高位显露肝内外胆管,直视 F 进行狭窄胆管整形,取除高位胆管结石和劈肝行胆肠吻合术或桥式胆肠内引流术,是当前胆道外科的热门课题。为配合临床肝内胆管手术,我们进行了肝内胆管解剖和组织学研究。材料和方法1 选用福尔马林固定肝31具,...高位显露肝内外胆管,直视 F 进行狭窄胆管整形,取除高位胆管结石和劈肝行胆肠吻合术或桥式胆肠内引流术,是当前胆道外科的热门课题。为配合临床肝内胆管手术,我们进行了肝内胆管解剖和组织学研究。材料和方法1 选用福尔马林固定肝31具,肝的脏面人工雕刻出 Glisson 氏系统的各管道,全程显露肝胆管及伴行的肝动脉和门静脉。用游标卡 R。展开更多
Benign biliary strictures are being increasingly treated with endoscopic techniques. The benign nature of the stricture should be first confirmed in order to ensure appropriate therapy. Surgery has been the traditiona...Benign biliary strictures are being increasingly treated with endoscopic techniques. The benign nature of the stricture should be first confirmed in order to ensure appropriate therapy. Surgery has been the traditional treatment, but there is increasing desire for minimally invasive endoscopic therapy. At present, endoscopy has become the first line approach for the therapy of post- liver transplant anastomotic strictures and distal （Bismuth ! and I） post-operative strictures. Strictures related to chronic pancreatitis have proven more difficult to treat, and endoscopic therapy is reserved for patients who are not surgical candidates. The preferred endoscopic approach is aggressive treatment with gradual dilation of the stricture and insertion of multiple plastic stents. The use of uncovered self expandable metal stents should be discouraged due to poor long-term results. Treatment with covered metal stents or bioabsorbable stents warrants further evaluation. This area of therapeutic endoscopy provides an ongoing opportunity for fresh research and innovation.展开更多
文摘Benign biliary strictures are being increasingly treated with endoscopic techniques. The benign nature of the stricture should be first confirmed in order to ensure appropriate therapy. Surgery has been the traditional treatment, but there is increasing desire for minimally invasive endoscopic therapy. At present, endoscopy has become the first line approach for the therapy of post- liver transplant anastomotic strictures and distal （Bismuth ! and I） post-operative strictures. Strictures related to chronic pancreatitis have proven more difficult to treat, and endoscopic therapy is reserved for patients who are not surgical candidates. The preferred endoscopic approach is aggressive treatment with gradual dilation of the stricture and insertion of multiple plastic stents. The use of uncovered self expandable metal stents should be discouraged due to poor long-term results. Treatment with covered metal stents or bioabsorbable stents warrants further evaluation. This area of therapeutic endoscopy provides an ongoing opportunity for fresh research and innovation.
