Biliary tract 第Œ¸‰¬è¯¾

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  • Cholecystolithiasis Gall stone

    Diagnosis : BUS 96% + + .

    CT MRI

  • Cholecystolithiasis Gall stone

    Treatment

    ( >3cm >10

  • Cholecystolithiasis Gall stone

    Treatment

    (Laparoscopic cholecystectomy) (Open Cholecystectomy)

  • Laparoscopic CholecystectomyLaparoscopic Cholecystectomy

  • Laparoscopic CholecystectomyLaparoscopic Cholecystectomy

  • Choledocholithiasis

    CBD

  • Etiology:Etiology: + + PathologyPathology

  • Clinical presentationsClinical presentations Charcot Clinical triad of

    Charcot

  • Lab examinations WBC Bilirubin SGPT AKP

    Radiology Findings BUS CT MRI PTC ERCP

  • DiagnosisDiagnosis Charcot +

    DifferentiationDifferentiation

  • ManagementManagement

  • --

    CBD +T BUS

    6

  • T T YY

  • --

    CBD Roux-en-Y + CBD

  • Roux-en-Y choledochojejunostomy

  • --

    Oddi CBD

  • --

    (EST)

  • Hepatolithiasis

    Etiology Pathology

  • Hepatolithiasis

    Clinical presentationsClinical presentations AOSC

  • Hepatolithiasis

    DiagnosisDiagnosis BUS CT PTC

  • Hepatolithiasis

    ManagementManagement + Oddi CBD-

  • Hepatolithiasis

    +

  • Charcot

    T

  • Infection of biliary tract

    Liu BinDivision of HPB Surgery

  • Infection of biliary tract

    Cholecystitis Cholangitis

    Cholecystitis Acute calculous cholecystitis 95% Acute acalculous cholecystitis 5%

  • Acute Calculous Cholecystitis

    Etiology G-Pathology

  • Acute Calculous Cholecystitis

    Clinical presentations

    -

    Murphy sign(+)

  • Acute Calculous Cholecystitis

    Laboratory examination WBC SGPT AKP Bilirubin am

    ylase

    Radiological examination BUS:

    CT MRI

  • Acute Calculous Cholecystitis

    Diagnosis and differentiation

  • Acute Calculous Cholecystitis

    Treatment

  • Acute Calculous Cholecystitis

    Operative treatment

    72

  • Chronic cholecystitis

    Etiology

    Pathology

  • Chronic cholecystitis

    Clinical presentations Signs:

  • Chronic cholecystitis

    Diagnosis BUS:

    Differentiations

  • Chronic cholecystitis

    Treatment

  • Acute Obstructive Suppurative Cholangitis, AOSC

    Acute Cholangitis of Severe Type ACSTEtiology 76-88.5% 8.7-11% T PTC

  • Acute Obstructive Suppurative Cholangitis, AOSC

    Pathology

    +

    >1.96kPa(20cmH2O)

  • Acute Obstructive Suppurative Cholangitis, AOSC

    Clinical presentationsReynolds Reynolds Charcot +

    39-40C

  • Acute Obstructive Suppurative Cholangitis, AOSC

    Clinical presentations T>39-40 C P>120 / BP WBC>20109/L PL PT

    BUS CT MRI MRCP

  • Acute Obstructive Suppurative Cholangitis, AOSC

    Treatment 6h)

  • Acute Obstructive Suppurative Cholangitis, AOSC

    Treatment

    T

    PTCD ERCP--ENBD endoscopic nasobiliary drainage)

  • AOSC

  • Tumor of biliary tract

    (polypoid lesions of gallbladder)-

    BUS

  • Tumor of biliary tract

    Differentiation of benign and malignant tumor

    1cm 1cm

    BUS

  • 1 2 3 10mm 4

  • adenomyomatous hyperplasiaadenomyomatous hyperplasia

    HE100

  • Carcinoma of Gallbladder

    25% 1% =1:1.98 60-70

    Etiology 70-98%

  • Carcinoma of Gallbladder

    Pathology 80%

  • Carcinoma of Gallbladder

    ClassificationNevinI II III IV

    V

  • Carcinoma of Gallbladder

    Classification of UICC I T1N0M0 II T2N0M0III 2cm T4N0M0 TXN1M0

    IVB TXN2M0TXN0M1

  • Carcinoma of Gallbladder

    Clinical presentations and classification

  • Carcinoma of Gallbladder

    Lab examinations CEA CA-19-9CA-19-9 CA-125

    Radiological examination BUS CT

  • CT

    CT

  • http://www.37c.com.cn/literature/library/theory/010/0100301407.jpg
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  • Carcinoma of Gallbladder

    Treatment Nevin I UICC I

    Nevin II III IVUICC I +

  • Carcinoma of Gallbladder

    Prognosis

  • Carcinoma of Bile Duct

    Etiology

  • Carcinoma of Bile Duct

    Pathology 1/3 50-75% 1/3 10-25%

    1/3 10-20%

  • Carcinoma of Bile Duct

    Clinical presentations and diagnosis 60 90%

  • Carcinoma of Bile Duct

    Signs

  • Clinical findingsClinical findings

  • Lab examinations

    AKP SGPT BIL CA19-9 CA125 CEA

    BUS CT MRI PTC ERCP

  • MRCPMRCP

  • Carcinoma of Bile Duct

    Treatment

  • Carcinoma of Bile Duct

    - Roux-en-Y PTC ERCP

    :

  • Palliative therapyPalliative therapy

  • Palliative therapyPalliative therapy

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