THE SIGNIFICANCE OF SPLANCHNIC BLOCK VIA ADIPOSE CAPSULE OF KIDNEY DURING EMERGENCY TREATMENT OF ACUTE CHOLANGITIS IN SEVERE TYPE_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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Department of General Surgery, Hospital of Luoyang Medical College, Luoyang 471003;

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Acute cholangitis Hypotension Splanchnic block Operative treatment Death rate

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Objective To study the neural mechanism of hypotension or shock state in acute cholangitis in severe type (ACST) and its value of clinical application.
Methods A technique of blocking abdominal splanchnic nervi via right adipose capsule of kidney was carried out on 28 patients by injecting 1% lidocaine before urgent operation.
Results After blocking the relevant nervi, hypotension or shock state in 23 patients were improved significantly (Ｐ＜0.05). The death rate was lower (14.3%) after having performed biliary decompressions with laparotomy. Conclusion Patients′ hypotension or shock state at the early phase of ACST is the result of neural reflex in which the splanchnic nervi is its afferent pathway. Blocking the relevant nervi before urgent operation, the valuable opportunity of emergency treatment can be obtainded and the complication and death rate are reduced significantly.

Citation： SUN Junjun,ZHENG Qichang,HU Youhua,et al.. THE SIGNIFICANCE OF SPLANCHNIC BLOCK VIA ADIPOSE CAPSULE OF KIDNEY DURING EMERGENCY TREATMENT OF ACUTE CHOLANGITIS IN SEVERE TYPE. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2000, 7(1): 42-43. doi: Copy

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1. Attila C, Alfredo S, Patricio B, et al. Common bile duct pressure in patients with common bile duct stones with or without acute suppurative cholangitis〔Ｊ〕. Arch Surg, 1988; 123(6)∶697.
2. Hiroaki K, Kazuhiro H, Sumito I, et al. Cholangitis〔Ｊ〕. World J Surg, 1984; 8(6)∶963.
3. 孙君军，郑启昌，朱天伦等. 急性胆管高压所致血液动力学变化中神经因素探讨〔Ｊ〕. 中华外科杂志， 1997； 35(12)∶771.
4. Cai WQ, Giorgio G. Innervation of the gall bladder and biliary pathways in the quinedpig〔Ｊ〕. J Anat, 1983; 136(1)∶97.
5. 郑思竞主编. 人体解剖学〔M〕. 第2版. 北京：人民卫生出版社， 1978∶339～340.
6. 杨品南，方基兴. 重症急性胆管炎并发多器官功能衰竭患者的死亡原因分析〔Ｊ〕. 中国普通外科杂志， 1996； 5(2)∶100.
7. 李永荣，姚德厚，郭贵林. 利多卡因对兔内毒素性肺损伤的防治作用〔Ｊ〕. 中华医学杂志， 1997； 77(6)∶473.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

THE SIGNIFICANCE OF SPLANCHNIC BLOCK VIA ADIPOSE CAPSULE OF KIDNEY DURING EMERGENCY TREATMENT OF ACUTE CHOLANGITIS IN SEVERE TYPE

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