ï»?!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd"> 胆总管å二指肠端侧å»åˆæœ?/title> <meta name="keywords" content="手术,胆总管å二指肠端侧å»åˆæœ?è‚胆外科手术" /> <meta name="description" content="" /> <link href="http://images.whrenai.com/news_images/new_css.css" rel="stylesheet" type="text/css"> <SCRIPT src="http://images.whrenai.com/by_images/showFlash.js"></SCRIPT> <script type="text/javascript" language="javascript" src="http://images.whrenai.com/js/copy.js "></script> <SCRIPT src="http://images.whrenai.com/by_images/showFlash.js"></SCRIPT> <script language="javascript" src="http://images.whrenai.com/zx.js"></script> <script language='javascript' src='/js/Page.js'></script> <script language='javascript' src='/js/Xmlhttp.js'></script> <script language='javascript' src='/common/InfoViewCount.aspx?ModelId=1&&Id=70475'></script> </head> <body> <!--LOGO--> <div class=z1> <div class=logo><img 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end--> <div class=time>08-03-07 17:05:04　　　www.39.net　　　39</div> <!--time end--> <div class=key>关键è¯ï¼š<a href='/List.aspx?chid=18&Keyword=%e6%89%8b%e6%9c%af&FieldName=tagnamestr' target='_blank'>手术</a></div> <!--key end--> <div class=daodu></div> <!--ad end--> <div class=geyan><label><span>å¥åº·è°šè¯­</span></label></div> <!--geyan end--> <div class=concent fang=08-03-07 17:05:04> <br> <p>胆总管å二指肠端侧å»åˆæœ?/p> <img border="0" src="../../Files/Shoushu/20081271572865677801.jpg" > ⑴切开è‚å二指肠韧å¸? <img border="0" src="../../Files/Shoushu/20081271572870377802.jpg" > ⑵分离胆总管 <img border="0" src="../../Files/Shoushu/20081271572870377803.jpg" > ⑶在胆总管å»åˆå¤„ç¼ç‰µå¼•çº? <img border="0" src="../../Files/Shoushu/20081271572925077804.jpg" > ⑷切断胆总管，ç¼é—­è¿œç«? <img border="0" src="../../Files/Shoushu/20081271572925077804.jpg" > ⑸分离å二指肠åŽï¼Œä½œå»åˆå£åŽå£å¤–层ç¼å? <img border="0" src="../../Files/Shoushu/20081271572926577805.jpg" > ⑹å»åˆå£åŽå£å†…层ç¼åˆåŽï¼Œåœ¨èƒ†æ€»ç®¡å‰å£å¦åˆ‡å°å£å®‰æ”¾t形引æµç®¡ <img border="0" src="../../Files/Shoushu/20081271572929677806.jpg" > ⑺ç¼åˆå»åˆå‰å£? <img border="0" src="../../Files/Shoushu/20081271572934377807.jpg"> ⑻大网膜覆盖å»åˆå? å›?　胆总管å二指肠端侧å»åˆæœ? <p>[适应è¯]</p><p>1.胆总管下端管å£çº¤ç»´æ€§ç‹­çª„ã€?/p><p>2.先天性胆总管下端闭é”或狭窄ã€?/p><p>3.先天性胆总管管囊肿ã€?/p><p>4.胆总管下段æŸä¼¤ä¿®è¡¥æœ‰å›°éš¾ã€?/p><p>[术å‰å‡†å¤‡ã€éº»é†‰]</p><p>åŒèƒ†æ€»ç®¡åˆ‡å¼€æŽ¢æŸ¥æœ¯ã€?/p><p>[手术步骤]</p><p>1.分离胆总管　切开è‚å二指肠韧带[å›? â‘´]，显露胆总管[å›? ⑵]，注æ„å‹¿æŸä¼¤è‚动脉åŠé—¨é™è„‰ã€‚在贴近å二指肠处，将胆总管的两侧ç¼ä¸¤é’ˆç‰µå¼•çº¿[å›? ⑶]，在ç¼çº¿ä»¥ä¸‹å°†åˆ†ç¦»çš„胆总管切断。然åŽï¼Œç¼é—­èƒ†æ€»ç®¡è¿œç«¯ã€‚内层用细ä¸çº¿ä½œå…¨å±‚间断内翻ç¼åˆï¼Œå¤–层用细ä¸çº¿ä½œæµ†è†œé—´æ–­ç¼åˆ[å›? â‘·]ã€?/p> <p>2.分离å二指肠　切开å二指肠é™éƒ¨å¤–侧缘腹膜，é’性分离å二指肠çƒéƒ¨åŠé™éƒ¨ï¼Œä½¿å二指肠å‘上移，使其与胆总管近端贴近，以å…å»åˆå£æœ‰å¼ åŠ›ã€?/p><p>3.ç¼åˆå»åˆå£ã€€å°†èƒ†æ€»ç®¡è¿‘端两侧与å二指肠çƒéƒ¨å‰ä¸Šå£ä½œä¸¤é’ˆå›ºå®šç‰µå¼•ç¼çº¿ï¼Œæ‹‰æ‹¢å»åˆå£ã€‚å»åˆæ³•ä¸Žä¾§ä¾§å»åˆæœ¯ç›¸åŒ[å›? ⑸～⑺]。最åŽç”¨æ‰‹æŒ‡æŽ¢æŸ¥å»åˆå£ç›´å¾„大å°ä¸Žé€šç•…情况åŽï¼Œç”¨å¤§ç½‘膜覆盖å»åˆåŒºï¼Œå¹¶åœ¨å‘¨å›´å›ºå®šç¼åˆæ•°é’ˆ[å›? â‘»]ã€?/p> <p>4.引æµã€ç¼åˆã€€åœ¨å»åˆå£é™„近放置一香烟引æµï¼Œè‡ªå³è‚‹ç¼˜ä¸‹è…¹å£å°åˆ‡å£å¼•å‡ºï¼Œç”¨å®‰å…¨åˆ«é’ˆå›ºå®šã€‚最åŽé€å±‚ç¼åˆè…¹å£ã€?/p><p>[术中注æ„事项åŠæœ¯åŽå¤„ç†]</p><p>1.胆总管å二指肠端侧å»åˆæ—¶ï¼Œèƒ†æ€»ç®¡ä¸è¦åˆ†ç¦»å¤ªé•¿ï¼Œç®¡å£ä¸å®œåˆ†ç¦»å¤ªå¹²å‡€ï¼Œä»¥å…管å£ç¼ºè¡€å死，影å“å»åˆå£æ„ˆåˆã€?/p><p>2.如胆管短，无法安置t形管时，也å¯åœ¨èƒ†ç®¡å二指肠å»åˆåŽï¼Œç”±å二指肠置入导尿管，通过å»åˆå£ã€‚方法是于å二指肠é™éƒ¨ä¸­æ®µå‰å£çºµè¡Œåˆ‡å¼€å二指肠，放入导尿管，其头端ç»å»åˆå£è¿›å…¥èƒ†ç®¡ã€‚ç¼åˆè‚ å£åˆ‡å£ï¼Œå¹¶ç¼åˆæ•°é’ˆåŒ…埋固定导尿管于å二指肠å£ã€?/p><p>3.其余åŒèƒ†æ€»ç®¡å二指肠侧侧å»åˆæœ¯ã€?/p> </div> <!--concent end--> <div class=next> <p><a href="http://www.whrenai.com/ssdq/gdwk/70474.html">胆总管å二指肠侧侧å»åˆæœ?/a></p> <p><a href="http://www.whrenai.com/ssdq/gdwk/70476.html">术中胆é“造影</a></p> </div> <!--next end--> <div class=fanhui><a href="http://www.whrenai.com"><img src="http://images.whrenai.com/news_images/back.gif" width="180" height="34" border="0" /></a><a href="http://dgt.zoosnet.net/LR/Chatpre.aspx?id=DGT13232427" target="_blank"><img 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