扬州大学：《外科学》课程教学课件（PPT讲稿，Surgery）Chapter 30. Biliary Tract Diseases

Biliary Tree

Biliary Tree

Biliary TreeBILIARYTREE

Biliary Tree • BILIARY TREE

Biliary Tree肝尾状叶

Biliary Tree

Biliary Tree胆总管2/3胰腺段胆总管胰管1smm肝胰壶腹13

Biliary Tree

Biliary Tree· Function- Secrete bile for digestion: Bile salts: Cholesterol. Water- Toxin expelling. Toxin dissolved in oil

Biliary Tree • Function – Secrete bile for digestion • Bile salts • Cholesterol • Water – Toxin expelling • Toxin dissolved in oil

Biliary TreeGENERALCONSIDERATIONSINBILIARYTREEPATHOPHYSIOLOGYPain>Colicpainorother-SymptomsJaundice-LaboratoryTests>elevationoftheserumbilirubinlevel-ImagingStudiesFever>infection-BacteriologyNinflammation

Biliary Tree • GENERAL CONSIDERATIONS IN BILIARY TREE PATHOPHYSIOLOGY – Symptoms – Laboratory Tests – Imaging Studies – Bacteriology ⚫ Pain ➢ Colic pain or other ⚫ Jaundice ➢ elevation of the serum bilirubin level ⚫ Fever ➢ infection ➢ inflammation

Biliary TreeGENERALCONSIDERATIONSINBILIARYTREEPATHOPHYSIOLOGYCBC- Symptoms>Infection-LaboratoryTestsLiverfunctiontests>Bilirubin-ImagingStudies>AlkalinephosphataseCoagulationfunctiontests-Bacteriology

Biliary Tree • GENERAL CONSIDERATIONS IN BILIARY TREE PATHOPHYSIOLOGY – Symptoms – Laboratory Tests – Imaging Studies – Bacteriology ⚫ CBC ➢ Infection ⚫ Liver function tests ➢ Bilirubin ➢ Alkaline phosphatase ⚫ Coagulation function tests

Biliary TreeGENERALCONSIDERATIONSINBILIARYTREEPATHOPHYSIOLOGYUltralsound>Sotnes-Symptoms≥inflammation-LaboratoryTestsPlian films>stones-Imaging StudiesMRIandMRCPCT-BacteriologyERCP

Biliary Tree • GENERAL CONSIDERATIONS IN BILIARY TREE PATHOPHYSIOLOGY – Symptoms – Laboratory Tests – Imaging Studies – Bacteriology ⚫ Ultralsound ➢ Sotnes ➢ inflammation ⚫ Plian films ➢ stones ⚫ MRI and MRCP ⚫ CT ⚫ ERCP

Biliary TreeGENERALCONSIDERATIONSINBILIARYTREEPATHOPHYSIOLOGY-Symptomsgram-negativeaerobes-LaboratoryTestsEnterobacteriacae Escherichia coli-ImagingStudies>Klebsiella>Enterobacter-Bacteriology

Biliary Tree • GENERAL CONSIDERATIONS IN BILIARY TREE PATHOPHYSIOLOGY – Symptoms – Laboratory Tests – Imaging Studies – Bacteriology ⚫ gram-negative aerobes ⚫ Enterobacteriacae ➢ Escherichia coli ➢ Klebsiella ➢ Enterobacter

BILIARYDISEASEVCalculous Biliary DiseaseVChronic CholecystitisBENIGNBILIARYVAcuteCalculous Cholecystitis-InfectionVCholedocholithiasis-ObstructionGallstone Pancreatitis- Bleeding-Parasitesandpo-Benign neoplasn VGallbladderCancerMALIGNANT BILI V Bile Duct Cancer-CancerVMetastaticand other tumors-Matastaticneop

BILIARY DISEASE • BENIGN BILIARY DISEASE – Infection – Obstruction – Bleeding – Parasites and parasitic disease – Benign neoplasm • MALIGNANT BILIARY DISEASE – Cancer – Matastatic neoplasm ✓Calculous Biliary Disease ✓Chronic Cholecystitis ✓Acute Calculous Cholecystitis ✓Choledocholithiasis ✓Gallstone Pancreatitis ✓Biliary Dyskinesia ✓✓Gallbladder Cancer Sphincter of Oddi Dysfunction ✓Bile Duct Cancer ✓Metastatic and other tumors