(外科学课件）16.liver diseases.ppt

Differential Diagnosis Simple cyst – no elements/stranding in walls Malignancy(tumor) – solid Amebic abscess – cannot be distinguished by imaging Right subphrenic abscess Biliary infection, cholangitis Treatment 1.Antibiotics: 2.Drainage: 3cm (1).Percutaneous by imaging; (2).drainage laparoscope (3). drainage by traditional way Drainage Drainage by percutaneously under ultrasound or CT 80% can be adequately treated by suction catheters inserted percutaneously under ultrasound or CT guidance. Surgical operation 1.drainage laparoscope 2. drainage by traditional way sometimes lobectomy No clinical response to Percutaneous drainage within 4-7 days Multiple, large or loculated abscesses confined to a single lobe Associated disease (e.g., biliary tract) Prognosis Overall mortality rate is 15% The mortality rate is about 40% in patients with malignant disease. Huge abscess may rupture. cancer of liver  Zhengrong shiDepartment of Hepatobiliary SurgeryThe First Affiliated Hospital Chongqing Medical University Primary liver cancer is quite common in world, and the number is increasing. Approximately 250000 people are diagnosed with this type of cancer each year in the China . Types of primary liver cancer. Pathology gross classification massive multinodular diffused microscopic classification hepatocellular carcinoma( HCC ) cholangiocellular carcinoma mixed type Hepatoma or hepatocellular carcinoma (HCC) is usually confined to the liver, although occasionally it spreads to other organs. It is more common in men and occurs mostly in people with a liver disease called cirrhosis(肝硬化). Three main cellular types of primary liver cancer Hepatocellular carcinoma----hepatoma Cholangiocellular carcinoma----cholangiocarcinoma A mixed form----hepatocholangioma Three types of gross morphology A massive form: a single predominant mass clea