Cholecystitis胆囊炎课件_.pptx

Cholecystitis;OVERVIEW; Acute cholecystitis requires urgent intervention, typically with antibiotics followed by cholecystectomy [k?l?s?s‘tekt?m?]. In the setting of acute cholecystitis, cholecystectomy is optimally performed soon after the diagnosis is made. If urgent cholecystectomy is not feasible, operation can be delayed until after the acute episode has resolved, and then the operation may be performed electively, provided that the acute process can be controlled, and the symptoms resolve [r?’z?lv]. ; Chronic cholecystitis is the manifestation of ongoing, intermittent inflammation or so-called biliary colic. Patients with this condition benefit symptomatically from elective cholecystectomy. A less common version of cholecystitis is acute acalculous cholecystitis, which occurs most often in critically ill patients. Although gallstones are, by definition, absent in this condition, cholecystectomy specimens in patients with acute acalculous cholecystitis often reveal biliary sludge. ; Anatomy of Gallbladder ; The gallbladder is a reservoir ‘rez?vwɑ: (r)] located on the undersurface of the right of the liver, within the cystic fossa(胆囊窝); it is separated from the hepatic parenchyma [p?re?k?m?] by the cystic plate, which is composed of connective tissue closely applied to the Glisson capsule and elongating the hilar plate . Sometimes the gallbladder is deeply embedded in the liver, but occasionally it occurs on a mesenteric attachment and may be susceptible to volvulus [v?lvj?l?s]. ;Anatomy of the plate system. A, Cystic plate, above the gallbladder. B, Hilar plate, above the biliary confluence and at the base of the quadrate lobe. C, Umbilical plate, above the umbilical portion of the portal vein. Large, curving arrows indicate the plane of dissection of the cystic plate during cholecystectomy and of the hilar plate during approaches to the left hepatic duct.; The gallbladder varies in size and consists of a fundus, a body,