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【product】Bile Duct Incision

- Jul 26, 2018 -

Bile duct incision and stone removal are mainly used for recurrence of residual stones or stones in the intrahepatic bile duct after biliary surgery. It is a relatively common surgical procedure.

Anesthesia and preoperative preparation

1. Anesthesia

general anesthesia.

2. Preoperative preparation

(1) Detailed medical history and system physical examination.

(2) Laboratory examination and evaluation of important organ functions such as heart, lung, liver and kidney.

(3) The application of preventive antibiotics.

(4) Symptomatic treatment with the disease.

Indication

After biliary surgery, residual stones or stones in the intrahepatic bile duct recur.

Contraindication

(1) Patients with acute biliary infections are not controlled.

(2) Those who cannot tolerate anesthesia and surgery.

(3) Multiple stones in the one-hepatic bile duct combined with hepatic fibrosis and atrophy.

Surgical procedure

General steps of surgery:

1. First cut the round ligament of the liver, the left coronary ligament and the left hepatic triangle ligament, free the left lobe of the liver, and find out the location of the stone.

2. At the site equivalent to the stone, cut the liver capsule along the direction of the left hepatic duct, bluntly separate the liver tissue into the intrahepatic bile duct stones, and separate the blood vessels parallel to the bile duct to avoid damage.

3. After the second traction line of the anterior wall of the bile duct is cut, the wall of the bile duct is cut longitudinally, and the stones in the bile duct are taken by stone pliers.

4. Exploring the intrahepatic bile duct and the hepatic bile duct is unblocked. If there is a stenosis, it should be corrected.

5. Place a suitable "T" tube in the intrahepatic bile duct.

6. Stitch the bile duct wall and liver incision.

Postoperative complications

Cholesterol, biliary infection.

Postoperative care

The "T" shaped tube should be properly fixed. The length of the drainage tube should be appropriate to prevent the patient from turning out and folding during the movement and folding. The drainage tube should be kept open, and the drainage volume, color, nature, and sediment should be observed.

Postoperative diet

Diet should be regularly quantified, mainly based on protein, carbohydrates and low-fat diet. Quit smoking and alcohol.

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