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總輸膽管內壓과 膽汁流出量에 管한 臨床的硏究

The Clinical Observations on the Intraductal Pressure of Common Blie Duct and the Amount of Bile

대한외과학회지 1966년 8권 10호 p.557 ~ 563
朴永寬, 金子勳,
소속 상세정보
朴永寬 (  ) - 서울대학교 醫科大學 外科學敎室
金子勳 (  ) - 서울대학교 醫科大學 外科學敎室

Abstract


The observations were performed on 17 patients with indwelling T-tube in the common bile duct and on 5 partients without hepatobiliary diseases as control.
The 17 subjects were grouped in three: Group Ⅰ were 13 cases of cholecystectomy, Group Ⅱ were 2 cases of sphincteric stenosis and Group Ⅲ 2 cases of congenital anomaly(absence of gall bladder) of the biliary tract. The pressnre of the common bile dnct was measured by means of water manomater on the operating table and postoperative period, and in the course of postoperative days the pressure was also measured before and after meals. The amount of bile was measured through the indwelling T-tube using 2 bottles, one for the amount of day-time (8:00A.M.-8:00P.M.) and the other for night (8:00P.M.-8:00A.M. of next morning). The results obtained are as follows:
(1) In control group, the common bile duct pressure on operating table was ranged from 80 mmH_2O. to 110 mmH_2O.
(2) Heart beat, respiration, cough and Valsalva´s maneuver usually caused fluctuation of intraductal pressure in all 17 cases.
(3) In cholecystectomized group, the pressure of the patients with gall stone showed a significant decrease after removal of the etiologic factors.
(4) The difference between the pressure before and after meal was 11.1 mm H_2O(mean) in Gronp Ⅰ, 44.4 mmH_2O in Group Ⅱ, 10.1 mmH_2O in Group Ⅲ respectively, but no significant difference was observed during the period of nothing per oral.
(5) The mean daily amount of bile during immediate postoperative days(N.P.O.) showed a marked decrease comparing to the amount of the days of oral intake, but no significant difference between the amount of day-time and nigth.
(6) In Group Ⅱ the pressure was significantly decreased after operation, but never returned to normal limits.
(7) In congenital anomaly of gall bladder, the pressure of common duct on the operation table showed a lower level, but rather a significant increase after operation.

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