Better use of biliary and pancreatic surgery, inte

e707004304 · Wysłany: Pią 12:15, 11 Mar 2011

Better use of biliary and pancreatic gut the basics of the Department of Surgery

After pancreatic duct segments near the head of pancreas and the ampulla ampulla,[link widoczny dla zalogowanych], including oral cancer. The early parts of the tumor caused by obstructive jaundice in ampullary mouth, it may be removed early treatment is better. This shows the importance of early surgery. Now, check many ways, patients are often in a variety of examination and treatment hospital, a lot of time, and finally to go to surgery, may delay the timing of surgery deserves special attention. 2.3 should be specifically mentioned the duodenum cancer, which mostly occur around the mouth from the ampulla, this phenomenon is currently no definitive explanation. I imagine ampullary bile pancreatic juice flows through the port and met here cause gastrointestinal fluid pH response, digestive enzymes, hormones, particularly the role of change may be relevant. Reverse peristalsis duodenum rather special 2.4, about three promoter: the bulb and descending junction, lowering the junction of Cross Ministry with the Ministry of the central cross. They alternating strong contraction, so that segmental duodenal appear to expand and contract, which is anti-duodenal contents into the stomach of power. But the anti-ampullary and bile duct are not shed easily. Very important reason is that in the duodenal ampulla oblique, the internal pressure increased when the duodenal lumen expansion, the ampulla was flattened, a feature in the design of the mechanism re-surgery is worth ampulla reference. 2.5 ampulla port area is the junction of the foregut and midgut, vary greatly not only translocation but also differentiate into a variety of mucosal epithelium, but also other parts do not have. 2.6 here sphincter (Oddi sphincter) under the control of intestinal hormones, the surgeon also can not afford to hand a similar sphincter. It is ranked the biliary and pancreatic hub of transportation systems can not be easily destroyed. Currently, indications for biliary enteric drainage put too wide, many complications, it is noteworthy. 2.7 One of the important role of the sphincter mechanism is the 3 reserves the duodenum or pancreatic resection of pancreatic head resection were more Westerners booze, fine wine, intractable abdominal pain of chronic pancreatitis and more. 237 total pancreatectomy is a method of treatment. Duodenum pancreatectomy reserved now attracting wider interest. Unlike Westerners,[link widoczny dla zalogowanych], Chinese drinking habits, which were less likely, but reservations can not be excluded or pancreatic head duodenectomy the possibility of the whole pancreas. Child surgery is to leave a small piece of pancreatic tissue subtotal pancreatectomy. German reports in recent years to retain the entire duodenum, pancreas removed. Pancreaticobiliary junction from the intestinal anatomy of view, the common bile duct after pancreatic part of the lower part of the blood supply from the head of the pancreas, after the last paragraph of a possible long-term bile duct stricture. Report from the German to see this. It appears that the effect of treatment of chronic pancreatitis is not necessarily better than the Child surgery. 4, gastric and duodenal retention of pancreaticoduodenectomy pancreaticobiliary junction of intestinal lesions, especially malignant tumors and which do not invaded the stomach, pylorus, duodenal bulb, could keep second duodenum bulb, the removal of pancreatic, stomach and pylorus does not hurt. In this way, keep a good stomach. By lymphatic drainage routes of view, there are reasonable. 5 questions on cytology identification of chronic pancreatitis and pancreatic cancer, just by visual observation during surgery is difficult to decide. Here special emphasis, do not cut pancreatic tissue biopsy. Because more than from the bottom of pancreatic duct,[link widoczny dla zalogowanych], the center of the pancreas,[link widoczny dla zalogowanych], pancreatic palpable hard to block the hair, the surface area is cancer week pancreatitis. If the direct cut biopsy, mostly reported as inflammatory tissue,[link widoczny dla zalogowanych], help in the diagnosis, but lead to misdiagnosis. Large cut to reach the center, there is the risk of pancreatic leakage occurred. So do pancreatic surgery cut biopsy is unreasonable, should do the pancreas puncture cytology. Puncture should be aligned with the center of pancreatic lumps, that is where the cancer site, the use of Chiba needle (diameter 0.7mm), pancreatic leakage can be avoided. This method has many uses, but not enough common. Therefore, in this emphasis, the hospital should be widely implemented cytology. According to the need to change the 80-page / book is 96 pages / volumes, each (of) Price 8.50 yuan, the annual total of 51.00 yuan 6. 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