6–7 days after birth and, as in eutherian mammals, is characterised by a condensation of the periductal mesenchyme into
a whorl around the ductal epithelial cells. A decrease in the density of the extracellular matrix was observed in the region
of the whorl. In contrast to eutherian mammals no changes were observed in the mean outer diameter of the Müllerian duct during
the early stages of regression. The time at which these mesenchymal changes occur corresponds to the period of Müllerian inhibiting
substance secretion in the postnatal tammar testis.
Accepted: 25 February 1997 相似文献
25.
经结膜下穹隆至上颌窦插管术治疗泪道阻塞的临床研究 总被引:1,自引:0,他引:1
采用经结膜囊下穹隆至上颌窦插管的术式引流泪液,治疗泪道阻塞引起的溢泪症,获得较为满意的效果。手术的主要步骤是:局麻后于结膜囊下穹隆内1/3区作一4mm长的结膜切口,自筋膜下分离至眶线下5mm。从切口伸入上颌窦骨钻钻通上颌窦顶壁,插入长短适度的义管,并向管内注入生理盐水,证实有液体流入鼻咽部后,固定义管。术后定期冲洗,无需拆线,应用这种术式治疗泪道阻塞引起的溢泪症218眼,其中溢泪完全消失151眼占82.1%,溢泪减轻的27眼占14.6%,总效率96.7%。 相似文献
26.
目的:分析损伤性肝外胆管狭窄发生的原因和损伤后狭窄的修复术式选择。方法:损伤性肝外胆管狭窄45例,诊断方法以B超,PTC、ERCP为主,全组分别行胆管空肠吻合术,胆管十二指肠吻合术,肝门胆管整形术等手术治疗。结果:随访36例,末次手术行胆管空肠吻合术33例,优良87.9%。结论:可见性损伤和隐性损伤所致的瘢痕收缩是胆道狭窄的主要原因,损伤性肝外胆管狭窄的治疗方法以胆管空肠Y形吻合术较为理想。 相似文献
27.
射精管异位开口于苗勒管囊肿 总被引:3,自引:0,他引:3
报告2例射精管异位开口于苗勒管囊肿。均以血精、血尿就诊,通过经皮输精管穿刺造影及染色尿道镜检查确诊。经抗炎及窥视下纵行剪开苗勒管囊肿前壁。1例治愈,1例好转。对本病的病因、临床表现、诊断、治疗及预后进行了讨论。 相似文献
28.
Maria P. Panozzo Carlo Fabris Daniela Basso Giuseppe Del Favero Aldo Infantino Attilio Cecchetto Mario Plebani Remo Naccarato 《Clinical and experimental pharmacology & physiology》1993,20(3):185-191
1. The authors investigated the effect of two extrahepatic cholestasis models (one by bile duct ligation and the other by choledocho-jugular fistula) on the hepatic clearance of horseradish peroxidase in male Sprague-Dawley rats divided into four groups. 2. In groups A (n = 5 rats) and B (n = 5), bile duct ligation was performed, while a choledocho-jugular fistula was created in groups C (n = 5) and D (n= 7). A 10 mg intravenous bolus of horseradish peroxidase was injected after 24 h (groups A and C), 48 h (groups B and D) or 1 h (Group E; five sham-operated rats). Serum and bile samples were then serially collected for 2 h. 3. In all groups, serum horseradish peroxidase levels increased soon after injection and then rapidly decreased, the curves being similar. Biliary excretion increased for 30 min and then slowly decreased. The highest horseradish peroxidase biliary concentrations and outputs were found in Group B followed by Group A; both groups had significantly higher levels than Group E. No difference was found between horseradish peroxidase biliary excretion of groups C and D and that of sham-operated rats. 4. When each group was considered separately, sampling times correlated with the corresponding ratios of bile/ plasma HRP. Significant differences were found between the relative slopes of groups A, B and E, but not between those of groups C, D and E. 5. In conclusion, bile duct obstruction greatly affects the plasma-bile transfer of fluid phase markers, such as horseradish peroxidase, while single retention, caused by choledocho-jugular fistula, has no influence. The increased biliary hyperpressure related to the duration of cholestasis may account for the degree of horseradish peroxidase transfer which, in turn, probably depends on an enhanced paracellular passage. 相似文献
29.
对我院14年来2322例直接胆管造影所发现的27例AJPBD进行研究,27例中胆总管囊肿8例,胆石症9例,慢性胰腺炎4例,胆管炎3例,胆囊癌2例,胰体癌1例。临床表现为上腹痛(92.6%),黄疸(70.4%),发热(48.1%)或Charcot三联症(44.4%)。发病年龄3~60岁(36.9士17.8)。共同管长15~44mm(20.2士5.9)。据胆、胰管汇合形式作者将AJPBD分为三型。值得注意的是本组3例复杂型患病年龄均<15岁。本组以胆、肠内引流手术效果满意。AJPBD与胆、胰疾病发生、发展密切相关,作者建议用“共同管综合征”来表述这一复杂病理现象。 相似文献
30.
Paediatric dacryocystorhinostomy 总被引:1,自引:0,他引:1
KN Hakin FRCS FRCOphth TJ Sullivan FRACO FRACS A Sharma FCOphth † RAN Welham FRCS FCOphth † 《Clinical & experimental ophthalmology》1994,22(4):231-235
Of 258 cases of dacryocystorhinostomy performed on children in the period September 1981 to September 1991, 130 were for simple, unresolved congenital nasolacrimal duct obstruction. Other indications for surgery included punctal agenesis, lacrimal fistula, post-traumatic and post-inflammatory canalicular obstruction. Of 177 children without canalicular pathology, 171 (96%) were relieved of symptoms with one operation, without canalicular intubation. Of 81 cases with canalicular disease, 55 of 70 (79%) who underwent DCR plus canalicular intubation, and 10 of 11 who underwent DCR plus Lester-Jones tube, were substantially improved with one operation. No child required peroperative or postoperative blood transfusion. Dacryocystorhinostomy in childhood, in experienced surgical hands, is a safe procedure, achieving relief of symptoms in most cases, particularly in the absence of canalicular disease. 相似文献