Bile duct calculus Can be from the oral cavity treatment

Bile duct calculus Can be from the oral cavity treatment
Deputy Director of gi medicine of Chinese-Japan Friendship Hospital Fan YanHua
Show favouritism to fattily and take in, have a dinner when being often indefinite, especially bad life style of having breakfast etc., lead to the fact the disease morbidity of modern biliary tract is rising constantly, among them there is a cholelithiasis patient in the average every ten people. Because there is no very effective medicine, the treatment of this disease often needs surgery. It is a commonsense method which treats gallbladder calculus that the peritoneoscope gallbladder excises the skill. But have a treat method, bile duct of calculus by route by oral cavity people that might find out about are not numerous, this kind of method neither has an operation punches in the belly wall, nor, but use the inner mirror skill, this is named cutting and fetching the stone skill through the inner mirror duodenum papilla.
Bile to digest whom food spend, after people have meal, bile that liver produce run to the duodenum through the bile duct instead to digest the food, it has an opening on the duodenum that this shows bile duct, are named the duodenum papilla on this split medical science, it is pancreatic juice and door and gate where the bile flowed out. Papilla this open one's mouth, bring convenience for treat pancreatic duct and the intersection of bile duct and disease. By the pancreas cholangiography skill (ERCP) of driving in the wrong direction of the inner mirror Use, this opening, carried on the operation.
Its basic tool of operation is: Doctor inserts the special inner mirror namely duodenum mirror used for ERCP by the patient's oral cavity, reach duodenum through esophagus and stomach, then insert through inner the intersection of mirror and narrow passage papilla cut to the intersection of duodenum and papilla and in the bile duct, cut the papilla a small mouth of long about several millimetres. The papilla cuts the knife to calls " The knife " ,But not a blade in the traditional meaning, but purpose-built wire, it is easy to insert in the papilla to open, the wire can play a cutting role while energizing, and cut-out the place and organize solidifying, do not bleed. The papilla is opened after the incision and expanded, fetching the tool instrument of stone implement can be inserted in the bile duct, pick calculus to the duodenum under the circumstances that the X-ray is perspected. If calculus too large, difficult to take out, can also insert bile duct in, break to pieces, shed garrulous the intersection of stone implement and tool instrument calculus, then fetch. Once calculus leaves the bile duct, would not produce danger to the human body. Because this kind of surgery wound is little, the patient resumes fast, a lot of hospitals regard this treatment as the first-selected method to treat calculus of person in over-all charge of gallbladder at home and abroad.
However, it can not be treated with this kind of method by all cholelithiasis. First of all, ERCP is seldom used for treating gallbladder calculus, this is because the gallbladder is in charge of slenderly and not on a straight line with the person in over-all charge of gallbladder, it is not apt to turn round to manage and reach the gallbladder to fetch the tool instrument of stone implement again through the gallbladder. So, though there are method treatment some acute cholecystitis and patient of gallbladder calculus through ERCP of mirror expert in some, but can not for patient and doctor to choose as the therapeutic method conventionally yet. Likewise, ERCP is not regarded as and treated the first-selected method of bile duct calculus in the liver either, especially there is many bile duct calculus in the liver, and when the position is deeper, it is difficult for ERCP to fetch the stone, this kind of disease often needs surgery and biliary tract mirror to treat. Even calculus of person in over-all charge of gallbladder, ERCP not all patients can be successful, it is too narrow to make a variation or open one's mouth such as patient's duodenum papilla is congenital, the apparatus is unable to reach the person in over-all charge of gallbladder through the papilla; Cholelithiasis too much too big really up to the mark, inner mirror unable to break to pieces, lose, fetch it net; The bile duct opens in the position and changes after operation of patient's intestines and stomach, it is too far from the stomach, difficult arrival of inner mirror.
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