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Crust allogeneic skin covering the early treatment of 26 patients with extensive deep burns


Explorer multiple large stones,[link widoczny dla zalogowanych], common bile duct stones with intrahepatic bile duct stones twelve , Mirizzi syndrome, or papillary duodenal diverticulum stone and other hard -line EST were managed with common bile duct exploration as a proper [ 41. * 545.3 .3 intraoperative venous injury prevention and treatment of bleeding when the line of common bile duct exploration . Bile duct wall of the vein to prevent bleeding,[link widoczny dla zalogowanych], cut in the bile duct before the direction parallel to the sides along the bile duct ligation after bleeding from the cut vascular sparse areas . Location should not be cut too close to the portal ,[link widoczny dla zalogowanych], should avoid excessive hepatic portal dissection , once the more serious intraoperative bleeding, first control the hepatoduodenal ligament ,[link widoczny dla zalogowanych], should not blindly clamp , causing more serious damage, cause more Bleeding and bile duct injury. In the event of injury hemorrhage hemostasis methods should be used instead of clamp ligation method should be used . Bile duct varicose veins poor flexibility, blood flow is relatively slow, in part after compression to achieve hemostasis thrombosis purposes. Coagulation disorders in patients with cirrhosis have ,[link widoczny dla zalogowanych], so time is as long as oppression , pressure 5 ~ 10min to get good results. 4 cases of bleeding in this group of patients, 2 cases were taken before the clamp ligation method, bleeding fails to stop bleeding after 2 cases with good effect .
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