METHOD FOR INTRAOPERATIVE DETECTION OF BILE LEAKAGE ACCOMPANYING HEPATECTOMY

摘要

FIELD: medicine.;SUBSTANCE: Venofer is used as a contrast medium. The bile duct system is enhanced before the stage of hepatectomy. The common bile duct is clamped with a bulldog vascular clamp and cannulated through the cystic duct remnant. The bile duct system is filled with a contrast solution of Venofer in a ratio of 2 ml in 200 ml of normal saline. The contrast solution continuously flows from a bottle through an infusion device. The bile duct filling is assessed as the contrast medium stops dropping. The liver pulp excision is performed. The resection involves monitoring the bile duct system integrity by visualising the enhanced bile ducts as shown by the contrast medium continuing dropping in a drop tube. Once the liver pulp excision is terminated, the check infusion of the solution is performed to detect any defects of the bile duct system integrity along the hepatectomy.;EFFECT: method provides the complete and uniform filling of the bile duct system by using the infusion device, enables visualising clearly the enhanced bile ducts of difference sizes, the presence of bile leakage and its origin before, during and after the hepatectomy, monitoring the bile leakage process by using Venofer and beginning the contrast enhancement procedure before the resection.;2 cl, 1 dwg, 1 ex