肝管

胆囊间置肝管十二指肠吻合术后胆汁成分的分析

The analysis of the bile component following interposition of gallbladder between the common hepatic duct and duodenum

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 .

胃呈U形，腹面有2个肝管的入口；

The stomach is U-shaped and there are 2 entrances for liver ducts in its ventral side .

LC中LUSCHKA肝管损伤

The trauma of Luschka hepatic duct about the laparoscopic cholecystectomy

左、右肝管在长度、外径方面存在差异（P0.01）；

Significant difference was revealed in the length and diameter between the right and left hepatic ducts ( P 0.01 ) .

目的探讨预防及处理腹腔镜胆囊切除术（laparoscopiccholecystectomy，LC）时胆囊床胆管（包括右肝管分支及迷走胆管）损伤的对策。

Objective To discuss the prevention and treatment of bile duct injures io the gallbladder bed during laparoscopic cholecystectomy ( LC ) .

胆道对合取左肝管鄄空肠Roux鄄en鄄Y式吻合。

Biliary duct reconstruction was made by Roux-en-Y anastomosis of the left hepatic duct and the jejunum .

经腹腔镜行先天性胆总管囊肿切除肝管空肠Roux-Y吻合术的探讨

Laparoscopic Total Cyst Excision with Roux-Y Hepatoenterostomy for Choledochal Cyst

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 .

总胆管囊肿切除、肝管空肠Rouxeny吻合术是Ⅰ型先天性胆管囊状扩张症的一种较为合理的手术方式。

Excision of the bile duct cyst and Roux-en-Y hepaticojejunostomy is of the first choice for treatment of the disease of type I.

肝管空肠Roux-en-Y型吻合术171例。本组190例术后恢复顺利，手术死亡4例（2.06%）。

Roux-en-Y hepaticoduodenostomy in 171.After the treatments , 190 patients recovered smoothly and 4 died ( 2.06 % ) .

E4型1例，行右肝管空肠Roux-en-y吻合术。

The type E4 was 1 case , which was cured by right hepatic duct jejunum Roux en y anastomotic .

方法在B超定位下于剑突下穿刺左肝管行PTC检查，拔针后压迫穿刺点5～10分钟。

Method Percutaneous transhepatic cholangiography was performed by puncturing the left hepatic duct below xiphoid under the guidance of ultrasound . The puncturing spot should be oppressed for 5 ~ 10 minutes after the needle was pulled out .

手术14例，13例行肝管空肠Roux-Y吻合，1例行肝管十二指肠吻合术。

In 14 operations , 13 received Roux-Y anastomosis of hepatic duct and jejunum , while one were subjected to anastomosis of hepatic duct and duodenum .

结论：EUS对原因不明的急性胆源性腹痛是有诊断价值的，尤其对B超和CT检查胆总管及左右肝管不增宽的患者更有意义。

Conclusion : There is a diagnostic value to use EUS to the acute abdominal pain with cholecystopathy , especially to the cases that common bile duct and left or right hepatic duct were not enlarge under the ultrasound of type B and CT .

结果：在同一投影层面上，斜冠位T2WI显示左右肝管、肝总管及胆总管的显示率优于常规冠状位。

Results : In the same plane , the sensitivity of showing ductus hepaticus and ductus hepaticus communis , ductus choledochus with MR oblique-coronal T2WI was superior to conventional MR coronal T2WI .

结果12例MOJ病人左右肝管间、肝管胆总管间共置入内支架16枚，内涵管8个。

Results Sixteen metal and 8 plastic stents were implanted between dilated bilateral intrahepatic and hepatic common bile duct in 12 MOJ patients .

方法：以4F5F肝管或蛇管作为导引管，同轴插入3F微导管，尽量接近病灶，对肝癌实施化疗栓塞术。

Methods : Used 4F 5F RH or cobra as the guiding tube , coaxially inserted it by 3F microcatheter and approached the focus as far as possible , then implemented chemoembolization for hepatic cell carcinoma .

结果：10例探查阴性，17例发现胆总管下端结石，1例伴左肝管开口部结石，直径4～6mm。

Results : The exploration was negative in 10 cases and stones were found at the inferior extremity of CBD in 17 cases . One case was accompanied by stones at the left hepatic duct .

结果37例中，证实为Luschka胆管17例、胆囊肝管4例、右前叶肝管及其分支3例；

Results According to the operative records , 17 among the 37 cases had leakage from Luschka bile duct , 4 from the cholecystohepatic duct and 3 from the right lobular hepatic duct and its branches .

胆总管直径大于1.0cm或多发结石，尤其并存二级支肝管结石者（无胆管狭窄），腹腔镜下一期手术LC+LCBDE是治疗胆囊疾病合并胆总管结石的最佳选择。

Whereas , LC + LCBDE is the procedure of choice for the patients with CBD diameter > 1.0 cm and with multiple CBD calculi , especially in merging with secondary intrahepatic bile duct calculi .

干预：入院后在插管全麻下行胆囊切除、胆总管囊肿切除、肝管空肠Roux-Y式吻合术，术后予抗感染、止血、抑酸、营养支持等治疗。

INTERVENTION : After the patient was admitted to our hospital , she accepted surgical treatment of Cholecystectomy , Choledochal cyst excision , hepaticojejunostomy of Roux-Y in general anesthesia . After the operation , the patient accepted anti-infective therapy , hemostasis . acid reducing , nutritional treatment .

副肝管的出现率为10%。

The incidence of the accessory hepatic duct was 10 % .

左肝管的长度、定位与临床应用

The Length , Localization and Clinical Application of Left Hepatic Duct

副肝管在胆道手术中的临床意义

Clinical Significance of Accessory Hepatic Duct During Operation of Biliary Tract

左、右肝管各自独立地开口于胆囊管近肠部。

Hepatic ducts each open into the cystic duct near the intestines .

胆囊床内肝管的应用解剖

Applied Anatomy of the Hepatic Duct in the Gallbladder Bed

左内叶肝管的行程较恒定。

The course of the left medial lobar duct is rather constant .

副肝管的出现、走行及长度；

Appearance , running and length of parahepatic duct ;

胆总管囊肿切除、总肝管空肠吻合术式探讨

Investigation for operation form of choledochal cystectomy and hepaticojejunostomy