肝硬化 - 腹腔镜治疗胆囊炎

肝硬化 - 腹腔镜治疗胆囊炎
Cholecystitis on Hepatic Cirrhosis - Laparoscopic Treatment

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2013-3-6 12:46 上传

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这个视频介绍的是一名男性患者，叫cholecistectomy，60岁，诊断为肝硬化-所造成的病毒C.他患有腹痛，右上腹，诊断为急性cholecistitis，但因为手术被推迟并发症的高风险（血液化验显示，凝血问题- TAP = 50％）。临床threatment是为30天（包括静脉内抗生素+镇痛药），没有结果。腹腔镜的threatment进行。
在手术过程中主要关心的是止血，侧支循环对胆囊的病人有很多，不同的剪辑被用来控制所有的囊性动脉的动脉分支，对胆囊体和静脉曲张（很罕见的状况）...
苗条的胆囊壁引起穿孔的操作过程。这是PLC控制的金属制品剪辑（高漏斗（和一个endoloop的。（眼底）。
手术后，第二天疼痛消失，病人仍留在医院使用7天的静脉内抗生素（环丙沙星甲硝唑），在这段期间后，他被释放了，没有征兆。
This is the video of a cholecistectomy of a male, 60 years, diagnosed with Hepatic Cirrhosis - caused by Virus C. He was suffering of abdominal pain on the right upper quadrant, the diagnose of acute cholecistitis was made but the surgery was postponed because of the high risk of complications (blood tests showed coagulation problems - TAP=50%). Clinical threatment was performed for 30 day (including endovenous antibiotics + analgesics) with no results. Laparoscopic threatment was performed.
During the surgery the main concern was the hemostasis, the patient had a lot of collateral circulation on the gallbladder, various clips were used to control all the arterial branches of the cystic artery, and on varicose veins on the gallbladder body (VERY RARE condition)...
The slim wall of the gallbladder provoked the perforation during the manipulation. That was controled using metalic clips (on the high infundibulum( and one endoloop.(on the fundus).
After the surgery, next day the pain was gone. Patient remained on the hospital using endovenous antibiotics (ciprofloxacin an metronidazol) for 7 days, after that period he was released, with no symptons.

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