肝总管

胆囊结石并胆总管或肝总管结石68例，作EST或网篮套石，63例（92.5%）成功取尽结石并行LC。

ERCP or EST was performed in 68 cases of extra-hepatic bile duct stone .

肝总管内径1～2mm。

The diameter of common hepatic duct is 1 ~ 2mm .

一旦确诊，应及早手术，并做好围手术期处理，手术以囊肿切除、肝总管空肠Roux－en－Y（综合性方法）吻合为好。

Cystectomy and Roux-en-Y choledochojejunostomy ( combined method ) should be taken as the best operative methods .

囊肿切除肝总管空肠Roux-en-Y吻合术治疗先天性胆管囊肿

Roux-en-Y hepaticojejunostomy after the cyst resection for congenital biliary duct cyst in Children

完全腹腔镜胆总管切除肝总管空肠Roux-Y吻合术五例经验

Total laparoscopic choledochus resection with Roux-Y hepatoenterostomy : report of 5 cases

改良肝总管空肠Roux-Y型吻合术治疗小儿先天性胆总管囊肿

Modified Roux-Y hepaticojejunostomy to treat choledochal cyst in children

Ⅳ型6例，行肝总管-空肠Roux-Y吻合术。

Are type ⅳ, which were done cholecystectomy and common hepatic bile duct-jejunum Roux-y anastomosis ;

方法采用囊肿切除肝总管空肠Roux-en-Y吻合术治疗小儿先天性胆管囊肿56例。

[ Methods ] 56 children with congenital biliary duct cyst were treated by Roux-en-Y hepaticojejunostomy after cyst resection .

囊肿外引流术只能作为急救措施，肝总管空肠Roux-en-Y吻合术伴抗反流术式，是囊肿切除术后重建胆道的理想术式。

Roux - en - Y hepaticojejunostomy and anti - countercurrent is an ideal operation of bile duct reconstruction after cyst excision .

方法对行囊肿切除、肝总管空肠Roux-en-Y吻合重建胆道的106例先天性胆总管囊肿病例进行回顾性分析和随访复查。

Methods 106 cases of CCC undergoing resection of CCC with Roux-en-Y hepaticojejunostomy as biliary tract reconstruction were followed up and analysed .

57例中，囊肿切除、肝总管空肠Roux-Y吻合37例，囊肿大部切除，胆管与空肠Roux-Y吻合12例。

Of the 57 patients , 37 were operated on with complete cyst excision combined with Roux en Y hepaticojejunostomy , and 12 with the excision of most of cyst .

结果28例病人分别行胆囊切除或部分胆囊切除，直接瘘口修补或胆囊壁补片修补及Rouxeny式肝总管十二指肠吻合术或空肠吻合术。

Results Cholecystectomy , partial cholecystectomy , direct closure of fistula or closure with gallbladder wall patch , and Roux en Y hepaticojejunostomy or hepaticoduodenostomy were performed for these 28 patients individually , and all of them were cured .

分别行胆囊切除或部分切除24例，胆囊胆管瘘口修补，胆管切开T管引流术5例，肝总管或胆总管与空肠Roux-en-Y吻合4例。

24 cases underwent cholecystectomy or partly cholecystectomy , 5 cases underwent cholecyst or bile duct fistula repair and T shape tube drainage , 4 cases underwent common bile duct or common hepatic duct to jejunum Roux-en-Y anastomosis .

结果635例LC中，主动中转开腹4例，术中胆囊动脉、胆囊动脉后支出血16例，均在腹腔镜下止血成功，1例肝总管损伤，术后第1d再次开腹手术。

Results Among 635 cases , 4 cases was converted to laparotomy , cystic artery or posterior branch of cystic artery hemorrhage in 16 cases and they were all been controlled successfully during laparoscope cholecystectomy , one case had common hepatic duct injury who was undergone laparotomy the next day .

结论紧贴囊壁剥离法切除胆总管囊肿，肝总管Roux-y型吻合术是治疗先天性胆总管囊肿的较好方法。

Conclusion The cyst resection nestling up against the cyst wall and the Roux-en-Y hepaticojejunostomy is a feasible method to treat CCC in children . the toxic action of PZA on liver is greater than that of other antitubercular drugs .

34例婴儿肝炎综合征中30例MRC能清楚显示胆总管、肝总管结构，2例显示较小胆囊，2例胆总管、肝总管未显示。

In 30 of the 34 patients with IHS , MR cholangiography clearly depicted common hepatic and common bile ducts , in 2 patients with IHS , only smaller gallbladder was depicted , in 2 patients , common bile duct and common hepatic duct were not depicted .

方法设计并应用了一种新术式以皮下通道型胆囊肝总管吻合术替代传统胆肠内引流术。

Methods A novel operation was designed instead of cholangiojejunostomy .

胆总管损伤4例，肝总管损伤2例，胆管损伤率033%。

The bile duct injury rate was 0.33 % .

2例表现为延迟性胆管狭窄，均为肝总管损伤，再次手术后痊愈。

Two patients with the manifestation of delayed bile duct stricture were cured by one operation .

胆囊切除致肝总管横断伴小网膜囊大量积液1例

A case report of common hepatic duct transection with a huge omental bursa cyst caused by cholecystectomy

胆囊管在胆囊颈的不同平面汇入肝总管。

The cystic duct joint the common hepatic duct at different plane of the neck of gallbladder .

结果12例均采用手术治疗，手术方式分别为胆囊切除或部分切除、直接瘘口修补、胆囊切除加胆总管或肝总管探查或胆肠内引流术，全部病人均治愈出院。

Results All the 12 cases treated by surgical operation . The operation included cholecystectomy or partial cholecystectomy , direct closure of fistula .

2例胆总管损伤、5例肝总管损伤、1例左右肝管与右侧副肝管横断伤。

Two cases injury happened at common bile duct , 5 cases at hepatico and 1 cases at left , right and subsidiary right extrahepatic bile ducts .

1例灼伤肝总管致术后胆漏，经开腹置T管6个月治愈。

Postoperative biliary leakage occurred in 1 case because of an injury of the common hepatic duct by electrocauterization , which was cured by open surgery with T-tube drainage for 6 months .

其中，胆总管横断伤7例，胆总管和肝总管部分损伤3例，右肝管损伤2例。

The complications included common bile duct transaction injury in 7 cases , partly injuring of common bile duct and common hepatic duct in 3 cases and right hepatic duct injury in 2 cases .

结果胆囊管变异发生率78.6%。其中胆囊管长度变异占41.7%，汇入位置变异占35.7%，汇入方向变异占52.4%，与肝总管并、绕行占47.6%。

Results The total variance rate of cystic duct was 78.6 % of which length was 41.7 % , postition was 35.7 % , direction was 52.4 % , collateral or circumambient with common hepatic duct was 47.6 % .

方法报道国内首例肝总管神经内分泌癌合并肝脏转移，结合国内已经报道的8例未发生转移病例，总结该病的诊断和治疗。

Method To summarize this disease 's diagnosis and treatment by analyzing a local first patient who was reported to suffer from the bile duct neuroendocrine carcinoma with liver transfer and 8 reported domestic cases of the bile duct neuroendocrine carcinoma without metastasis .

结果在27例患者中，胆总管横断3例，肝总管横断8例，肝总管壁损伤13例，右副肝管损伤2例，右肝管损伤1例。

Results Of the 27 patients , 3 suffered from transverse injury of the choledoch , 8 from transverse injury of the common hepatic duct , 13 from injury of the choledochal wall , 2 from subsidiary right hepatic duct injury , one patient had right hepatic duct injury .

结果：狭窄部位：位于肝总管近端3例（占13.6%），远端2例（占9.1%），总胆管中上段17例（占77.3%）。

Results : The stricture was located in the middle and supper part of common bile duct in 17 cases ( 77.3 % )? in the distal part of extrahepatic duct in 3 ( 13.6 % ) and in proximal part of extrahepatic duct in 2 ( 9.1 % ) .

结果：MRCP清楚显示14例正常左、右肝管，肝总管，胆总管和胆囊；

Results : MRCP showed clearly the normal left and right hepatic duct , common bile duct and gallbladder of 14 cases .