duodenal drainage

Duodenal drainage is a method of diverting duodenal juice and bile from the duodenal drainage tube for in vitro examination. Treatment of diseases: cholecystitis gallstones Indication It is used when it is difficult to diagnose gallbladder and bile duct inflammation, obstruction, stones and dysfunction. Can assist in the diagnosis of hepatobiliary parasitic diseases, such as liver flukes, Langjamin flagellates. It can also measure the pancreatic enzyme of duodenal juice, understand the functional status of the pancreas and the occult blood test to find cancer cells by centrifugation. Contraindications It is not appropriate to have esophageal varices, esophageal stricture, esophageal tumor, aortic aneurysm, severe hypertension, cardiovascular disease, heart failure, late pregnancy, physical weakness and other serious diseases. Preoperative preparation 1. Patient preparation (1) First explain to the patient the purpose, significance and requirements of the operation to relieve the patient's concerns and obtain patient cooperation. (2) 3 days before surgery, the patient should enter a low-fat diet to avoid the lack of bile or poor concentration and affect the test results. (3) Fasting for 12 hours before surgery. 2, item preparation Aseptic treatment of 1 duodenal drainage tube with metal head, 1 bending disc, 1 vascular clamp, 2 gauze, 50 ml and 5 ml syringes; treatment towel and small rubber towel 1 piece, sterilized 33% magnesium sulfate 50 ml, 1 alcohol lamp, 1 match, 1 test tube holder, 4 culture tubes and 3 small flasks, respectively marked with A, B, C and D. 3, preoperative measurement of the length of the patient's digestive tract from the mouth angle through the mandibular angle along the trachea straight down to the xiphoid; from the top of the head to the xiphoid; from the tip of the nose through the earlobe to the xiphoid. Surgical procedure 1. Check for ban on water on the eve of dinner. Explain the purpose and method of the examination to the patient to obtain cooperation. 2. Insert the duodenal drainage tube into the 50cm mark through the mouth and evacuate the gastric juice. 3, the patient takes the left lateral position, the head is high and the feet are low (the bed head is 30cm high), and the tube is swallowed to the 60cm mark at a speed of 0.5cm/min. Avoid rushing for success. 4, the patient sits on the center edge of the bed, feet on the chair separately, hands on the knees, the upper body leans forward, repeated deep breathing 5-7 times; then the right lateral position, the head low feet high (head Sleeping at the end of the bed, continue to swallow at a speed of 0.5 cm/min to the 75 cm mark. 5. When the drainage tube enters a depth of about 70cm, the drainage tube can be opened to observe the color of the remaining liquid. If it continues to be yellow, the pH is measured by pH test paper. If it is alkaline, it will reach the duodenum. Leave the specimen, which is duodenal juice (butrate). 6. Inject 30-40ml of warm 33% magnesium sulfate solution, clamp the duodenal tube for 5-10min, then relax the hemostat, the liquid will naturally flow out, and introduce the drainage liquid into several test tubes according to color and turbidity. The golden yellow liquid is from the bile duct and the bile duct bile, about 5-30ml (sodium solution); the dark brown thick liquid flows out of the gallbladder bile within about 25 minutes, about 40ml (ethyl acetate); finally, the lemon-colored thin liquid is from the liver gallbladder. Tube bile (liquid C). The three liquids of A, B and C were collected and sent to the test in 3 clean tubes and 3 culture tubes. 7. After the inspection is completed, pull out the drainage tube. patients wash, eat, record.