Complications on the clinical treatment of bile duct injury.docVIP

 PAGE \* MERGEFORMAT 7 Complications on the clinical treatment of bile duct injury [Keywords:] surgical treatment of traumatic bile duct injury (A) of bile leakage, bile peritonitis [Diagnostics] 1. Bile drainage tube or cigarette of peritoneal drainage leakage, or wound leakage, wet dressings. 2. In the right upper quadrant abdominal pain, lower abdomen or whole abdomen, and tenderness, rebound. 3. Jaundice, with bile obstruction vary. 4. Fever, elevated white blood cell and neutrophil. 5.B ultrasound examination can be found in the upper abdomen or lower abdomen liquid dark area and, if jaundice, intrahepatic duct dilatation may be found. [Therapy] 1. Closer peritoneal drainage and symptoms and signs 2. To strengthen and support Liver treatment and maintain water and electrolyte balance. 3. The application of broad-spectrum antibiotics. 4. Surgical treatment. (B) obstructive jaundice after surgery [Diagnosis] judged as obstructive jaundice or nonobstructive jaundice, excluding medical jaundice. 1.B ultrasound to know whether the intrahepatic bile duct dilatation and the degree of expansion, whether the expansion of the extrahepatic bile ducts, dilated extrahepatic bile duct and the expansion of the length. 2.PTC check the understanding of the extent of expansion of the hepatic duct, blocking the site. 3.ERCP check the understanding of obstructive sites and the bottom of the bile duct lesions. Check to determine whether the above blocking, blocking sites and blocking reasons. [Therapy] 1. Active for longer preoperative preparation, including liver protection, nutrition, water and electrolyte balance and jaundice conditions to correct abnormal clotting mechanism. 2. Timing of surgery (1) obstructive jaundice with bile leakage, bile peritonitis, fever, emergency surgery. (2) postoperative obstructive jaundice, should be within 7 ~ 10 d after early surgery. (3) more than 7 ~ 10 d were, PTC