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what does The treatment of hepatolithiasis have?

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Before my uncle to see a doctor because of Biliary Colic, and later test results that are intrahepatic bile duct stones, and now my uncle still in the hospital recuperating, he was very worried that the disease would affect his work, and wanted to cure it as soon as possible

Ask the experts, the treatment of hepatolithiasis What?


best answer


(A) treatment

Intrahepatic bile duct stone treatment is a difficult surgery because of clinical understanding of anatomical pathology technology resulted in a number of reasons the treatment of intrahepatic bile duct stones there are still many problems affecting the therapeutic effects of it should be given particular attention and careful treatment of

1. Intrahepatic bile duct stones difficulties in surgical treatment of bile duct stones due to the complexity of the pathology in the thinking, it is different from the other diseases of gallbladder stones gallbladder stones can not be treated in accordance with the principles and methods to deal with bile duct stones in the gallbladder stones can be use of oral or puncture RONGSHI medication infusion and achieved a certain effect of intrahepatic bile duct stones is currently no ideal drug RONGSHI; cholelithiasis cholecystectomy can be definitive treatment of intrahepatic bile duct stones can not be wide excision of liver bile duct to intrahepatic bile duct stones scattered inside and outside the lesions tend to merge and expand intra-and extrahepatic biliary stricture is technically it is sometimes difficult time in the surgery to be addressed completely and sometimes the patient is in shock with acute cholangitis, preoperative critical state of emergency surgery the situation is unclear or only allow emergency measure left intrahepatic lesions bile duct stone with surgical treatment of portal hypertension is very difficult bile duct stones and other reasons led to frequent after surgical treatment of residual stones and bile duct stricture bile duct stones after national statistics the incidence of residual stones as high as 40% to 70% left intrahepatic bile duct stricture resulting in a greater proportion of about 30% of cases need to revisit biliary tract surgery is that many serious increase in the number of patients with surgical pathology is even more complicated and it takes more susceptible to biliary stricture re-operation thereby increasing the surgical complications, Mortality

2. Intrahepatic bile duct stones with the principles of surgical treatment of the improvement of medical practice and clinics, the system means to enhance technological advances to deal with bile duct stones must adhere to a holistic and comprehensive understanding of the dialectical principle of checks and portal imaging anatomy of three-dimensional imaging The concept of the traditional liver surgery extrahepatic surgery to be possible the treatment of intrahepatic bile duct stones using surgical techniques for treatment of liver and intrahepatic hilar bold pipes in order to achieve a good reveal the formation of a relatively complete surgical treatment of bile duct stones in principle that what is taken to remove stones in a net correction of bile duct stricture lesion recovery and the establishment of the physiological function and patency of biliary bile flow to avoid and prevent the recurrence of biliary tract infection and stone

3. Ready preoperative preparation to avoid the accident and emergency surgical treatment in accordance with the principles of systematic planning and overall design of the right intrahepatic bile duct stones were not as acute, especially when the pathology is unclear circumstances under which surgical approach combining Chinese and Western medicine can be taken to give appropriate antibiotics by the biliary duct nasal tube decompression or percutaneous transhepatic bile duct drainage to correct water-electrolyte disorders and acid-base balance through the emergency period of aggressive treatment of complications of preoperative diagnosis of gallstone clearly part of the location and extent of bile duct stricture and extrahepatic bile duct pathology liver function and general condition may be formulated according to lesion and the actual treatment program seeks to prepare the case of the first operation has been in many cases surgery should seriously consider the well-designed effort to become the last operation

4. Combined surgery and follow-up treatment

(1) The combination of surgery: surgical treatment of hepatolithiasis is very difficult to use a surgical operation completely resolved in a variety of surgical method must be taken together to complement each other in order to meet the treatment needs such as stone in the left lobe or left lobe of the liver fibrosis of liver tissue atrophy viable left lobe of liver or hepatic left lateral lobectomy, such as concomitant hepatic hilar bile duct stricture bile duct angioplasty, such as the gallbladder bile duct tissue defect can be round ligament repair, such as flap or a larger defect in the stomach or jejunum can be vascularized pedicle flap for repair of the bottom as long as no stricture of extrahepatic bile duct bile duct angioplasty as far as possible to retain the end of the extrahepatic bile duct and common bile duct sphincter function, such as broad leaf for the left and right hepatic hilar bile duct stones and the merger of the hepatic duct stricture can be cut up from the liver revealed 1 ~ 2 of the hepatic duct stricture and admission to lift the net intrahepatic bile duct stones with ultrasound lithotripsy mirror is now direct access to intrahepatic bile duct to rubble because of the TV monitor can reach 3 to 4 bile duct for stone, and it is broken edge suction side Most cases can be removed in the surgery all the biliary tract stones with mirror therapy improves the therapeutic effect of intrahepatic bile duct stones

If the extrahepatic bile duct stricture can no longer use or for re-surgery treatment of intrahepatic stones and bile duct stricture after lifting it is desirable that the hepatic bile duct or intrahepatic bile duct jejunum Roux-Y anastomosis important point is that the remaining lesions, such as the liver, especially liver bile duct stricture had not been lifted in the following line in the narrow bile - after intestinal anastomosis was unobstructed drainage of bile is not only unresolved but will also increase the intestinal bile reflux biliary tract infection or severe cholangitis or so stone recurrence is a common clinical re-operation reason

(2) Follow-up treatment: namely, surgery, placed within the intrahepatic or extrahepatic bile ducts of this catheter can be a simple pipe can also be a balloon catheter placed in the position according to whether the residual extrahepatic biliary strictures and duct stones whether Some features may be extrahepatic bile duct stricture or anastomotic balloon catheter within the support are the need to retain a longer time is normally 6 to 12 months for patients who require long-term catheters can be used to reduce the U-shaped tube loss of bile

Biliary duct surgery could play a multifaceted role in: to infection of bile drainage; support the biliary-enteric anastomosis; support and expansion of bile duct stricture; anti-inflammatory drug infusion through the catheter to stop bleeding RONGSHI; through the catheter for voice hydraulic shock rock; sinus catheter with cholangioscopy treatment of residual stones or gravel; cholangiography catheter to observe the pathological conditions of liver bile ducts inside and outside the treatment decision to the next, and whether these measures are operative removal of catheter treatment to continue and to add only a combination of surgery and follow-up treatment can improve a good combination of surgical treatment of intrahepatic bile duct stones effect


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