Résumé
Objective To explore the diagnosis and treatment of iatrogenic bile duct injury during choledochocystectomy. Methods Clinical data of 24 cases of iatrogenic bile duct injury were analyzed retrospectively from 2005 to 2009. Results Eight patients underwent early repair of bile duct within 4 days after the injury. 14 patients with later recognized bile duct injury underwent selective operations, and two patients were discharged after their jaundice were relieved without any surgical treatment. Supporting T tubes were left in place in 22 patients for 8 to 14 months after operations, without any biliary obstruction found after one year and six months to five year follow-up. Conclusions Early bile duct injury within 4 days was easily treated, but later bile duct injury should have selective operation. The patients with jaundice could be diagnosed with PTCD and ERCP to observe the bile duct injury. During operation membrane-to-membrane wide hepatojejunostomy helps prevent later anastomotic stenosis. The left in drainage tube in anastomotic stoma for more than 8 months improves success rate in the process of injuried bile duct repair.
Résumé
Objective To establish a method for content determination of hyodeoxycholic acid in Qingkailing Injection. Methods An UltimateXB-C18 column (5 ?m, 250 mm?4.6 mm) was used with a mobile phase of acetonitril-water-phosphoric acid (35∶65∶0.1). The flow rate was 1 mL/min. The temperature of the column was 40 ℃. The detection wavelength was 192 nm. Results There was a good linear relationship between the concentration of hyodeoxycholic acid and absorption area value in range of 0.201 35～1.006 75 mg/mL, r=0.999 6. The average recovery was 98.25% with RSD=1.26%. Conclusion This method was accurate, credible and repeatable which can be used to control the quality of Qingkailing Injection.
Résumé
450, can be chosen as the indication of preoperative jaundice-reducing. The jaundice index descending rate can be chosen as the standard of the operation opportunity.