Pancreolith with pancreatic carcinoma is a rare disease. It’s difficult to be diagnosed before operation. In this study we summerized 29 cases of pancreolith (including cases of pancreolith with pancreatic carcinoma) during Jan. 1989 to Oct. 1994 treated in our hospital. The clinical characteristics were the following more male patients encomtered; many had the history of chronic alcoholic pancreatitis and many accompanied with diabetes; the main symptoms were persistent upper abdominal pain, pain in the back anoxia, diarrhea, wasting, but rarely jaundice. Main points in diagnosis: ①When the symptoms of chronic pancreatitis are getting worse and the patients become wasting, the carcinoma should be considered. ②Mutiple investigations such as B-US, CT, and MRI, CA19-9, CEA should be taken. ③Exploretory laparotomy and freezy biopsy is performed If nesscessery. Two patients were diagnosed before operation in this study. 3 cases had pancreatoduodenectomy. One had biopsy and other had pancreatojejunostomy.
Analysis of hospital cases of cholelithiasis in every four years of the recent 3 decades clearly shows the tendency of changes of cholelithiasis in clinical appearance in Chengdu.Constituent ratio of gallbladder stone was 12.56% in 70’s,47.54% in 80’s and 81.38% in 90’s.Bill duct stones including acute obstructive suppurative cholangitis was 71.01%, 46.08%,and 15.82% respectively. Biliary ascariasis was 11.67%, 2.75% and 0.68% respectively. Age incidence shows right moving, i.e. old patients increased. Urban patients increased.The influencing factors listed are: improvement of diagnostic methods; improvement of livelihood and diet; increased life expectancy; more health follow up examinations; technical improvements in rural areas and etc.
目的 探讨胆源性肝脓肿的诊治方法。方法 对我院2000~2004年期间收治并确诊为胆源性肝脓肿的12例患者进行分析，在应用抗生素和全身支持的前提下，再依据其病变发生、发展的不同阶段采用不同手段治疗。结果 4例急性期患者中2例行急诊胆道引流手术后治愈，另2例转为亚急性期（脓肿融合期）； 6例亚急性期患者均经B超导向下行脓肿穿刺抽脓后注入抗生素治疗后治愈； 4例慢性期患者行脓肿切开引流后治愈。结论 本病在应用广谱抗生素（二联抗生素）和全身支持治疗的前提下，再根据病变不同时期采用不同方法治疗，可获得良好效果。
目的 探索急性化脓性梗阻性胆管炎20世纪90年代后期与80年代以前的差异，探讨对本病治疗的方向。 方法 收集我院1996～2000年病例，并与我院1950～1981年资料进行比较。 结果 ①发病率显著降低，从46.08%降至15.62%； ②发病年龄延后10～20岁； ③入院时病情相对较轻，有休克者从51.39%降至22.80%； ④病死率明显下降，从25.78%降至3.50%； ⑤再手术患者显著增加，从12.12%增至55.20%。造成上述差异的原因与患者就诊早，及时的治疗，医务人员的水平提高，药品与医学的发展等有关。 结论 对急性梗阻性化脓性胆管炎患者，虽然发病率和死亡率已明显下降，仍需足够重视，因术后T管造影和B超检查发现肝内残石或胆管狭窄者，高达85.1%，复发再手术率达55.2%，远不能令人满意。为提高远期效果，应在急诊手术引流后，待患者病情平稳后，再进一步检查和彻底处理肝内病变。
【摘要】目的 探讨成人先天性胆总管囊肿的诊断和治疗。方法 对我科收治的7例成人先天性胆总管囊肿患者的资料进行回顾性分析。术前B超诊断正确率为91.9%(34／37)。6例行囊肿切除和肝总管空肠Roux-Y吻合术，1例因癌变行胰十二指肠切除术。结果 共随访29例，随访率为78.4%，平均随访43个月，未发现恶变者。结论 B超应作为先天性胆总管囊肿的首选检查，囊肿切除和肝总管空肠Roux-Y吻合术应作为首选术式，早期诊断，早期根治性治疗，是先天性胆总管囊肿诊治的关键。
【Abstract】Objective To analysis the clinical characteristics, pathogenesis, diagnosis and treatment of acute acalculous cholecystitis.Methods Seventy-nine cases of acute acalculous cholecystitis from January 1996 to January 2003 were retrospectively reviewed.Results Of those 79 cases, 13 cases were treated nonoperatively and 66 cases were treated operatively. Twentythree cases were suppurative, 43 cases were gangrenous with perforation in 18 cases，which were proved by postoperative pathology. Seventysix cases were cured and 3 cases were dead. Conclusion Keeping vigilant alert, observing dynamically as well as appropriate operative intervention are effective to improve the prognosis of acute acalculous cholecystitis.