结石性胆囊炎的诊断和治疗.ppt

结石性胆囊炎的诊断和治疗 The Diagnosis and Treatment for Calculous Cholecystitis,Teaching Rounds&Case Analysis,让我们回顾一下这份病例,Diagnosis:Calculous Cholecystitis,中上腹疼痛1天,伴肩背部酸痛,进食油腻后,什么样的人容易得胆囊结石？,OR,Epidemiology,High Risk Factor,Pathogenesis,溶贫、肝硬化、心脏术后胆道感染肠肝循环被破坏肝前肝后因素,Symptoms and Signs,还是以方才的图片为例,右中上腹疼痛,伴肩背部酸痛,进食油腻后,吐,Clinical Feature,Maybe Other Surgical Diseases?,Are U Sure Of The Diagnosis?,Differential Diagnosis,Preoperative Preparation,三大常规肝肾功能凝血功能肿瘤指标血脂血糖。,How to Operation?,Laparoscopic Cholecystectomy，LC,让我们学习一段LC视频,Transumbilical Single-Port Laparoscopic Cholecystectomy,TUSPLC,Patient Discharge,这时，我们应该告诉他：你现在是个相当健康的人，但是还是需要注意我所说的以下问题。,Discharge Orders,NO,NO,否则,我们这样做。别人如何做？,我们选择LC让我们看看国内外其他医生的选择！,别人选什么？,小切口胆囊,估计会很辛苦的,保胆取石,腔镜下保胆取石,经皮胆道镜保胆取石：硬镜、纤维镜,复发！,Natural Orifice Translumi-nal Endoscopic Surgery,NOTES,男人怎么办？,da Vinci Surgical System,费用5万元有必要吗？,无创手术？,体外震波碎石口服药溶石胆囊内注射药物溶石,ERCP,安全性？有效性？,summary,结石性胆囊炎：流行性病学病因病机临床表现辅助检查鉴别诊断治疗及预后,