ERCP, EST LC combined clinical analysis of treatme

ncycgdxhl · Wysłany: Sob 22:33, 19 Mar 2011

ERCP, EST LC combined clinical analysis of treatment of cholelithiasis

Including open surgery before and LC, ER-CP, EST and all other methods, does not have any kind of treatment is appropriate for all cases. Associated with or suspected of gallbladder disease in patients with common bile duct stones before LC line treatment should be combined with selected physical condition of patients and hospital technical requirements into account: (1) in patients with cardiopulmonary conditions, can tolerate pneumoperitoneum; not resistant bullied abdominal been replaced open surgery. (2) the possibility of the existence of common bile duct stones and their size and number. (3), gallbladder and other lesions of extrahepatic bile duct, with or without atrophic cholecystitis and biliary anatomical variations exist. (4), endoscopic surgery of the technical capacity and the level of expertise. (5) the need to treat stones by open surgery. ERCP is currently reported incidence of complications of 1% ~ 9% 【5J. A total of 38 patients in this group 4 cases of complications, accounting for 10.5% of all cases, similar to those reported in literature, and major complications were mild pancreatitis, cholangitis and bleeding sphincter incision, no mortality cases. On the use of contrast agents, the current trend is more consistent use of ERCP is non-ionic contrast agent has nothing to do with pancreatitis,[link widoczny dla zalogowanych], we have been using an ionic contrast agent diatrizoate contrast,[link widoczny dla zalogowanych], is not observed in the incidence of postoperative pancreatitis increased. After a large-scale prospective study to determine factors that have pancreatitis: duodenal sphincter disorders, young, normal bilirubin,[link widoczny dla zalogowanych], sphincterotomy, pancreatic sphincterotomy, pancreatic duct imaging, a postoperative ERCP history of pancreatitis ¨ 6. _7 Freeman and other factors that have 5 of complications of ERCP and EST occurrence: Oddi sphincter dysfunction; cirrhosis; intubation difficult; preparatory sphincterotomy; percutaneous endoscopic joint operations. So a reduction of ERCP, EST pancreatitis complications,[link widoczny dla zalogowanych], improve technique, master intubation skills is the fundamental measure for this type of biliary tract disease patients, our experience is as deep insertion duct, the first non-imaging, through the catheter adjustment, the use of ultra-smooth wire and other measures to recognize again into the bile duct imaging, so you can avoid the pancreatic duct imaging, imaging can not be blind. Strict selection of surgical indications, and strictly control the direction and length of the incision, injection of contrast agent moderate intensity, the slow cut, after cut after the careful hemostasis during and after fasting,[link widoczny dla zalogowanych], monitor urine amylase, pancreatic secretion of conventional suppression agents (such as Hospice and other drugs) can reduce the incidence of complications. 【
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