About 69 cases of bile duct exploration through the cystic duct intraoperative angiography joint Choledochoscope（对69例胆管探索通过胆囊管术中造影联合胆道镜）.docVIP

About 69 cases of bile duct exploration through the cystic duct intraoperative angiography joint Choledochoscope [Keywords:] via the cystic duct, intraoperative angiography, Choledochoscope bile duct exploration 1 Clinical data 199906/200512 completed a total of 69 cases through the cystic duct intraoperative angiography joint Choledochoscope bile duct exploration, male 26 cases, 43 females, aged 21 to 81 (average 47.2 years old. Preoperative B-mode ultrasound underwent CT, ERCP check conventional preoperative diagnosis of gallstones and biliary stones in 39 cases, 10 cases of chronic cholecystitis and biliary stones, gallstones and biliary dilatation in 9 cases, 11 cases of gallstones. or small incision Rufu, clamp traction gallbladder pot abdomen revealed hepatic duct, common bile duct and free neck tube, processing cystic artery, suspected common bile duct exploration indications for the first part of the neck incision 1 cm away from the common bile duct, stretching from the imaging tube and cholangiography clamp fixed angiography. before surgery to identify and the intraoperative angiography stones, balloon dilator inserted into the incision in the neck at the the expansion neck tube 3 ~ 5 min, such as carotid wall is thin, flexible, self import Incision of neck tube and longitudinal incision the common bile duct, up to 5 to 6 mm in diameter, stuck Choledochoscope understanding of right and left hepatic duct branch without stones, re-exploration of the common bile duct and nipple. stones stone stone basket larger gravel can remove the ampulla incarcerated stones as difficult to remove, push the duodenum via the papilla. suspected duodenal papilla stenosis, can balloon dilator expansion stone flush bile duct after a thorough check whether the residual stones larger stones is not easy to pull out, cut Interchange portion of the common bile duct wall, slowly remove the stones, then 40 absorbable suture interrupted suture, ligation neck exploration after remo