论文部分内容阅读
患者男,33岁,因肝胆管结石行胆囊切除、肝胆管切开取石、间置空肠术。术中见胆囊内有结石,肝门区肝总管内有成团结石。在解剖Calot氏三角区时,未发现胆囊管。沿胆囊颈部顺着胆囊管往下追踪解剖,胆囊管单独开口于十二指肠球部与降部交界处的右侧缘。在肝门处切开胆总管,取出结石,常规处理胆囊动脉,切开胆囊,取出结石,见胆囊底部右侧有0.3cm的开口两个,直通右肝前叶肝管,有胆汁流出。双重结扎副肝管后,予以切断。沿胆囊切口剖开胆囊管直至距十二指肠1.5cm处,胆囊管直径0.8cm,壁厚0.4cm。同时将F24橡皮导尿管分别插入胆囊管和肝总管内,均能顺利进入十二指肠。两管在十二指肠的开口相距约3.0cm,胆囊管和肝总管基本上是并
Male, 33 years old, cholecystectomy due to hepatolithiasis, cholangiopexy and intercostal space jejunostomy. See intraoperative gallbladder stones, hilar hepatic duct into a group of stones. No cystic duct was found when dissecting the Calot’s trigone. Along the gallbladder neck along the cystic duct to track the anatomy down, the cystic duct separately opened in the duodenal bulb and descending part of the junction of the right side of the edge. The common bile duct was opened at the hilar portal, the gallbladder was removed, the gallbladder was routinely treated, the gallbladder was dissected, the stone was removed, and there was an opening of 0.3 cm on the right side of the bottom of the gallbladder. After double ligation of the hepatic duct, be cut off. Cut along the gallbladder incision cystic duct until the distance of 1.5cm from the duodenum, cystic duct diameter 0.8cm, wall thickness 0.4cm. At the same time F24 rubber catheter inserted into the cystic duct and the hepatic duct, can successfully enter the duodenum. The two ducts are about 3.0 cm apart from the openings of the duodenum. The cystic duct and the common hepatic duct are essentially the same