Pub Date : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.006
Jiajia Pan, Fang Chen, Hao Zhang, Q. Qiu
Objective To analyze the CT and MRI manifestations of undifferentiated hepatic embryonal sarcoma in adults with an aim to improve the preoperative diagnosis of this disease. Methods A retrospective analysis was carried out on the clinical data of 11 patients with undifferentiated hepatic embryonal sarcoma treated in Wenzhou People’s Hospital of Zhejiang and Wenzhou Central Hospital of Zhejiang between January 2008 and December 2018. There were 5 males and 6 females. The age ranged from 46 to 76 years (median 64 years). The site, size, morphology, margin, and pattern and degree of enhancement of the tumors were analyzed. Results Among the 11 patients, 10 patients had a single tumor, only 1 patient had multiple tumors. A total of seven patients' tumors were located in the right liver, 2 in the left liver, and 2 involved both the left and right livers. The maximum diameter of the tumors ranged from 5.5 cm to 21.2 cm, the maximum diameter (10.2±4.8 cm). The edge of tumors was clear in 9 patients and unclear in 2 patients. The tumors were elliptical in 4 patients or irregular in 7 patients. Plain CT scan showed 4 patients' tumors had mainly a cystic component, while 5 patients had both cystic and solid components. Plain MRI scan showed that five tumors were cystic and solid, with mixed internal signals. T1 weighted imaging (T1WI) showed slightly lower and lower signals; T2 weighted imaging (T2WI) showed slightly higher and higher signals. There was a low signal stripe separating inside; Diffusion-weighted imaging showed a high signal and apparent diffusion coefficient showed a low signal. The enhancement was characterized by "fast in and fast out" (marked enhancement in the arterial phase and fast clearance in the venous phase), and "delayed enhancement" (mild to moderate enhancement in the arterial phase and even more obvious enhancement in the venous or delayed phase). Conclusion Adult undifferentiated embryonic sarcoma has certain CT and MRI features. Its shape is elliptical or irregular, and mostly with a clear boundary. There were intratumoral cystic or cystic solid components, with mixed density/signal on CT and MRI, being characterized by "fast in and fast out" and "delayed enhancement" on intravenous contrast enhanced scans. Key words: Liver neoplasms; Tomography, X-ray computed; Magnetic resonance imaging; Undifferentiated embryonal sarcoma
目的分析成人未分化肝胚胎肉瘤的CT和MRI表现，提高对该病的术前诊断。方法回顾性分析2008年1月至2018年12月在浙江省温州市人民医院和浙江省温州市中心医院治疗的11例未分化肝胚胎肉瘤患者的临床资料。男性5人，女性6人。年龄46 ~ 76岁(中位64岁)。分析肿瘤的位置、大小、形态、边缘、类型和增强程度。结果11例患者中单发肿瘤10例，多发肿瘤1例。7例患者肿瘤位于右肝，2例位于左肝，2例同时累及左右肝。肿瘤最大直径为5.5 cm ~ 21.2 cm，最大直径(10.2±4.8 cm)。9例肿瘤边缘清晰，2例肿瘤边缘不清晰。肿瘤呈椭圆形者4例，不规则者7例。CT平扫显示4例肿瘤以囊性成分为主，5例肿瘤既有囊性成分又有实性成分。MRI平扫示5例肿瘤为囊性实性，内信号混杂。T1加权成像(T1WI)信号稍低、稍低;T2加权成像(T2WI)呈略高、高信号。里面有一条低信号条纹;弥散加权成像为高信号，视扩散系数为低信号。强化表现为“快进快出”(动脉期强化明显，静脉期清除快)和“延迟强化”(动脉期轻度至中度强化，静脉期或延迟期强化更为明显)。结论成人未分化胚胎肉瘤具有一定的CT和MRI特征。它的形状是椭圆形或不规则的，大多有一个明确的边界。肿瘤内可见囊性或囊性实性成分，CT、MRI表现为密度/信号混合，静脉增强扫描表现为“快进快出”、“延迟增强”。关键词:肝脏肿瘤;断层扫描，x射线计算机;磁共振成像;未分化胚胎肉瘤
{"title":"CT and MRI features of undifferentiated embryonal sarcoma of liver in adults","authors":"Jiajia Pan, Fang Chen, Hao Zhang, Q. Qiu","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.006","url":null,"abstract":"Objective \u0000To analyze the CT and MRI manifestations of undifferentiated hepatic embryonal sarcoma in adults with an aim to improve the preoperative diagnosis of this disease. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was carried out on the clinical data of 11 patients with undifferentiated hepatic embryonal sarcoma treated in Wenzhou People’s Hospital of Zhejiang and Wenzhou Central Hospital of Zhejiang between January 2008 and December 2018. There were 5 males and 6 females. The age ranged from 46 to 76 years (median 64 years). The site, size, morphology, margin, and pattern and degree of enhancement of the tumors were analyzed. \u0000 \u0000 \u0000Results \u0000Among the 11 patients, 10 patients had a single tumor, only 1 patient had multiple tumors. A total of seven patients' tumors were located in the right liver, 2 in the left liver, and 2 involved both the left and right livers. The maximum diameter of the tumors ranged from 5.5 cm to 21.2 cm, the maximum diameter (10.2±4.8 cm). The edge of tumors was clear in 9 patients and unclear in 2 patients. The tumors were elliptical in 4 patients or irregular in 7 patients. Plain CT scan showed 4 patients' tumors had mainly a cystic component, while 5 patients had both cystic and solid components. Plain MRI scan showed that five tumors were cystic and solid, with mixed internal signals. T1 weighted imaging (T1WI) showed slightly lower and lower signals; T2 weighted imaging (T2WI) showed slightly higher and higher signals. There was a low signal stripe separating inside; Diffusion-weighted imaging showed a high signal and apparent diffusion coefficient showed a low signal. The enhancement was characterized by \"fast in and fast out\" (marked enhancement in the arterial phase and fast clearance in the venous phase), and \"delayed enhancement\" (mild to moderate enhancement in the arterial phase and even more obvious enhancement in the venous or delayed phase). \u0000 \u0000 \u0000Conclusion \u0000Adult undifferentiated embryonic sarcoma has certain CT and MRI features. Its shape is elliptical or irregular, and mostly with a clear boundary. There were intratumoral cystic or cystic solid components, with mixed density/signal on CT and MRI, being characterized by \"fast in and fast out\" and \"delayed enhancement\" on intravenous contrast enhanced scans. \u0000 \u0000 \u0000Key words: \u0000Liver neoplasms; Tomography, X-ray computed; Magnetic resonance imaging; Undifferentiated embryonal sarcoma","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"819-822"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43401529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.009
Jin-shu Wu, Jianhui Yang, Gong Weizhi, J. Li, Weimin Yi, Fahui Cheng, Liu Changjun
Objective To summarize our clinical experience and management of an anomalous proximal bile duct joining the cystic duct in laparoscopic cholecystectomy (LC). Methods A retrospective study was conducted on 8 patients who had an anomalous right anterior bile duct joining the cystic duct who were treated at the Hunan Provincial People's Hospital from March 2003 to January 2019. Results All the 8 patients were diagnosed to have gallstones cholecystitis on preoperative CT, MRI and abdominal ultrasound. There were no suggestions of an anomalous bile duct. A total of 6 patients underwent reoperation after LC due to abdominal pain and biliary peritonitis. These 6 patients were treated with drainage and T-tube insertion. In the other 2 patients, the anomalous bile duct opening which joined the cystic duct were detected during LC. There was one patient converted to open laparotomy with preservation of the cystic duct and underwent common bile duct T-tube drainage. The other patients continued with laparoscopic surgery. The cystic duct was partially resected with removal of gallbladder, followed by common bile duct drainage. The average follow-up period was 3.4 years and the results were satisfactory. Conclusions Biliary duct anomaly is the main cause of iatrogenic proximal bile duct injury during laparoscopic cholecystectomy. It is not uncommon to have the anomaly of insertion of right anterior segmental bile duct to the cystic duct. To avoid iatrogenic biliary tract injury, careful preoperative study of X-ray films, accurate identification of the intraoperative gallbladder triangle anatomical structures. Strict adherence to carry out the three-word procedure of " discrimination, cut, identify" will help to reduce the incidence of biliary tract complications in laparoscopic cholecystectomy. Key words: Cholecystectomy; Biliary duct injury; Bile duct variation; Right lower anterior lobe; Repair strategy
{"title":"Ectopic right anterior inferior segmental bile duct and iatrogenic proximal bile duct injury: report of eight patients","authors":"Jin-shu Wu, Jianhui Yang, Gong Weizhi, J. Li, Weimin Yi, Fahui Cheng, Liu Changjun","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.009","url":null,"abstract":"Objective \u0000To summarize our clinical experience and management of an anomalous proximal bile duct joining the cystic duct in laparoscopic cholecystectomy (LC). \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted on 8 patients who had an anomalous right anterior bile duct joining the cystic duct who were treated at the Hunan Provincial People's Hospital from March 2003 to January 2019. \u0000 \u0000 \u0000Results \u0000All the 8 patients were diagnosed to have gallstones cholecystitis on preoperative CT, MRI and abdominal ultrasound. There were no suggestions of an anomalous bile duct. A total of 6 patients underwent reoperation after LC due to abdominal pain and biliary peritonitis. These 6 patients were treated with drainage and T-tube insertion. In the other 2 patients, the anomalous bile duct opening which joined the cystic duct were detected during LC. There was one patient converted to open laparotomy with preservation of the cystic duct and underwent common bile duct T-tube drainage. The other patients continued with laparoscopic surgery. The cystic duct was partially resected with removal of gallbladder, followed by common bile duct drainage. The average follow-up period was 3.4 years and the results were satisfactory. \u0000 \u0000 \u0000Conclusions \u0000Biliary duct anomaly is the main cause of iatrogenic proximal bile duct injury during laparoscopic cholecystectomy. It is not uncommon to have the anomaly of insertion of right anterior segmental bile duct to the cystic duct. To avoid iatrogenic biliary tract injury, careful preoperative study of X-ray films, accurate identification of the intraoperative gallbladder triangle anatomical structures. Strict adherence to carry out the three-word procedure of \" discrimination, cut, identify\" will help to reduce the incidence of biliary tract complications in laparoscopic cholecystectomy. \u0000 \u0000 \u0000Key words: \u0000Cholecystectomy; Biliary duct injury; Bile duct variation; Right lower anterior lobe; Repair strategy","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":" 26","pages":"834-837"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41254891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.013
Yang-Ke Hu, Shengdong Wu, Ke Wang, Jing Huang, Jiongze Fang, Caide Lu
Objective To study the impact of intraoperative pancreatic resection margin status on prognosis in patients with pancreatic head cancer. Methods The clinical and follow-up data of 109 patients who underwent pancreaticoduodenectomy at Ningbo Lihuili Hospital from March 2012 to October 2018 were analyzed retrospectively. The association of intraoperative resection margin status and other clinicopathological factors on prognosis was analyzed by the Kaplan-Meier method and the Cox proportional hazard model. Logistic multivariate analysis was used to study factors influencing the margin status. Results Of 109 patients, 20 had a positive intraoperative resection margin, and 89 had a negative margin. Postoperative pathological examination showed that all the patients had a negative surgical margin. Univariate analysis suggested that CA19-9 before operation, preoperative adjuvant chemotherapy, intraoperative pancreatic resection margin status, maximum diameter of tumor, perineural invasion, lymphovascular invasion, tumor differentiation, and N staging were significantly related to survival in the entire cohort (all P 0.05). Analysis of the clinicopathological factors between the two groups showed that in the positive pancreatic neck margin group, the distribution of adverse pathologic factors like low tumor differentiation, tumor diameter ≥4 cm, perineural invasion and lymphovascular invasion were significantly different compared with the negative group (P<0.05). Tumor diameter ≥4 cm (OR=5.72, 95%CI: 1.60~20.49) and low tumor differentiation (OR=3.79, 95%CI: 1.20~11.95) were independent influencing factors of positive margin on logistic multivariate analysis. Conclusions Intraoperative pancreatic positive margin was not an independent risk factor of prognosis, but it was meaningful in predicting survival. Presence of positive margins was often combined with existence of some adverse pathological features, such as large tumor diameter and low tumor differentiation. Prognosis of patients with a positive margin was often poor. A positive pancreatic margin was an intraoperative marker of poor tumor biology in patients with pancreatic ductal adenocarcinoma. Key words: Pancreatic neoplasms; Positive margin; Pancreaticoduodenectomy; Prognosis
{"title":"The impact of intraoperative pancreatic resection margin status on prognosis of patients with pancreatic head cancer","authors":"Yang-Ke Hu, Shengdong Wu, Ke Wang, Jing Huang, Jiongze Fang, Caide Lu","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.013","url":null,"abstract":"Objective \u0000To study the impact of intraoperative pancreatic resection margin status on prognosis in patients with pancreatic head cancer. \u0000 \u0000 \u0000Methods \u0000The clinical and follow-up data of 109 patients who underwent pancreaticoduodenectomy at Ningbo Lihuili Hospital from March 2012 to October 2018 were analyzed retrospectively. The association of intraoperative resection margin status and other clinicopathological factors on prognosis was analyzed by the Kaplan-Meier method and the Cox proportional hazard model. Logistic multivariate analysis was used to study factors influencing the margin status. \u0000 \u0000 \u0000Results \u0000Of 109 patients, 20 had a positive intraoperative resection margin, and 89 had a negative margin. Postoperative pathological examination showed that all the patients had a negative surgical margin. Univariate analysis suggested that CA19-9 before operation, preoperative adjuvant chemotherapy, intraoperative pancreatic resection margin status, maximum diameter of tumor, perineural invasion, lymphovascular invasion, tumor differentiation, and N staging were significantly related to survival in the entire cohort (all P 0.05). Analysis of the clinicopathological factors between the two groups showed that in the positive pancreatic neck margin group, the distribution of adverse pathologic factors like low tumor differentiation, tumor diameter ≥4 cm, perineural invasion and lymphovascular invasion were significantly different compared with the negative group (P<0.05). Tumor diameter ≥4 cm (OR=5.72, 95%CI: 1.60~20.49) and low tumor differentiation (OR=3.79, 95%CI: 1.20~11.95) were independent influencing factors of positive margin on logistic multivariate analysis. \u0000 \u0000 \u0000Conclusions \u0000Intraoperative pancreatic positive margin was not an independent risk factor of prognosis, but it was meaningful in predicting survival. Presence of positive margins was often combined with existence of some adverse pathological features, such as large tumor diameter and low tumor differentiation. Prognosis of patients with a positive margin was often poor. A positive pancreatic margin was an intraoperative marker of poor tumor biology in patients with pancreatic ductal adenocarcinoma. \u0000 \u0000 \u0000Key words: \u0000Pancreatic neoplasms; Positive margin; Pancreaticoduodenectomy; Prognosis","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"850-854"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46188960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.014
Cao Dayong, Y. Zhen, Sun Bingyi, Lin Guoying, Z. Ning
Objective To explore the effect of insulin-like growth factor-Ⅰ (IGF-Ⅰ) receptor on radiosensitivity of HepG2 cells and the underlying mechanism. Methods HepG2 cells were divided into the following groups: negative control group, siRNA group, irradiation group and combined group. HepG2 cells were transfected with IGF-Ⅰ receptor siRNA combined with irradiation therapy to investigate the effect on cell proliferation by methyl thiazolyl tetrazolium and cell cycle using flow cytometry. Expression of IGF-Ⅰ receptor, proliferating cell nuclear antigen (PCNA), cyclin-dependent kinases 1(CDK1) and Survivin were detected using Western blotting and Q-PCR. Results The expression of IGF-Ⅰ receptor in HepG2 cells was decreased significantly after siRNA transfection compared with the control group. After the combinational therapy, cell viability was decreased significantly according with control group [(1.02±0.08) vs. (1.08± 0.10) vs. (0.60±0.07)]; In addition, cell cycle was arrested in G2/M[(20.3±0.3)% vs. (22.6±0.4)% vs. (34.7±0.5)%] and CDK1 expression was reduced significantly. The relative expression of Survivin in siRNA group was lower than negative control group, the difference was statistically significant (P<0.05). Conclusion Inhibition of IGF-Ⅰ receptor can enhance the radiosensitivity of HepG2 cells through cell cycle arrest. Key words: Carcinoma, hepatocellular; Radiation tolerance; Cell cycle; Insulin-like growth factor-Ⅰ receptor; Survivin
{"title":"Effect of insulin-like growth factor-I receptor on radiosensitivity of HepG2 cells","authors":"Cao Dayong, Y. Zhen, Sun Bingyi, Lin Guoying, Z. Ning","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.014","url":null,"abstract":"Objective \u0000To explore the effect of insulin-like growth factor-Ⅰ (IGF-Ⅰ) receptor on radiosensitivity of HepG2 cells and the underlying mechanism. \u0000 \u0000 \u0000Methods \u0000HepG2 cells were divided into the following groups: negative control group, siRNA group, irradiation group and combined group. HepG2 cells were transfected with IGF-Ⅰ receptor siRNA combined with irradiation therapy to investigate the effect on cell proliferation by methyl thiazolyl tetrazolium and cell cycle using flow cytometry. Expression of IGF-Ⅰ receptor, proliferating cell nuclear antigen (PCNA), cyclin-dependent kinases 1(CDK1) and Survivin were detected using Western blotting and Q-PCR. \u0000 \u0000 \u0000Results \u0000The expression of IGF-Ⅰ receptor in HepG2 cells was decreased significantly after siRNA transfection compared with the control group. After the combinational therapy, cell viability was decreased significantly according with control group [(1.02±0.08) vs. (1.08± 0.10) vs. (0.60±0.07)]; In addition, cell cycle was arrested in G2/M[(20.3±0.3)% vs. (22.6±0.4)% vs. (34.7±0.5)%] and CDK1 expression was reduced significantly. The relative expression of Survivin in siRNA group was lower than negative control group, the difference was statistically significant (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Inhibition of IGF-Ⅰ receptor can enhance the radiosensitivity of HepG2 cells through cell cycle arrest. \u0000 \u0000 \u0000Key words: \u0000Carcinoma, hepatocellular; Radiation tolerance; Cell cycle; Insulin-like growth factor-Ⅰ receptor; Survivin","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"855-859"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44239706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.012
Jianzhang Qin, Xueqing Liu, Le Wang, J. Duan
Objective To summarize the clinical experience of laparoscopic duodenum-preserving subtotal pancreatic head resection (LDPPHR). Methods The clinical data of 8 patients with LDPPHR performed at the Second Hospital of Hebei Medical University from November 2016 to February 2019 were analyzed retrospectively. Results All the eight patients underwent LDPPHR successfully. The operation time was 207.0~540.0 minutes. The estimated blood loss was 50.0~200.0 ml. The postoperative hospital stay was 10.0~27.0 days. One patient developed pancreatic fistula of grade B, and one patient developed biliary fistula. Pathologic results showed pancreatic solid pseudopaillary neoplasm in 3 patients, intraductal papillary mucinous neoplasms in 1 patient, mucinous cystadenoma in 1 patient, serous cystadenoma in 1 patient, neuroendocrine neoplasm in 1 patient, and pancreatic true cyst in 1 patient. Conclusion LDPPHR is a safe and effective surgical method for treatment of pancreatic head inflammatory mass, pancreatic head benign or low-grade malignant tumors. Key words: Laparoscopes; Pancreaticoduodenectomy; Pancreatic neoplasms; Duodenum-preserving pancreatic head resection; Pancreatic head inflammatory mass; Duodenal blood supply
{"title":"Laparoscopic duodenum-preserving subtotal pancreatic head resection: a clinical analysis of eight patients","authors":"Jianzhang Qin, Xueqing Liu, Le Wang, J. Duan","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.012","url":null,"abstract":"Objective \u0000To summarize the clinical experience of laparoscopic duodenum-preserving subtotal pancreatic head resection (LDPPHR). \u0000 \u0000 \u0000Methods \u0000The clinical data of 8 patients with LDPPHR performed at the Second Hospital of Hebei Medical University from November 2016 to February 2019 were analyzed retrospectively. \u0000 \u0000 \u0000Results \u0000All the eight patients underwent LDPPHR successfully. The operation time was 207.0~540.0 minutes. The estimated blood loss was 50.0~200.0 ml. The postoperative hospital stay was 10.0~27.0 days. One patient developed pancreatic fistula of grade B, and one patient developed biliary fistula. Pathologic results showed pancreatic solid pseudopaillary neoplasm in 3 patients, intraductal papillary mucinous neoplasms in 1 patient, mucinous cystadenoma in 1 patient, serous cystadenoma in 1 patient, neuroendocrine neoplasm in 1 patient, and pancreatic true cyst in 1 patient. \u0000 \u0000 \u0000Conclusion \u0000LDPPHR is a safe and effective surgical method for treatment of pancreatic head inflammatory mass, pancreatic head benign or low-grade malignant tumors. \u0000 \u0000 \u0000Key words: \u0000Laparoscopes; Pancreaticoduodenectomy; Pancreatic neoplasms; Duodenum-preserving pancreatic head resection; Pancreatic head inflammatory mass; Duodenal blood supply","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"846-849"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43749580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.020
Zhongshan Lu, Wei Wang, Z. Zhong, Q. Ye, G. Peng
Hepatic ischemia-reperfusion injury is an inevitable clinical phenomenon during the liver transplantation. The mechanism of hepatic ischemia-reperfusion injury is complex, with reactive oxygen species, inflammatory factors, calcium overload, neutrophils and Kupffer cells involved. If injury continues to getting worsen, liver cells will undergo necrosis, apoptosis, and autophagy. Interventions for hepatic ischemia-reperfusion injury mainly include ischemic preconditioning, drug pretreatment, chemical pretreatment, mild hypothermia pretreatment, and machine perfusion and gene-targeted therapy in recent years. With the indepth research of injury mechanism, new intervention methods continue to emerge, which will bring new ideas for clinical prevention and treatment of liver ischemia-reperfusion injury. Key words: Liver; Reperfusion injury; Intervention
{"title":"Advances in intervention measures for hepatic ischemia-reperfusion injury","authors":"Zhongshan Lu, Wei Wang, Z. Zhong, Q. Ye, G. Peng","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.020","url":null,"abstract":"Hepatic ischemia-reperfusion injury is an inevitable clinical phenomenon during the liver transplantation. The mechanism of hepatic ischemia-reperfusion injury is complex, with reactive oxygen species, inflammatory factors, calcium overload, neutrophils and Kupffer cells involved. If injury continues to getting worsen, liver cells will undergo necrosis, apoptosis, and autophagy. Interventions for hepatic ischemia-reperfusion injury mainly include ischemic preconditioning, drug pretreatment, chemical pretreatment, mild hypothermia pretreatment, and machine perfusion and gene-targeted therapy in recent years. With the indepth research of injury mechanism, new intervention methods continue to emerge, which will bring new ideas for clinical prevention and treatment of liver ischemia-reperfusion injury. \u0000 \u0000 \u0000Key words: \u0000Liver; Reperfusion injury; Intervention","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"871-874"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42112335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.005
Baiwen Chen, K. Qiu, Hong Li
Objective To compare the safety and efficacy of the retrograde and the antegrade techniques in laparoscopic left hemihepatectomy. Methods Of the 65 patients who underwent laparoscopic left hemihepatectomy between January 2016 to June 2018 at the Ningbo Li Huili Hospital of Medical Center, retrograde left hemihepatectomy was carried out in 31 patients, and antegrade left hemihepatectomy in 34 patients. The perioperative data, duration of operation, intraoperative blood loss, postoperative complications (including major bleeding, abdominal abscess and bile leakage), and post-operative hospital stay were retrospectively compared between the two groups. Results There were no significant differences in the perioperative general status between the two groups (P>0.05). Both the duration of operation [(121.5±22.1) min vs. (190.9±48.9) min, P 0.05]. Conclusions Occlusion of hepatic vascular inflow and outflow combined with retrograde left hemihepatectomy was safe and feasibly. The retrograde approach was superior to the antegrade approach in laparoscopic left hemihepatectomy. Key words: Laparoscopes; Hepatectomy; Retrograde; Antegrade
{"title":"A comparative study on two different techniques in laparoscopic left hemihepatectomy","authors":"Baiwen Chen, K. Qiu, Hong Li","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.005","url":null,"abstract":"Objective \u0000To compare the safety and efficacy of the retrograde and the antegrade techniques in laparoscopic left hemihepatectomy. \u0000 \u0000 \u0000Methods \u0000Of the 65 patients who underwent laparoscopic left hemihepatectomy between January 2016 to June 2018 at the Ningbo Li Huili Hospital of Medical Center, retrograde left hemihepatectomy was carried out in 31 patients, and antegrade left hemihepatectomy in 34 patients. The perioperative data, duration of operation, intraoperative blood loss, postoperative complications (including major bleeding, abdominal abscess and bile leakage), and post-operative hospital stay were retrospectively compared between the two groups. \u0000 \u0000 \u0000Results \u0000There were no significant differences in the perioperative general status between the two groups (P>0.05). Both the duration of operation [(121.5±22.1) min vs. (190.9±48.9) min, P 0.05]. \u0000 \u0000 \u0000Conclusions \u0000Occlusion of hepatic vascular inflow and outflow combined with retrograde left hemihepatectomy was safe and feasibly. The retrograde approach was superior to the antegrade approach in laparoscopic left hemihepatectomy. \u0000 \u0000 \u0000Key words: \u0000Laparoscopes; Hepatectomy; Retrograde; Antegrade","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"815-818"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44567713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Biliary stent implantation and enteral nutrition via the same route for advanced pancreatic head carcinoma: a report of two cases","authors":"Yongqiang Liu, Y. Guo, Wenying Mao, Jiaqi Li, H. Liu","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.018","url":null,"abstract":"胰头癌患者早期无特异性症状，出现临床症状大多已属中晚期。胰头癌引起胆道梗阻所致的阻塞型黄疸是最常见的症状，若引起十二指肠梗阻，还可出现恶心呕吐、进食困难、恶液质等症状。本文报道2例胰头癌晚期伴有胆道及十二指肠梗阻的患者资料。","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"866-867"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44043075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.10.007
Bo Yuan, Xiao-hui Fu, L. Yin, Wen-long Yu, Jian Liu, Xiang Wang, Yongjie Zhang
Objective To analyze the clinical value of serum tumor markers CA19-9, CA242, CEA, CA724 and CA125 in the diagnosis and prognosis of gallbladder carcinoma patients. Methods A retrospective analysis of the preoperative serum levels of CA19-9, CA242, CEA, CA724 and CA125 in 132 patients with gallbladder cancer admitted to Eastern Hepatobiliary Surgery Hospital from March 2009 to December 2013 for sensitivity comparison, Kaplan-Meier survival table was used for univariate survival analysis, and the log-rank method was compared for differences. The Cox regression model was used for multivariate survival analysis. Results The sensitivities of CA19-9, CA242, CA125, CEA and CA724 were 67.4%, 63.6%, 42.4%, 24.2% and 22.7%, respectively. There were no significant differences of the sensitivity between CA19-9 and CA242 (P>0.05). However, whether CA19-9 or CA242, there were significant differences of diagnostic sensitivity compared to CEA or CA724 or CA125 (all P 0.05). Similarly, CA242 also has such a situation when compared with CA242 alone (all P>0.05). Univariate survival analysis showed there were statistically significant differences in CA19-9, CA242, and CEA (all P<0.05). Cox regression suggested that CA242 is an independent prognostic factor for gallbladder carcinoma. CA242 is closely related to histological grade of gallbladder carcinoma, lymph node metastasis and TNM staging. Conclusions CA19-9 and CA242 have definite value in the diagnosis of gallbladder carcinoma. CA242 is an independent prognostic factor for gallbladder carcinoma. Key words: Gallbladder neoplasms; CA19-9 antigen; Carcinoembryonic antigen; Diagnosis, differential; Prognosis; Tumor marker
{"title":"The value of combined detection of tumor biomarkers in the diagnosis and prognosis of patients with gallbladder carcinom","authors":"Bo Yuan, Xiao-hui Fu, L. Yin, Wen-long Yu, Jian Liu, Xiang Wang, Yongjie Zhang","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.10.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.10.007","url":null,"abstract":"Objective \u0000To analyze the clinical value of serum tumor markers CA19-9, CA242, CEA, CA724 and CA125 in the diagnosis and prognosis of gallbladder carcinoma patients. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis of the preoperative serum levels of CA19-9, CA242, CEA, CA724 and CA125 in 132 patients with gallbladder cancer admitted to Eastern Hepatobiliary Surgery Hospital from March 2009 to December 2013 for sensitivity comparison, Kaplan-Meier survival table was used for univariate survival analysis, and the log-rank method was compared for differences. The Cox regression model was used for multivariate survival analysis. \u0000 \u0000 \u0000Results \u0000The sensitivities of CA19-9, CA242, CA125, CEA and CA724 were 67.4%, 63.6%, 42.4%, 24.2% and 22.7%, respectively. There were no significant differences of the sensitivity between CA19-9 and CA242 (P>0.05). However, whether CA19-9 or CA242, there were significant differences of diagnostic sensitivity compared to CEA or CA724 or CA125 (all P 0.05). Similarly, CA242 also has such a situation when compared with CA242 alone (all P>0.05). Univariate survival analysis showed there were statistically significant differences in CA19-9, CA242, and CEA (all P<0.05). Cox regression suggested that CA242 is an independent prognostic factor for gallbladder carcinoma. CA242 is closely related to histological grade of gallbladder carcinoma, lymph node metastasis and TNM staging. \u0000 \u0000 \u0000Conclusions \u0000CA19-9 and CA242 have definite value in the diagnosis of gallbladder carcinoma. CA242 is an independent prognostic factor for gallbladder carcinoma. \u0000 \u0000 \u0000Key words: \u0000Gallbladder neoplasms; CA19-9 antigen; Carcinoembryonic antigen; Diagnosis, differential; Prognosis; Tumor marker","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"746-750"},"PeriodicalIF":0.0,"publicationDate":"2019-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45292652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.10.013
Tuergan Talaiti, Ruiqing Zhang, Xinhua Chen, H. Wen, Y. Shao, Aihaiti Kasimu
Objective To analyze the changes of local immune cells in liver of mice caused by nanosecond pulse therapy for hepatocellular carcinoma. Methods Forty C57BL-6J of mice were randomly divided into four groups: negative control group (n=10), tumor group (n=10), surgical resection group (n=10) and nanosecond pulse group (n=10). Hepa 1-6 cells were injected into the left hepatic lobe of mice in tumor group, resection group and nanosecond pulse group to construct the orthotopic xenograft tumor model. Left hepatic lobectomy was performed in the surgical excision group and nanosecond pulse was performed in the nanosecond pulse group 7 days after the construction. All mice were sacrificed 7 days after the treatment. CD3＋ was detected by flow cytometry in the left hepatic lobe lesion, the nanosecond pulse group and the normal liver tissue of the right hepatic lobe in the liver and tumor groups of the blank control group. T, CD4＋T, CD8＋T, regulatory T cells (Treg), myeloid-derived suppressor cells (MDSC), natural killer cells (NK), B cells, and the ratio of CD4＋T to CD8＋T. Results In the blank control group, the tumor group the number of lesion in the mice and the pulse area of the nanosecond pulse group CD4＋T cells in blank control group (normal liver)>nanosecond pulse group>tumor group [(25.77±3.76)% vs. (15.72±2.70)% vs. (12.68±3.13)%, P blank control group>nanosecond pulse group [(14.01±2.75)% vs. (13.99±1.41)% vs. (8.42±2.21)%, P blank control group > tumor group [(1.90±0.17) vs. (1.86±0.32) vs. (0.93±0.21), P blank control group > tumor group [(47.65±3.77)% vs. (33.74±3.91)% vs. (15.94±6.10)%, P nanosecond pulse group > blank control group [(18.49±2.74)% vs. (8.41±3.05)% vs. (2.15±0.69)%, P 0.05). Normal liver tissue in right lobe of liver in 4 groups the ratio of CD4＋T to CD8＋T in blank control group >nanosecond pulse group >surgical resection group >tumor group [(1.86±0.32) vs. (1.85±0.43) vs. (1.52±0.16) vs. (1.36±0.29), P surgical resection group >blank control group> Tumor group [(46.85±8.30)% vs. (34.23±6.17)% vs. (33.74±3.91)% vs. (27.64±2.20)%, P resection group>nanosecond pulse group>blank control group [(26.34±6.23)% vs. (7.01±2.04)% vs. (3.63±1.59)% vs. (3.19±1.50)% , P resection group>nanosecond pulse group>blank control group [(12.22±2.02)% vs. (5.00±0.73)% vs. (2.87±0.96)% vs. (2.15±0.69)%, P 0.05). Conclusion Nanosecond pulse ablation of primary hepatocellular carcinoma of mice can induce immune response in ablation area and other hepatic lobes, which may be due to the anti-tumor immunity induced by nanosecond pulse. Key words: Liver Neoplasms; Nanosecond pulse; Ablation; Immune response; Tumor microenvironment
{"title":"Nanosecond pulse ablation of hepatocellular carcinoma effect on the immune cells in the liver region of mice","authors":"Tuergan Talaiti, Ruiqing Zhang, Xinhua Chen, H. Wen, Y. Shao, Aihaiti Kasimu","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.10.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.10.013","url":null,"abstract":"Objective \u0000To analyze the changes of local immune cells in liver of mice caused by nanosecond pulse therapy for hepatocellular carcinoma. \u0000 \u0000 \u0000Methods \u0000Forty C57BL-6J of mice were randomly divided into four groups: negative control group (n=10), tumor group (n=10), surgical resection group (n=10) and nanosecond pulse group (n=10). Hepa 1-6 cells were injected into the left hepatic lobe of mice in tumor group, resection group and nanosecond pulse group to construct the orthotopic xenograft tumor model. Left hepatic lobectomy was performed in the surgical excision group and nanosecond pulse was performed in the nanosecond pulse group 7 days after the construction. All mice were sacrificed 7 days after the treatment. CD3＋ was detected by flow cytometry in the left hepatic lobe lesion, the nanosecond pulse group and the normal liver tissue of the right hepatic lobe in the liver and tumor groups of the blank control group. T, CD4＋T, CD8＋T, regulatory T cells (Treg), myeloid-derived suppressor cells (MDSC), natural killer cells (NK), B cells, and the ratio of CD4＋T to CD8＋T. \u0000 \u0000 \u0000Results \u0000In the blank control group, the tumor group the number of lesion in the mice and the pulse area of the nanosecond pulse group CD4＋T cells in blank control group (normal liver)>nanosecond pulse group>tumor group [(25.77±3.76)% vs. (15.72±2.70)% vs. (12.68±3.13)%, P blank control group>nanosecond pulse group [(14.01±2.75)% vs. (13.99±1.41)% vs. (8.42±2.21)%, P blank control group > tumor group [(1.90±0.17) vs. (1.86±0.32) vs. (0.93±0.21), P blank control group > tumor group [(47.65±3.77)% vs. (33.74±3.91)% vs. (15.94±6.10)%, P nanosecond pulse group > blank control group [(18.49±2.74)% vs. (8.41±3.05)% vs. (2.15±0.69)%, P 0.05). Normal liver tissue in right lobe of liver in 4 groups the ratio of CD4＋T to CD8＋T in blank control group >nanosecond pulse group >surgical resection group >tumor group [(1.86±0.32) vs. (1.85±0.43) vs. (1.52±0.16) vs. (1.36±0.29), P surgical resection group >blank control group> Tumor group [(46.85±8.30)% vs. (34.23±6.17)% vs. (33.74±3.91)% vs. (27.64±2.20)%, P resection group>nanosecond pulse group>blank control group [(26.34±6.23)% vs. (7.01±2.04)% vs. (3.63±1.59)% vs. (3.19±1.50)% , P resection group>nanosecond pulse group>blank control group [(12.22±2.02)% vs. (5.00±0.73)% vs. (2.87±0.96)% vs. (2.15±0.69)%, P 0.05). \u0000 \u0000 \u0000Conclusion \u0000Nanosecond pulse ablation of primary hepatocellular carcinoma of mice can induce immune response in ablation area and other hepatic lobes, which may be due to the anti-tumor immunity induced by nanosecond pulse. \u0000 \u0000 \u0000Key words: \u0000Liver Neoplasms; Nanosecond pulse; Ablation; Immune response; Tumor microenvironment","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"771-775"},"PeriodicalIF":0.0,"publicationDate":"2019-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45966693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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