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胆总管疾病

胆总管疾病的相关文献在1989年到2021年内共计103篇,主要集中在外科学、内科学、临床医学 等领域,其中期刊论文98篇、会议论文5篇、专利文献33062篇;相关期刊66种,包括大家健康(下旬版)、中国医学影像技术、临床肝胆病杂志等; 相关会议5种,包括2013中国西部声学学术交流会、2010微创外科论坛、第13届全国普通外科学术会议等;胆总管疾病的相关文献由347位作者贡献,包括陈安平、刘安、索运生等。

胆总管疾病—发文量

期刊论文>

论文:98 占比:0.30%

会议论文>

论文:5 占比:0.02%

专利文献>

论文:33062 占比:99.69%

总计:33165篇

胆总管疾病—发文趋势图

胆总管疾病

-研究学者

  • 陈安平
  • 刘安
  • 索运生
  • 肖宏
  • 易斌
  • 王征夏
  • 陈先林
  • 龙飞伍
  • 李振东
  • 王佳牧
  • 期刊论文
  • 会议论文
  • 专利文献

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    • 李鸿晔; 韦亚蓉; 李会会; 丁浩; 洪江龙; 孟海轮; 徐张巍; 鲍峻峻; 梅俏
    • 摘要: 目的 回顾性分析胆总管远端狭窄患者的超声内镜(EUS)特征,为EUS评估胆总管远端狭窄提供临床依据.方法 收集安徽医科大学第一附属医院2016年4月—2020年3月行EUS检查的175例胆总管远端狭窄的患者临床资料,分析患者的临床表现、实验室、影像学及EUS检查结果,并进行随访,总结胆总管远端狭窄的EUS特征.计数资料两组间比较采用χ2检验,计量资料两组间比较采用t检验.结果 175例胆总管远端狭窄患者中,良性胆总管远端狭窄85例(85/175,48.57%),恶性胆总管远端狭窄90例(90/175,51.43%).在恶性胆总管远端狭窄的患者中,EUS显示狭窄长度高于良性胆总管远端狭窄患者[(14.1±3.0)mmvs(7.9±3.0)mm,t=13.358,P<0.001],同时EUS发现恶性胆总管远端狭窄患者的管腔低回声占位(57.8%vs34.1%,χ2=9.843,P=0.002)、周围淋巴结肿大(26.7%vs 12.9%,χ2=5.147,P=0.023)及胰管扩张(51.1%vs 28.2%,χ2=9.532,P=0.002)等特征性改变发生率高于良性胆总管远端狭窄患者.EUS和MRCP两者联合诊断良性胆总管远端狭窄的敏感性为70.6%,诊断恶性胆总管远端狭窄的敏感性为92.2%.结论 胆总管远端狭窄具有如较长狭窄、低回声、周围淋巴结肿大及胰管扩张等EUS图像特征,有助于临床中胆总管远端狭窄的鉴别诊断作用.
    • 刘倩怡; 阮巍山; 岑川
    • 摘要: 目的 研究胆总管疾病超声内镜联合经内镜逆行胆胰管造影术的诊疗价值.方法 回顾性选取2018年6月至2020年6月中山市人民医院消化内科胆总管疾病患者50例,均接受超声内镜、ERCP、手术病理,将手术病理结果作为金标准,统计分析超声内镜、ERCP单独、联合检查的诊断价值.结果 超声内镜检查的诊断敏感度为88.5%(23/26),特异度为91.7% (22/24),准确度为90.0%(45/50),阳性预测值为92.0%(23/25),阴性预测值为88.0%(22/25).ERCP检查的诊断敏感度为80.8%(21/26),特异度为95.8%(23/24),准确度为88.0%(44/50),阳性预测值为95.5%(21/22),阴性预测值为82.1%(23/28).超声内镜联合ERCP检查的诊断敏感度为96.2%(25/26),特异度为91.7%(22/24),准确度为94.0% (47/50),阳性预测值为92.6%(25/27),阴性预测值为95.7%(22/23).超声内镜、ERCP联合检查的诊断敏感度、准确度、阴性预测值均显著高于单独检查(P<0.05).结论 胆总管疾病超声内镜联合ERCP检查的诊疗价值较单独检查高.
    • 徐承东; 黄国权; 汪建文; 张林杰; 张虎
    • 摘要: 目的探讨256层螺旋CT曲面重建(CPR)在胆总管梗阻性病变中的应用价值。方法回顾性分析经手术病理证实的172例胆总管梗阻性病变患者的CT资料,患者接受256层螺旋CT平扫、多期增强扫描,后对图像进行CPR。以病理诊断结果为金标准,比较CT平扫+增强检查与联合CPR的诊断效能。结果良性梗阻占74.42%(128/172),恶性梗阻占25.58%(44/172);所有患者均表现为胆总管不同部位狭窄、中断及不同程度肝内外胆管扩张。CT平扫+增强定位诊断符合率为93.02%(160/172),低于联合CPR的95.93%(165/172),但差异无统计学意义(P=0.238);CT平扫+增强定性诊断符合率为87.21%(150/172),低于联合CPR的95.35%(164/172)(P=0.007)。结论256层螺旋CT平扫与多期增强联合CPR可提高胆总管梗阻性病变的定性诊断准确率,为临床提供更客观、准确的信息。
    • 赵长勇; 周俊晶; 戴赛民; 张勇; 郭子健
    • 摘要: Objective To evaluate gastrobiliary duct drainage in the treatment for iatrogenic distal common bile duct injury found during the operation.Methods We analyzed clinical data of 17 cases with application of gastrobiliary duct drainage in immediate treatment for the injury of distal common bile duct found during the operation from June 2010 to June 2016.Postoperative bile drainage,postoperative gastrointestinal function recovery,time for removal of the gastrobiliary duct and hospitalization time were recorded.Postoperative bile leakage,intestinal fistula and pancreatic leakage were observed.Patients were followed up until June 2016.Results The mean volume of bile drainage on the third postoperative day were (310 ± 112)ml,the mean time of postoperative gastrointestinal function recovery were (3.0 ± 1.5) days,time for removal of the gastrobiliary stent were (7.5 ± 1.0) days and hospitalization time were (9.5 ± 1.5) days.There was no postoperative bile leakage,intestinal fistula and pancreatic leakage.All patients were followed up for a median time of 12 months (range,1-45 months).Meanwhile,we found no significant biliary strictures and cholangitis patients.Conclusion Gastrobiliary duct drainage is a simple,rational and effective treatment for iatrogenic injury of distal common bile duct during common bile duct exploration.%目的 探讨胃胆管引流术在胆总管下段损伤即时治疗中的应用价值.方法 回顾性分析2010年6月至2016年6月应用胃胆管引流术即时治疗术中发现的胆总管下段损伤的17例患者的临床资料.统计术后第3天胆汁引流量、术后胃肠功能恢复时间、术后拔除胃胆管时间及术后平均住院时间.观察术后有无胆漏、肠瘘及胰漏表现.采用门诊及电话随访.术后随访复查肝功能,B超及MRCP.随访时间截至2016年6月.结果 17例患者均应用胃胆管引流术治疗,术后第3天平均胆汁引流量(310±112) ml,术后平均胃肠功能恢复时间(3.0±1.5)d,术后平均拔除胃胆管时间(7.5±1.0)d,术后平均住院(9.5±1.5)d.术后无胆漏、肠瘘及胰漏表现.所有患者术后获得随访,随访时间为1~ 45个月,中位随访时间为12个月,术后无明显胆道狭窄及胆管炎.结论 胃胆管引流术治疗胆总管下段损伤方法简单、易行,疗效满意.
    • 樊剑锋; 石英佐; 朱晓敏; 浦晓; 王达丰; 宣晓琪; 程明
    • 摘要: Objetive To explore the clinical efficacy of a modified biliary-enteric loop type (Warren) anastomosis in treating biliary tract dilatation in children.Methods A retrospective analysis was made on 44 cases of biliary tract dilatation in children underwent surgery from Jan.2010 to Sep.2013.Methods loop-type biliary-enteric anastomosis were performed in 20 cases (test group)and biliary-enteric Roux-en-Y anastomosis in 24 cases (control group).The operation time for biliary-enteric anastomosis,patients'recovery time,liver function and postoperative complications between the 2 groups were compared.Results Operation time for bil-iary-enteric anastomosis and patients'recovery time were (63 ±11 min)and (21 ±4 h)in test group and (75 ±15 min)and (33 ±6 h)in control group,with statistical difference between the 2 groups(P <0.05).Except 1 case of adhesive intestinal obstruction in control group,there was no significant difference between the two groups in biliary drainage,jaundice elimination,postoperative complications and incidence of re-operation. Conclusions Compared with biliary-enteric Roux-en-Y anastomosis,the modified biliary-enteric (Warren)an-astomosis is a simple and reliable operation technique for biliary tract dilatation in children with better short-term outcomes.%目的:探讨改良胆肠袢式(Warren)吻合术重建胆道治疗小儿胆管扩张症的临床疗效。方法回顾性分析2010年1月至2013年9月我们收治的44例胆管扩张症患儿临床资料,其中20例行改良胆肠袢式(Warren)吻合术(改良组),24例行胆管空肠 Roux-en-Y 吻合术(Roux — Y 组)。比较两组手术时间、肠功能恢复时间、肝功能恢复情况及术后并发症情况。结果改良组平均手术时间(63±11)min,Roux—Y 组平均手术时间(75±15)min,差异有统计学意义(P <0.05)。改良组术后肠功能恢复时间(21±4)h,Roux—Y 组(33±6)h,差异有统计学意义(P <0.05)。两组肝功能恢复情况和退黄效果相同。除 Roux—Y 组有1例因肠粘连肠梗阻住院保守治疗后缓解外,两组均无返流性胆管炎等并发症。结论改良胆肠袢式吻合术重建胆道治疗小儿胆管扩张症的疗效与 Roux-en-Y 吻合术相同,但操作简便,术后肠功能恢复快。
    • 胡铤; 陈安平; 王佳牧; 索运生; 易斌
    • 摘要: Objective To summarize the experience with the intraoperative endoscopic nasobiliary drainage transabdominally during the course of operation of laparoscopy (LENBD). Methods From October 2013 to February 2015, there were 125 cases undergoing LENBD transabdominally, involving choledochotomy, electrohydralic lithothipsy, dilation and incision on the stenosis of papillary, bile duct drainage through the tranoral endoscopic nasobiliary drainage and primary closure of duct incision. Results The procedure was successful in 112 cases (89.6%) of biliary drainage out of 125 cases. Nasal bile duct intubation failed in 5 cases (4.0%), wherein the transfer for ureteral catheter drainage of bile duct in 2 cases, T tube drainage in 1 cases, bile duct drainage in 2 cases give up. Nasobiliary discount cause no liquid outflow in 2 cases (1.6%). In 3 cases (2.4%) of nasal bile duct early detachment, and lead to obstructive jaundice after operation in 1 cases that through to place again the tranoral endoscopic nasobiliary drainage. The bile leakage was occurred in 1 cases (0.8%) with primary closure of duct incision and cured by patent drainage. There were 2 cases (1.6%) got a slight pancreatitis after duodenoscopic papillotomy . Non case residual stones in the biliary duct of 125 cases. No other serious complications and non case died postoperatively. Conclusion If patients are suitable, LENBD transabdominally was safe and effective in the hands of skilled endoscopists.%目的总结运用腹腔镜术中经腹留置鼻胆管引流的治疗经验。方法从2013年10月~2015年2月运用腹腔镜术中经腹留置鼻胆管引流的手术方式,即腹腔镜术中十二指肠镜下鼻胆管引流术(LENBD),对125例患者进行治疗。结果 LENBD 125例中,112例胆管引流获得成功(89.6%)。鼻胆管插管失败5例(4.0%),其中中转为输尿管导管胆管引流2例,T管引流1例,放弃胆管引流2例。鼻胆管打折导致无任何液体流出2例(1.6%)。鼻胆管早期滑脱3例(2.4%),并导致术后梗阻性黄疸1例,再次置鼻胆管治愈。术后胆漏1例(0.8%),经腹腔引流管引流自愈。乳头切开术后发生轻症胰腺炎2例(1.6%)。胆管无残石。无其他严重并发症,无死亡。结论选择合适的病例,腹腔镜术中经腹留置鼻胆管引流是可行、有效和安全的。
    • 汪海; 王怀志; 魏从光; 宋永庆; 谢景军
    • 摘要: Objective To investigate the clinical effect of laparoscopic cholecystectomy ( LC) combined with en-doscopic sphincterotomy ( EST) in treatment of cholelithiasis complicated by choledochal stricture end or thin choledocho-lith. Methods A total of 87 patients with cholelithiasis complicated by choledochal stricture end or thin choledocholith admitted during July 2008 and July 2013 were divided into observation group ( n=45 ) and control group ( n=42 ) ac-cording to the therapy methods. The control group was given conventional open surgery, while the observation group was given LC combined with EST. The removed stones condition, intraoperative bleeding volume, operation time, hospital stay, postoperative complications and calculus recurrence in the two groups were observed and compared. The level chan-ges of direct bilirubin, white blood cell count, alanine transarninase (ALT) and C-reactive protein on postoperative 3rd and 7th d in the two groups were also observed and compared. Results All the stones were cleared, and no stone was left in the two groups. Compared with those in the control group, less intraoperative bleeding volume, shorter operation time and hospital stay were found in observation group, and the differences were statistically significant (P 0. 05 ). Conclusion The laparoscopic cholecystectomy combined with endoscopic sphincterotomy in treatment of cholelithiasis complicated by choledochal stricture end or thin choledocholith has a higher stone clearance rate, shorter operation time and hospital stay and less intraoperative bleeding volume. It has quicker digestion of postoperative obstructive jaundice and recovery of liver function with less inflammatory response.%目的:研究胆石症合并胆总管末端狭窄或细径胆总管结石患者应用腹腔镜胆囊切除术( laparoscopic cholecystectomy, LC)联合十二指肠镜下乳头切开术( endoscopic sphincterotomy, EST)治疗的临床效果。方法选择武警河南总队医院2008年7月—2013年7月收治的87例胆石症合并胆总管末端狭窄或细径胆总管结石,依据治疗方式分为研究组(n=45)与对照组(n=42),对照组行常规开腹手术治疗,研究组行LC联合EST治疗。对比观察两组结石取出情况,术中出血量,手术时间,住院时间,术后3、7d血中直接胆红素、白细胞计数、丙氨酸转氨酶、C-反应蛋白的变化,术后并发症发生及结石复发情况。结果两组结石均取净,无残留结石。与对照组比较,研究组术中出血量少,手术时间、住院时间短,差异均有统计学意义(P0.05)。结论胆石症合并胆总管末端狭窄或细径胆总管结石患者应用LC联合EST治疗,不仅结石取净率高,手术时间、住院时间短,术中出血量、并发症少,而且术后梗阻性黄疸消解迅速、肝功能恢复快、炎症反应少,临床应结合患者具体情况制定个体化治疗方案予以推广。
    • 汪海; 王怀志; 魏从光; 宋永庆; 谢景军
    • 摘要: 目的 研究胆石症合并胆总管末端狭窄或细径胆总管结石患者应用腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)联合十二指肠镜下乳头切开术(endoscopic sphincterotomy,EST)治疗的临床效果。方法 选择武警河南总队医院2008年7月—2013年7月收治的87例胆石症合并胆总管末端狭窄或细径胆总管结石,依据治疗方式分为研究组(n=45)与对照组(n=42),对照组行常规开腹手术治疗,研究组行LC联合EST治疗。对比观察两组结石取出情况,术中出血量,手术时间,住院时间,术后3、7 d血中直接胆红素、白细胞计数、丙氨酸转氨酶、C-反应蛋白的变化,术后并发症发生及结石复发情况。结果 两组结石均取净,无残留结石。与对照组比较,研究组术中出血量少,手术时间、住院时间短,差异均有统计学意义(P〈0.05);术后3、7 d血中直接胆红素、白细胞计数、丙氨酸转氨酶、C-反应蛋白均低于对照组(P〈0.05);术后并发症发生率及结石复发率差异无统计学意义(P〉0.05)。结论 胆石症合并胆总管末端狭窄或细径胆总管结石患者应用LC联合EST治疗,不仅结石取净率高,手术时间、住院时间短,术中出血量、并发症少,而且术后梗阻性黄疸消解迅速、肝功能恢复快、炎症反应少,临床应结合患者具体情况制定个体化治疗方案予以推广。
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