膽道狹窄解剖生理以及手術(shù)過(guò)程

1、關(guān)于膽道狹窄的解剖生理及手術(shù)過(guò)程第一張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月第二張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月The Procedure操作過(guò)程 第三張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月The Procedure操作過(guò)程第四張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月The Procedure操作過(guò)程第五張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Treatment Alternatives: PTCA Procedure選擇性治療：經(jīng)皮冠狀動(dòng)脈內(nèi)成形術(shù)操作過(guò)程第六張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Angioplasty Balloon Inflation球囊擴(kuò)張血管成

2、形術(shù)第七張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Treatment Alternatives: PTCA Procedure選擇性治療：經(jīng)皮冠狀動(dòng)脈內(nèi)成形術(shù)操作過(guò)程第八張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Treatment Alternatives: Peripheral Stent Procedure選擇性治療：外周血管支架置入術(shù)第九張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Stent Implant支架置入第十張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Peripheral Procedures and Equipment膽道解剖生理第十一張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月

3、胸主動(dòng)脈肱動(dòng)脈腋動(dòng)脈右髂總動(dòng)脈右髂外動(dòng)脈 腹主動(dòng)脈左髂內(nèi)動(dòng)脈 左股動(dòng)脈右腎動(dòng)脈肝總動(dòng)脈 腸系膜下動(dòng)脈 脾動(dòng)脈 左胃動(dòng)脈 腸系膜上動(dòng)脈腹腔干頭臂動(dòng)脈左鎖骨下動(dòng)脈左頸總動(dòng)脈Copyright 1983. Principles of Human Anatomy. Third Edition. Gerard J. Tortora. This material is used by permission of John Wiley & Sons, Inc.第十二張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Biliary Tract Anatomy 膽道解剖 The biliary tract is mad

4、e up of the liver, pancreas, gallbladder, pancreatic duct, common bile duct, hepatic duct . 膽道由肝臟，胰腺，膽囊，胰管，總膽管，肝管組成。The biliary tract is part of the digestive system.膽道是消化系統(tǒng)的一部分第十三張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Liver肝臟Function功能: Metabolism of: carbohydrates, fat, protein 代謝碳水化合物，脂肪，蛋白質(zhì) Removal of drugs and h

5、ormones代謝藥物和激素Excretion of bile分泌排出膽汁Copyright 1989. Novartis. Reprinted with permission from the Atlas of Human Anatomy, illustrated by Frank H. Netter, M.D. All rights reserved.第十四張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Biliary Tract Anatomy 膽道解剖 Copyright 1989. Novartis. Reprinted with permission from the Atlas of

6、Human Anatomy, illustrated by Frank H. Netter, M.D. All rights reserved.第十五張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Biliary Tract Anatomy 膽道解剖 Bile is secreted by the liver, through the hepatic ducts, and stored in the gallbladder. 膽汁由肝臟分泌并儲(chǔ)存在膽囊Bile exits gallbladder via cystic duct into common bile duct into small int

7、estine. 膽囊中的膽汁經(jīng)過(guò)總膽管進(jìn)入小腸 Function功能:Copyright 1989. Novartis. Reprinted with permission from the Atlas of Human Anatomy, illustrated by Frank H. Netter, M.D. All rights reserved.Digestion of fatty foods and fat-soluble vitamins消化食物中的脂肪和脂溶性維生素Gallbladder膽囊第十六張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Biliary Tract Anatomy膽

8、道解剖Copyright 1989. Novartis. Reprinted with permission from the Atlas of Human Anatomy, illustrated by Frank H. Netter, M.D. All rights reserved.Pancreas胰腺Secretes hormones分泌激素 insulin胰島素 glucagon胰高血糖素to aid digestion幫助消化Pancreatic duct胰管Common bile duct總膽管第十七張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Biliary Tract Anato

9、my 膽道解剖 第十八張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Biliary Stenting: Purpose膽道支架：目的 To treat symptoms of patients with malignant tumors (due to cancer of the biliary tract) which block the flow of bile into the intestines. 治療因?yàn)槟懙缾盒阅[瘤阻塞膽管，影響膽汁進(jìn)入小腸引起的癥狀。第十九張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月 Diagnosis of Biliary Stricture膽道結(jié)構(gòu)的檢查 Perc

10、utaneous Transhepatic Cholangiography (PTHC/PTC) approach經(jīng)皮經(jīng)肝膽管造影術(shù)Endoscopic Retrograde Cholangiopancreatography (ERCP)內(nèi)鏡下逆行膽管胰造影術(shù)第二十張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Portal Venous SystemAnatomy and Procedures門靜脈系統(tǒng)解剖和手術(shù)過(guò)程第二十一張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月 Feeds blood into the liver 輸送血液進(jìn)入肝臟 Consists of superior, inferior

11、 mesenteric, splenic, gastric, and cystic arteries 收集腸系膜上、下動(dòng)脈，脾動(dòng)脈，胃動(dòng)脈，和膽囊動(dòng)脈來(lái)的血液。 Portal Vein System門靜脈系統(tǒng)第二十二張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Portal Vein System門靜脈系統(tǒng) Liver receives blood from the portal vein and hepatic artery. 肝臟收集門靜脈和肝 動(dòng)脈來(lái)的血液 Blood leaves the liver through the hepatic vein.血液經(jīng)肝靜脈離開肝臟Copyright

12、1989. Novartis. Reprinted with permission from the Atlas of Human Anatomy, illustrated by Frank H. Netter, M.D. All rights reserved.Hepatic artery肝動(dòng)脈Hepatic vein肝靜脈Portal vein門靜脈第二十三張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Cause病因:A blocked vessel in the liver due to cancer,tissue scarring by cirrhosis, hepatitis, etc.

13、 因?yàn)榘┌Y、肝炎或肝硬化所致的組織纖維疤痕化造成的肝血管受壓。Blood flow is forced backward causing veins to enlarge, resulting in variceal bleeding.血液被迫反流造成靜脈擴(kuò)張，靜脈曲張破裂出血。Clinical Symptoms臨床癥狀:Jaundice, ascites, edema, respiratory distress, GI hemorrhage, hepatic encephalopathy黃疸，腹水，浮腫，呼吸性窘迫，胃腸道出血和肝性腦病。Portal Hypertension門靜脈高壓第二十

14、四張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Portal Vein System 門靜脈系統(tǒng) 第二十五張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月Portal Hypertension: TreatmentTIPS Procedure門靜脈高壓治療措施 A procedure used to treat portal hypertension in the liver as a result of blocked blood flow in the portal vein. 用于治療因門靜脈阻塞所致的肝內(nèi)門靜脈高壓措施。Transjugular 經(jīng)頸靜脈的Intrahepatic 肝內(nèi)的 Por

15、tosystemic門體循環(huán)的Shunt 分流 第二十六張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月TIPS Procedure治療措施 This shunt (TIPS) will take blood from the vein feeding the liver (portal vein) to another vein that takes blood out of the liver (hepatic vein). 這一分流術(shù)將流進(jìn)肝臟的門靜脈的血液分流到別的靜脈將血液帶離肝臟。This decreases the pressure in the portal vein and may

16、 help reduce the symptoms of portal hypertension. 這將減少門靜脈的壓力并幫助減輕門脈高壓癥狀。Copyright 1989. Novartis. Reprinted with permission from the Atlas of Human Anatomy, illustrated by Frank H. Netter, M.D. All rights reserved.第二十七張，PPT共二十九頁(yè)，創(chuàng)作于2022年6月A channel is created between the hepatic vein and the portal vein. Tract of liver tissue between veins is dilated with a 8mm or larger balloon.在肝靜脈和門靜脈間建立通道，并在肝臟組織間的靜脈內(nèi)用直徑8毫米或更大的球囊擴(kuò)張。Sheath is reintroduced into the portal vein after dilatation.分流后在門靜脈里重新置入鞘Shunt or stent is placed