What is bile duct stricture and how should it be treated?

What is bile duct stricture and how should it be treated?

What is a bile duct stricture?

The bile duct is formed from the micro bile ducts formed by the liver cells in the liver, to the intrahepatic bile duct, and then to the relatively thick common bile duct, all the way to the intestinal tract. The distribution of all bile ducts is like a tree. The narrowing or obstruction of the bile duct in any part is called bile duct stenosis, and the common clinical stenosis is mainly the stenosis of the common bile duct and the stenosis of the main branches of the intrahepatic bile duct.

Bile duct strictures can be caused by a variety of etiologies, and are classified into two categories: benign bile duct strictures and malignant bile duct strictures according to their pathological types. At present, the differential diagnosis of bile duct strictures is still difficult, and early diagnosis can help patients with malignant strictures obtain the best prognosis and avoid unnecessary surgery for patients with benign strictures.

Causes of bile duct strictures

· Causes of benign bile duct strictures

Benign Biliary Stricture (BBS) refers to the local formation of scar tissue in the bile duct lumen caused by a series of non-malignant diseases, eventually resulting in complete or incomplete stenosis of the bile duct. Untreated benign bile duct strictures are often secondary to complications that can lead to serious adverse outcomes (irreversible liver cell damage, recurrent sepsis, etc.).

  1. Inflammatory diseases

Inflammatory stricture caused by bile duct stones complicated by infection, chronic pancreatitis, cholangitis (primary sclerosing cholangitis, IgG4-related sclerosing cholangitis).

  1. History of biliary surgery

Cholecystectomy, pancreaticoduodenectomy, biliary-enteric (liver-enteric) anastomosis, after liver transplantation.

3, iatrogenic injury

Improper operation of biliary tract, inflammatory contraction and stenosis after damage to the bile duct.

  1. Other situations

Blood vessels compress the bile duct and bile duct stones cause bile duct obstruction and relative stenosis.

· Causes of malignant bile duct strictures

Malignant Biliary Stricture (MBS) refers to tumor stenosis caused by primary or exogenous compression of bile ducts such as bile duct cancer, pancreatic cancer, ampullary cancer, and metastatic cancer.

Treatment of bile duct strictures

· An examination

The most routine examination for bile duct stenosis is abdominal ultrasound, which can only be used as a primary screening tool for benign bile duct stenosis. When malignant bile duct stenosis is highly suspected, contrast-enhanced CT and MRCP should be performed. The combination of the two methods can improve the accuracy of diagnosis.

· Treat

There are different treatment methods for benign and malignant bile duct stenosis, mainly surgical treatment, the principle is “relieve the stenosis, unobstructed drainage”. In clinical practice, only about 15% to 24% of bile duct strictures are benign, and most of them are caused by malignant lesions. Many malignant patients have no obvious symptoms in the early stage, so the diagnosis is difficult, and the best treatment opportunity is lost. Therefore, all patients with bile duct stenosis should be paid high attention, and timely medical treatment and detailed evaluation should be carried out.

General anesthesia is equivalent to dying once? Is it true that waking up will make you stupid and dumb? Come in to learn

Minor ailments can be cured with medication and injections, but in many cases, organs need to be removed and radiotherapy is required for relief. In order to improve the patient experience and reduce pain, general anesthesia is necessary to remove the organs. Some patients report that they wake up after general anesthesia with unclear consciousness, memory loss, and even slowed thinking ability.

So the question is, will general anesthesia damage the brain?

The process of general anesthesia surgery on the body
In the mid-19th century, the University of Massachusetts General Hospital in the United States performed surgical anesthesia demonstrations, and since then, medicine has welcomed the beginning of anesthesia and the pain of surgical excision alone has become a thing of the past.

1、Anesthesia induction

A relatively conscious person cannot switch to deep sleep within a short period of time, and anesthesia induction is a high-risk stage for complications, generally divided into intravenous and inhalation anesthesia. In less than three minutes, the patient enters deep sleep, the muscles gradually relax and cannot breathe on their own, so a breathing channel must be established through external medical instruments. When the passage is successfully established and the patient’s symptoms return to normal, the next step should be performed.

Anesthesia: Why Does It Work?

2、Anesthesia maintenance

Anesthesia is used to maintain life after surgical treatment. After the patient loses consciousness, the anesthesiologist will monitor all the physiological symptoms, such as blood pressure, heart rate, bleeding volume and respiratory rate. This data should not be deviated, and the drug injection dose should be adjusted according to the changes. In general, there are more than ten kinds of emergency medications.

3、Anesthesia awakening

After the surgery is completed, the doctor will switch to pain medication to avoid pain in the patient’s wound. When everything is stable and recovered, the patient will be woken up gradually, the vital signs will be measured, and the surgery will be successfully finished.

Generally speaking, according to the body’s basic metabolism, the anesthetic drug components will be excreted in the urine through the liver and kidney respiratory system within 8 hours. If the liver and kidney function is impaired, the metabolism time is longer. The technique has been developed for over a century so far, and the drugs are absolutely safe to use, and the dose used can hardly affect the memory, consciousness and thinking of adults.

In middle-aged and elderly patients, the body’s organs are gradually going downhill, the metabolic ability is pivotal, and the neurological response is greatly reduced, therefore, after receiving surgery, the consciousness learning ability will be relatively affected within a short period of time. This is clinically referred to as post-operative cognitive dysfunction.

With the gradual metabolism of medications, patients can return to normal within a week, although some patients may experience this for up to several months due to their unique physical condition.

What is Anesthesia for Ambulatory Surgery? - Windy City Anesthesia

The first injection of anesthesia is not harmful to children in their adolescent development, but frequent anesthesia may affect the development of children under the age of three.

What if the child wakes up unexpectedly during the procedure?
The only purpose of anesthesia injections is to reduce the patient’s pain, complete the surgery more efficiently, and help him or her return to a healthy body and life.

However, there are always exceptions to this rule. Many bodies are intolerant to anesthesia, causing patients to wake up during the procedure, which requires the anesthesiologist to perform emergency injections immediately.

Na, from Canada, underwent surgery 10 years ago, and everything was normal after the anesthesia before the surgery, but in the middle of the surgery, she felt pain and could even hear the conversations of the people around her clearly. Although conscious, but the body can not move, open eyes, slowly look at the scalpel, layer by layer lift the belly, want to remind the surrounding people, but they can not move and can not make a sound. Although the surgery was finally over, these hours were like a nightmare for Yu Na.

This condition is a relatively rare complication in the medical profession, known as intraoperative anesthesia awareness, which simply means that the anesthesia has failed. If the medical staff can detect the return of the patient’s physiological characteristics during the surgery, they must intervene in time to prevent the anesthesia from failing and reduce the patient’s pain.

How Anesthesia Works | HowStuffWorks

Nowadays, in order to prevent such a situation, the surgeon will give the patient a cuff during the induction of anesthesia. The main function is that, when anesthesia fails, the slightest movement can be fed back to the anesthesiologist for dose adjustment to avoid medical errors and allow patients to suffer from surgical excision.

At present, there is no definite conclusion as to what makes a patient awake during anesthesia. It is only speculated that it may be related to the patient’s age, drug dosage, weight, body type, type of surgery, surgery time, and many other aspects, and the specific details are still under study.

However, if the patient has unstable vital signs and other chronic diseases, it is likely to affect the entire surgical procedure and the effect of anesthesia, and even leave neurological problems for six months to a year afterwards.

Is playing virtual reality games bad for your health?

At present, VR virtual reality games are becoming more and more popular, and it will also become a trend to be accepted by more and more people, especially young people. But some experts and industry watchers worry that frequent use of VR technology could carry some health risks, including eye strain, migraines and accidental falls. The following includes an introduction to VR safety, as well as the potential negative and positive physical effects that VR VR gaming can have.

What Is Virtual Reality? (+3 Types of VR Experiences)

Is VR bad for your eyes?
Some of the health risks of using VR devices seem obvious. For example, when you wear a VR device, the sound and full coverage of the VR video will reduce your perception of the surrounding environment, making you more likely to fall, step on other objects or pets. However, as VR technology becomes more widely used, the health risks associated with it are slowly emerging. For example, some ophthalmologists are concerned that VR could cause eye strain and have long-term effects on the connection between the eye and the brain.

We all know that looking at a computer screen too much can cause eyestrain, a condition also known as Computer Vision Syndrome (CVS). The screen of the VR device is not much different from the LCD screen of the computer in preventing eye fatigue. The eyes will also feel fatigued when facing the screen of the VR device for a long time, which means that the frequent use of the VR device may lead to CVS and related symptoms, such as, Headache and visual fatigue. However, proper rest can help prevent CVS, while the use of dedicated VR equipment lenses can also reduce eye strain.

Can True Virtual Reality Become A Reality? - IPC Digital

but! A VR screen is one big difference from a typical LCD screen! When looking at a VR screen, our eyes don’t just look at one screen, but each eye looks at a screen, and each screen is only a few centimeters away from your face or even closer! This dual-screen setup can lead to an illusion of a brain-eye connection called a “vergence-acquilation conflict,” a visual phenomenon that tricks the eye into sensing that things that are close are also close In the long run, this illusion can cause fatigue and visual discomfort in VR users, and in a few people, it can also lead to persistent headaches and nausea. Long-term “fusion-adaptation conflict” may even lead to vision problems, that is, back to reality, you find that your eyes are not working well. Among them, young children are at the greatest risk of developing eye diseases related to VR virtual reality. The reason is that the connections between a child’s eyes and brain are not yet fully developed. Children who play too many VR games are prone to eye diseases such as myopia.

What are the bad effects of playing VR games when you are sick or injured?
If you’re sick or injured, then playing a VR game might not do you any good, or make you feel uncomfortable, and it might make your symptoms more pronounced. One game developer recovering from a concussion said she spent days demoing a VR game at a well-known video game developer conference, and during her VR demo, some concussions occurred. Symptoms such as motion sickness appear. Of course, this is just a case, but these cases are being confirmed by some studies or medical journals.

What Is Virtual Reality? | Wonderopolis

In addition, most VR virtual reality equipment manufacturers recommend that if the player is pregnant, older, or has other conditions that affect the experience of virtual reality, such as abnormal vision, mental disorder, heart disease, etc., before playing VR virtual reality games Consult a doctor first. At the same time, equipment manufacturers will also remind you that playing VR may also cause epileptic seizures or fainting, which means that even if the player is healthy, there may be situations that are dangerous to the body.

A study has shown that virtual reality (VR) can elicit strong emotional responses — a condition that can be more difficult to control than looking at a normal computer monitor, especially for players with mental illness. Experts also worry that the use of VR games could slow or affect users’ recovery from sinus infections, headaches, eye ailments, stomach problems and even colds. The above diseases all require a relatively balanced care to successfully recover, but if you play VR games at this time, the recovery effect may be unsatisfactory.

All in all, while VR gaming is unlikely to cause long-term physical harm to humans, it may affect recovery from injury or illness. So, if you’re physically uncomfortable, play VR games as little as possible.

The knotty problem of applying real-world laws to VR and AR | World  Economic Forum

Can virtual reality help improve health?
Jeremy Bailenson, founder of Stanford University’s Virtual Reality Lab, is optimistic about the future of virtual reality. He believes VR virtual reality can make us healthier by narrowing the line between the digital and real worlds. With virtual reality, people can experience virtual scenes that are almost as real as the real thing. For example, interacting with food in virtual reality may have the effect of allowing players to eat less while feeling fuller, which could be beneficial for weight loss.

At the same time, there are more and more medical applications of VR virtual reality. Scientists are using virtual reality and simulation experiments for a variety of purposes, including human balance training and mental health programs.

History of Virtual Reality | The Franklin Institute

So, is VR virtual reality safe? Research suggests that there may be some minor risks associated with gaming with VR, but so far there have been no cases of serious side effects. Right now, it’s also difficult to know whether VR’s long-term health effects will be positive or negative. Therefore, players who like to play VR games should know the information they should know, and while enjoying the fun brought by the game, take a proper rest without being too addicted.