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- Mirizzi's syndrome is a rare entity of common hepatic duct obstruction by gall stone or cystic duct stone. 摘要胆囊管或胆囊结石所致之阻塞性黄胆，在临床上是很少见的。
- Methods: The clinical data of8 cases of accessory hepatic duct injury during laparoscopic cholecystectomy were retrospectively analzed. 方法:回顾总结腹腔镜胆囊切除术中8例副肝管损伤的临床资料。
- In cases of hepatic duct transection, one patient received palliative percutaneous biliary drainage to relieve the sepsis, while the other died of sepsis after operation. 在二位肝管横切的病人中，一位接受保守性的经皮穿肝胆道引流术来舒解败血症，另一位则于外科手术后因败血症死亡；
- Outside the porta hepatis, the main hepatic duct joins the cystic duct from the gallbladder to form the common bile duct, which drains into the duodenum. 在肝门外部?总肝管与从胆囊来的胆囊管汇合形成胆总管?并汇入十二指肠。
- The cystic duct runs superiorly at first and then turns posteriorly and inferiorly to join the common hepatic duct, forming the bile duct, which empties into the duodenum. 胆囊管先行向上方，然后转向后下方与肝总管会合，形成总胆管通向十二指肠。
- Methods A kind of allotype T tube was designed,and its two upper arms cound be placed in left and right hepatic duct simultaneously and its lower arm in choledochus. 方法自行设计一种异型T管,两上臂可以同时放置在左、右肝管内,下臂置于胆总管内。术后若发现残余结石,可直接以胆道镜经T管取石。选取临床病例59例,应用本方法行临床试验。
- The reason for unsuccesful clean out included: accompanied cannular stricture of hepatic duct, aberrance of hepatic duct and inlaid calculi in grade 3 hepatic duct. 取石失败的原因为 :合并肝胆管管状狭窄 ,胆管有解剖变异 ,结石位于 3级以上胆管并嵌顿。
- Figure 7. A, Klatskin's tumor (tumor located in the hepatic duct bifurcation) in a patient with primary sclerosing cholangitis; B, corresponding cholangiogram (ERCP image). 溃疡性结肠炎(256人中有一个)和原发性硬化性胆管炎(4-20%25)病人有高胆管癌发病率(图7)。胆管癌的累计危险度在上述疾病诊断后的10年为11.;2%25。
- The cystic duct ru superiorly at first and then tur posteriorly and inferiorly to join the common hepatic duct, forming the bile duct, which empties into the duodenum. 胆囊管先行向上方，然后转向后下方与肝总管会合，形成总胆管通向十二指肠。
- Cholangiography of Mirizzi syndrome revealed a broad, curvilinear impression on the common hepatic duct in the area where the cystic duct or gallbladder was in direct apposition, hepatic bile duct dilation above the level of the cystic duct. Mirizzi综合征在胆道造影上的典型表现为 :胆管位于胆囊管或胆囊直接对应之处可见较宽的弧形充盈缺损 ,边缘光滑 ,其上胆管扩张。
- The abnormal cases clearly showed the occlusion the expansion of cholangiopancreatic duct, with and the diameters of expanded biliary duct and hepatic duct were greater than 1.0cm, with 100% sensitivity and 93.3% location accuracy . 异常组可清楚显示胆胰管梗阻扩张的形态 ;扩张肝管、胆管的直径大于 1 .;0cm;敏感性 1 0 0%25;定位准确性 93
- Traditionally, disruption of the common bile duct or common hepatic duct is treated by debridement and an end-to-end anastomosis or anastomosis of the proximal duct to the duodenum or jejunum. 传统上，治疗总胆管或总肝胆管破裂术再加以末端对末端吻合术，亦就是将近端肝胆管接到十二指肠或空肠。
- Conclusions To prevent injury of accessory hepatic duct, pre-and intra-peration identification of the condition is very important, and especially by intraoperative cholangiography. 结论为防止副肝管损伤，应加强术前，术中副肝管诊断，尤其是术中胆道造影。
- If located on the side of common hepatic duct tumor, often asymptomatic the beginning, when the impact to the contralateral hepatic duct openings only when the emergence of obstructive jaundice. 如位于一侧肝管癌肿，开始常无症状，当影响至对侧肝管开口时，才出现阻塞性黄疸。
- Results The total variance rate of cystic duct was 78.6% of which length was 41.7%,postition was 35.7%,direction was 52.4%,collateral or circumambient with common hepatic duct was 47.6%. 6%25。其中胆囊管长度变异占41。7%25,汇入位置变异占35。7%25,汇入方向变异占52。4%25,与肝总管并、绕行占47。
- Objective To discuss the preventive measures of iatrogenic injury to the bile ducts, encountering the variation of right hepatic duct in open cholecystectomy. 目的探讨开腹胆囊切除术中遇到右肝管变异时,医源性胆管损伤的预防措施。
- Lateral branch of left hepatic duct 左肝管外侧支
- Left hepatic duct of caudate lobe 尾叶左肝管
- sclerotic carcinoma of hepatic duct 硬化型肝胆管癌
- Posterior branch of right hepatic duct 右肝管后支
