The article is consulted professionally by MSc, BS. Dang Manh Cuong – Diagnostic Imaging Doctor – Department of Diagnostic Imaging – Share99 Central Park International Hospital.
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A biotheration in the bile tract under the instructions of digital shooting to erase the background is one of the modern techniques. This method helps doctors directly intervene in the lesion in the bile way to diagnose and treat the disease, limiting dangerous accidents.
1. General overview
Diseases associated with the bile catem inside or outside the liver are quite diverse and complex, especially if there is a spread that causes bile obstruction. Identifying the hism hism hismful organization of lesions and giving appropriate treatments is one of the important goals for clinical practice.
Duodenal endoscopic biopsy plays a major role in vater glossy diseases and the low bile ducoscopy. However, there are many cases of severe narrowing or high damage in the umbilical cord area of the liver that make the endoscope in reachable.
A biother biosing in the skin's bile duct was first introduced in 1980, which has so far been widely applied worldwide. This technique is performed by inserting a biopsy instrument into the bile guts through the liver tissue. The success rate of obtaining a patient is quite high, helping to complement cases where a biopsy cannot be performed through an endoscopy or through the liver.
Meanwhile, the background digital angiography system (DSA – abbreviated by the phrase "Digital Subtraction Angiography") is the method of an imaging diagnosis. Digital an anethorization techniques erase the background combining X-rays and digital imaging processing, helping to capture the vascular system in the body and intervene for treatment. The outstanding advantage of this method is minimal invasiveness, without the need for open surgery.
2. When is a biosy required in the bile?
2.1. Specify
This technique is usually carried out in case of benign or malignant bile obstruction for any reason, and it is also impossible to diagnose it with an endoscopic or liver biopsy. Specifically:
- In/out-of-liver, hepatic/recurrent bile cancer;
- Cancer of the stomach, pancreas or gallbladder invades the bile;
- Metalysed cancer of the bile, including: Cervical cancer, cancer of the lymphatic system, bronchi;
- Chronic bile bromatitis;
- Fibrosis of the main bile tract.
2.2. Contrainatrained
Do not perform a biosy in the bipolar tract under the instructions of the digital scan to erase the background if the patient has severe blood clot disorders, indicators:
- Inr blood clot time > 1.5;
- Number of tinglets < 50 G/l (cần truyền khối tiểu cầu trước khi can thiệp);
- Prothrombin Blood Clot Factor < 50% (truyền plasma tươi trước khi can thiệp).
Other contraintraines include:
- Acute liver and bile tract infections (hepatic or bile anesthosis);
- Hemorrhagic hemorrhesity of the bile.
3. Prepare
3.1. Implementer
- Specialists;
- Support doctors;
- Photoetroetrosy technicians;
- Nurses;
- Anesthesisisisisi doctor / technician (if the patient is unable to cooperate).
3.2. media
- Digital Subtraction Angiography (DSA);
- Films, film printers, and image storage systems;
- Lead coat, apron to shield X-rays.
3.3. medications
- Local anesthetics or body anesthesia as prescribed;
- Water-soluble Iodine phototholyer;
- Antiseptic solution of the skin, mucous membranes.
3.4. Common medical supplies
- 5ml and 10ml injection pumps;
- Distilled water, physiological saline;
- Surgical gloves, shirts, hats, and masks;
- Ionile intervention kit: Knives, scissors, clamps, 4 metal bowls, bean trays and tool containers;
- Gauze, cotton, surgical adhesive tape;
- Medicines and emergency instruments if there is a drug accident.
3.5. Special Medical Supplies
- Needles poke Chiba;
- The tube set enters the vessel;
- 0.035 inch standard conductor;
- Rigid conductor 0.035inch, long type 260-300cm;
- Cobra 4-5F an anorthortic cathethetic tube;
- Pig tail drainage 6-12F;
- Endoscopic biopsy pliers (Forceps);
- Sutures of the skin.
3.6. patient
- Be well explained about the procedure to cooperate well with the physician;
- Fasting and drinking before 6 hours can be drunk under 50ml of water;
- If there is a blood clot disorder, vitamin K supplements should be treated;
- Intravenous pre-interventional antibiotic injections 6 hours;
- At the intervention room: The patient lies on his back, installing a machine that monitors survival indicators. Antiseptic of the skin, then covered with aseptic towels with holes;
- In case the patient is too agitated, refuses to lie still, give sedatives …
3.7. Test vouchers
- Medical records for inpatient treatment;
- There is a certificate for conducting the procedure that has been passed;
- Computer-layered imaging, X-rays, MRI... if any.
4. Proceeding process
4.1. Skin-to-skin bile photography
- Use an ointer to check the cathetro that drains the bile through the skin;
- Insert the conductor, then unpled the bile duc cathetheity;
- Proceed to insert cathethees into the bile duccy through conductors;
- Digitally capture and erase the bile path background through the cathe tube;
- Locate where a bios biomede is expected.
4.2. biopsy
- Drain cathethees;
- Thread the vascular catheter into the bile veins through the conductor;
- Unpled conductors;
- Insert endoscopic bioscopy pliers into the bile veins through the vascular catheter;
- Use endoscopic biopic pliers to cut 3-5 pieces held in the bile ment.
4.3. Reset bile circulating through the skin
- Remove endoscopic biopic pliers from the bile and catheters of the vessels;
- Insert the conductor into the bile veins and drain the catheter of the vessel;
- Proceed to the cathethees that drain the bile circulating through the skin.
5. Accidents and handling
If the bio-bio biomedical piece is chewy, opaque white, and the size and quantity are large enough according to the requirements of the surgery, the technique is considered successful. In rare cases, a biosy in the bile way is at risk of accidents such as:
- Bile bleeding
Medical treatment is required, combining clinical monitoring, stools, mucous membranes, and red blood cells capacity of the patient. If there is continued bile bleeding, an interventional electrolycular doctor should be consulted. The remedy may be to replace the drain cathe or consider the circuit node.
- Perforation of the bile dder
This condition usually degenerates on its own. Complications of bile peritonitis are rare, if there are signs, a specialist consultation.
A biother biosing in the bile tract under the guidance of digital imaging removes the background, giving many advantages, giving information to diagnose and support treatment. Due to the sight of the bile entered the bile way, the technique allows the diagnosis of lesions of the bile way. Bile paths if not treated in time will cause many dangerous complications, so people need to go to a reputable hospital to promptly treat when there are signs, avoiding complicated developments affecting health.
Digital imaging techniques that erase DSA backgrounds and bios in the bile tract have been widely used. At Share99 International Health Hub, there is a team of experienced specialists, along with modern equipment, using digital an analtic techniques to erase the DSA background in a bile intestinal biopsy, helping doctors in diagnosing and treating quickly and accurately.
Before receiving the job at Share99 Central Park International Health Hub in December 2017, Dr. Dang Manh Cuong had over 18 years of experience in the field of ultrasound – imaging at Hai Phong Transport Health Hub, MRI Department of Nguyen Tri Phuong Health Hub and Imaging Department of Becamex International Health Hub.
For examination and treatment at Share99 International Health Hub, please go directly to Share99 Health System or register for an online examination HERE.
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