Objective To study the treatment and outcomes of hepatic biloma after minimally invasive interventional therapies. Methods From January 2013 to December 2018, patients who underwent transcatheter arterial chemoembolization, percutaneous microwave ablation, and percutaneous biliary drainage (PTBD) at the Affiliated Hospital to Jiangnan University (Wuxi No.3 Hospital) and developed postoperative biloma that required treatment were included into this study. Results Of 43 bilomas, 14 were treated with percutaneous drainage. There were 9 males and 5 females, with an average age of 61(29-85) years. These bilomas could be classified into the following 3 types: extrahepatic bilomas (2 patients), simple bilomas (10 patients) and infected bilomas (2 patients). The treatments included PTBD, drainage of percutaneous biloma or a combination of both. Conclusion Biloma is a known complication after minimally invasive interventional therapies. These bilomas could be classified to guide treatment and to improve prognosis. Key words: Liver; Bilomas; Interventional treatment; Drainage
{"title":"Hepatic biloma after minimally invasive interventional therapies: treatment and outcomes","authors":"Fei Yang, Jianwei Jiang, Peng Wang, Gang Cheng, Xinsheng Li, Meng Zhang","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.03.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.03.005","url":null,"abstract":"Objective \u0000To study the treatment and outcomes of hepatic biloma after minimally invasive interventional therapies. \u0000 \u0000 \u0000Methods \u0000From January 2013 to December 2018, patients who underwent transcatheter arterial chemoembolization, percutaneous microwave ablation, and percutaneous biliary drainage (PTBD) at the Affiliated Hospital to Jiangnan University (Wuxi No.3 Hospital) and developed postoperative biloma that required treatment were included into this study. \u0000 \u0000 \u0000Results \u0000Of 43 bilomas, 14 were treated with percutaneous drainage. There were 9 males and 5 females, with an average age of 61(29-85) years. These bilomas could be classified into the following 3 types: extrahepatic bilomas (2 patients), simple bilomas (10 patients) and infected bilomas (2 patients). The treatments included PTBD, drainage of percutaneous biloma or a combination of both. \u0000 \u0000 \u0000Conclusion \u0000Biloma is a known complication after minimally invasive interventional therapies. These bilomas could be classified to guide treatment and to improve prognosis. \u0000 \u0000 \u0000Key words: \u0000Liver; Bilomas; Interventional treatment; Drainage","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"177-179"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43054033","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 : 2020-03-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2020.03.009
Q. Ke, Lei Wang, Nanping Lin, Fuli Xin, Yongyi Zeng, Jingfeng Liu
Objective To systematically review the clinical effectiveness of combined postoperative adjuvant transcatheter arterial chemoembolization (TACE) with portal vein chemotherapy (PVC) versus TACE alone in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT). Methods Databases including PubMed, Embase, Cochrane Library, Medline, Web of Science, CNKI, China Biology Medicine, Wan Fang and VIP were searched from Jan 1st 2000 to Jun 30th 2019 for eligible studies on clinical effectiveness of combined postoperative adjuvant TACE with PVC versus TACE alone in patients with HCC and PVTT. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The secondary endpoint was adverse events. These endpoints were evaluated by odds ratio (OR) and 95% confidence interval (CI) using Review Manager 5.3 software. Results Nine studies with 642 patients were enrolled in this meta-analysis. There were 323 patients in the TACE group and 319 patients in the TACE plus PVC group. The pooled OR for the 1-, 2-, and 3-year OS were all significantly better in the TACE plus PVC group than the TACE group (1-year OS, OR=2.20, 95% CI: 1.53-3.17; 2-year OS, OR=2.44, 95% CI: 1.69-3.53; 3-year OS, OR=2.30, 95% CI: 1.52-3.46) (all P 0.05). Conclusion Postoperative adjuvant TACE combined with PVC for patients with HCC and PVTT was safe and effective, and was significantly better than TACE alone in long-term prognosis. Large-scale, multi-center, prospective studies are needed to support the conclusion. Key words: Carcinoma, hepatocellular; Portal vein tumor thrombosis; Transarterial chemoembolization; Portal vein chemotherapy; Meta-analysis
{"title":"Combined postoperative adjuvant transarterial chemoembolization and portal vein chemotherapy to treat patients with hepatocellular carcinoma and portal vein tumor thrombosis: a meta-analysis","authors":"Q. Ke, Lei Wang, Nanping Lin, Fuli Xin, Yongyi Zeng, Jingfeng Liu","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.03.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.03.009","url":null,"abstract":"Objective \u0000To systematically review the clinical effectiveness of combined postoperative adjuvant transcatheter arterial chemoembolization (TACE) with portal vein chemotherapy (PVC) versus TACE alone in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT). \u0000 \u0000 \u0000Methods \u0000Databases including PubMed, Embase, Cochrane Library, Medline, Web of Science, CNKI, China Biology Medicine, Wan Fang and VIP were searched from Jan 1st 2000 to Jun 30th 2019 for eligible studies on clinical effectiveness of combined postoperative adjuvant TACE with PVC versus TACE alone in patients with HCC and PVTT. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The secondary endpoint was adverse events. These endpoints were evaluated by odds ratio (OR) and 95% confidence interval (CI) using Review Manager 5.3 software. \u0000 \u0000 \u0000Results \u0000Nine studies with 642 patients were enrolled in this meta-analysis. There were 323 patients in the TACE group and 319 patients in the TACE plus PVC group. The pooled OR for the 1-, 2-, and 3-year OS were all significantly better in the TACE plus PVC group than the TACE group (1-year OS, OR=2.20, 95% CI: 1.53-3.17; 2-year OS, OR=2.44, 95% CI: 1.69-3.53; 3-year OS, OR=2.30, 95% CI: 1.52-3.46) (all P 0.05). \u0000 \u0000 \u0000Conclusion \u0000Postoperative adjuvant TACE combined with PVC for patients with HCC and PVTT was safe and effective, and was significantly better than TACE alone in long-term prognosis. Large-scale, multi-center, prospective studies are needed to support the conclusion. \u0000 \u0000 \u0000Key words: \u0000Carcinoma, hepatocellular; Portal vein tumor thrombosis; Transarterial chemoembolization; Portal vein chemotherapy; Meta-analysis","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"192-198"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41708621","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}
Objective To study the efficacy and safety of percutaneous transhepatic one-step biliary fistulation (PTOBF) with rigid cholangioscopic lithotripsy for treatment of complicated hepatolithiasis under the ultrasonic navigation technique. Methods In this retrospective study, PTOBF lithotripsy surgery was performed in 94 patients with hepatolithiasis under general anesthesia with tracheal intubation, and with percutaneous transhepatic puncture of targeted bile duct under ultrasonic navigation in The First Affiliated Hospital of Guangzhou Medical University. Biliary expanders were used along a guidewire to expand the sinus gradually until 14Fr to establish a fistulous channel. Lithotripsy was then performed through the channel by rigid cholangioscopy. The operation-related data were collected and analyzed, including puncture and fistula establishment success ratio, complication rate, intraoperative blood loss, residual and recurrence hepatolithiasis rates. Results 94 patients (total 122 patient-times) underwent PTOBF lithotripsy. There was no perioperative mortality. The overall puncture success rate was 100%, and the fistula/puncture rate was 97.5% (119/122). In 118 patients success was achieved in 2 time (96.7%). The complication rate was 9.6% (9/94). The average intraoperation blood loss were (24.9±21.3)ml. The residual calculus rate after therapy was 13.8%(13/94). All patients were followed-up for a period that ranged between 18 and 30 months. The recurrence rate was 14.9%(14/94). Conclusions Ultrasonic navigation technique plays an important role in bile duct puncture, sinus expansion and rigid cholangioscopic lithotripsy for treatment of complicated hepatolithiasis. PTOBF lithotripsy is a safe and effective procedure, which provides a new way in mini-invasive treatment for hepatolithiasis. It is worth generalizing. Key words: Ultrasound; Navigation; Percutaneous transhepatic puncture; Hepatolithiasis; Rigid cholangioscope
{"title":"The ultrasonic navigation technique in percutaneous transhepatic one-step biliary fistulation with rigid cholangioscopic lithotripsy for complicated hepatolithiasis","authors":"Canhua Zhu, Ping Wang, Beiwang Sun, Chengcheng Liu, Yanmin Liu, Xinghua Zhou, Fei Gao, Dazhi Zhou","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.005","url":null,"abstract":"Objective \u0000To study the efficacy and safety of percutaneous transhepatic one-step biliary fistulation (PTOBF) with rigid cholangioscopic lithotripsy for treatment of complicated hepatolithiasis under the ultrasonic navigation technique. \u0000 \u0000 \u0000Methods \u0000In this retrospective study, PTOBF lithotripsy surgery was performed in 94 patients with hepatolithiasis under general anesthesia with tracheal intubation, and with percutaneous transhepatic puncture of targeted bile duct under ultrasonic navigation in The First Affiliated Hospital of Guangzhou Medical University. Biliary expanders were used along a guidewire to expand the sinus gradually until 14Fr to establish a fistulous channel. Lithotripsy was then performed through the channel by rigid cholangioscopy. The operation-related data were collected and analyzed, including puncture and fistula establishment success ratio, complication rate, intraoperative blood loss, residual and recurrence hepatolithiasis rates. \u0000 \u0000 \u0000Results \u000094 patients (total 122 patient-times) underwent PTOBF lithotripsy. There was no perioperative mortality. The overall puncture success rate was 100%, and the fistula/puncture rate was 97.5% (119/122). In 118 patients success was achieved in 2 time (96.7%). The complication rate was 9.6% (9/94). The average intraoperation blood loss were (24.9±21.3)ml. The residual calculus rate after therapy was 13.8%(13/94). All patients were followed-up for a period that ranged between 18 and 30 months. The recurrence rate was 14.9%(14/94). \u0000 \u0000 \u0000Conclusions \u0000Ultrasonic navigation technique plays an important role in bile duct puncture, sinus expansion and rigid cholangioscopic lithotripsy for treatment of complicated hepatolithiasis. PTOBF lithotripsy is a safe and effective procedure, which provides a new way in mini-invasive treatment for hepatolithiasis. It is worth generalizing. \u0000 \u0000 \u0000Key words: \u0000Ultrasound; Navigation; Percutaneous transhepatic puncture; Hepatolithiasis; Rigid cholangioscope","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"103-107"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43378435","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 : 2020-02-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2020.02.003
Xiao-bing Luo, Rui-hong Ma, Hong-ying Cai, Tie Qiao
Objective To study the relationship among bile components and different gallstone types through comparing and analyzing gallbladder bile contents in patients with different types of gallstones. Methods A retrospective study of 542 consecutive patients with gallstones or gallbladder polyps was conducted. The stone composition type and 14 kinds of bile components from these patients were analyzed. The bile parameters consisted of potassium (K+ ), sodium (Na+ ), chlorine (Cl-), calcium (Ca2+ ), bicarbonate (HCO3-), magnesium (Mg2+ ), aspartate aminotransferase (AST), glutamyltranspeptidase (GGT), alkaline phosphatase (ALP), total bilirubin (TBIL), total bile acid (TBA), cholesterol (CHO), lactate dehydrogenase (LDH) and pH. Finally, the content of these bile components among the different types of stones and gallbladder polyps were compared. According to the composition determined by Fourier transform infrared spectroscopy (FTIR), the gallstone patients were divided into five groups. Results Compared with other groups, the content of K+ , GGT, ALP, TBIL, TBA and CHO in the calcium carbonate stone group were lower (P 0.05). In addition, there was no difference in bile contents among the pigment gallstone group, mixed stone group and polyp group (P>0.05). Conclusions In gallstone patients, the bile components of patients with calcium carbonate stones is significantly different. The high cholesterol content in bile is the main feature of cholesterol stone patients, and there is no significant difference in bile composition between patients with pigment stones and mixed stones. Key words: Cholecystolithiasis; Bile; Gallbladder polyps; Cholesterol; Bile acid; Calcium carbonate stones
{"title":"Comparative analysis of bile components in patients with different types of gallstones","authors":"Xiao-bing Luo, Rui-hong Ma, Hong-ying Cai, Tie Qiao","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.003","url":null,"abstract":"Objective \u0000To study the relationship among bile components and different gallstone types through comparing and analyzing gallbladder bile contents in patients with different types of gallstones. \u0000 \u0000 \u0000Methods \u0000A retrospective study of 542 consecutive patients with gallstones or gallbladder polyps was conducted. The stone composition type and 14 kinds of bile components from these patients were analyzed. The bile parameters consisted of potassium (K+ ), sodium (Na+ ), chlorine (Cl-), calcium (Ca2+ ), bicarbonate (HCO3-), magnesium (Mg2+ ), aspartate aminotransferase (AST), glutamyltranspeptidase (GGT), alkaline phosphatase (ALP), total bilirubin (TBIL), total bile acid (TBA), cholesterol (CHO), lactate dehydrogenase (LDH) and pH. Finally, the content of these bile components among the different types of stones and gallbladder polyps were compared. According to the composition determined by Fourier transform infrared spectroscopy (FTIR), the gallstone patients were divided into five groups. \u0000 \u0000 \u0000Results \u0000Compared with other groups, the content of K+ , GGT, ALP, TBIL, TBA and CHO in the calcium carbonate stone group were lower (P 0.05). In addition, there was no difference in bile contents among the pigment gallstone group, mixed stone group and polyp group (P>0.05). \u0000 \u0000 \u0000Conclusions \u0000In gallstone patients, the bile components of patients with calcium carbonate stones is significantly different. The high cholesterol content in bile is the main feature of cholesterol stone patients, and there is no significant difference in bile composition between patients with pigment stones and mixed stones. \u0000 \u0000 \u0000Key words: \u0000Cholecystolithiasis; Bile; Gallbladder polyps; Cholesterol; Bile acid; Calcium carbonate stones","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"96-99"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48166994","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":"Minimally invasive treatment of pancreatic fistula complicated with infection after pancreaticoduodenectomy: a case report","authors":"Chong-Chong Gao, Fei Lı, F. Cao, Xiaohui Wang, Ang Li","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.014","url":null,"abstract":"胰十二指肠切除术后胰瘘继发感染患者病情重，病死率高，治疗难度较大。本文报道了一例将\"经腹膜后入路腹腔镜下坏死组织清创术\"应用于胰瘘继发感染治疗的患者，并取得了较好的效果，为胰瘘继发感染微创治疗提供了新思路。","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"148-149"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41501271","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 : 2020-02-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2020.02.012
Bin Hou, H. Cao, Liu Yang, D. Sun, Yuan Shi, Z. Shen, Hongli Song
Objective To study the effect of bone marrow mesenchymal stem cells (BMMSCs) combined with normothermic mechanical perfusion (NMP) on biliary epithelial cells (BEC) after DCD donor liver transplantation in rats. Methods The third generation of BMMSCs and the BMMSCs modified by Ad/HO-1 (Ad/HO-1/BMMSCs) were cultured, identified and expanded in vitro. To establish a stable NMP system device in vitro. The DCD liver transplantation models were constructed in rats after cardiac ischemia for 30 minutes, 220 SD recipient rats were randomly divided into sham operation group (S group, n=44) static cold storage (SCS group, n=44) group, and simple NMP group (P group, n=44), BMMSCs combined with NMP group (BP group, n=44) and BMMSCs modified by Ad/HO-1 combine with NMP group (HBP group, n=44), NMP group, BP group and HBP group were subjected to vitro perfusion for 4h. The group were taken at 0, 1, 7 and 14 days after transplantation and the relevant indicators were detected, n=6 in each group. The survival rate of the recipient rats, liver function and pathological changes of the bile duct were observed. The expression of cytokeratin 19 (CK19) protein in BEC was detected by immunohistochemistry and Western blot. Apoptotic biliary epithelial cells were detected by TUNEL staining and the expression of apoptosis-related protein caspase-3 was detected by immunohistochemistry. Results The survival time of HBP group was significantly prolonged for (5.6±0.8) d in SCS group vs. (18.4±2.0) d in NMP group, (20.5±1.5) d in BP group, (82.5±3.2) d in HBP group, the differences were statistically significant (all P<0.05). Compared with other groups, the HBP group and the BP group were significantly improved in liver function and biliary pathology, and the expression of CK19 protein in BEC was significantly increased [(0.81±0.02) in S group vs. (0.35±0.03) in SCS group, (0.47±0.02) in NMP group, (0.63±0.02) in BP group, (0.77±0.01) in HBP group on postoperative day (POD) 14], the differences were statistically significant (all P<0.05). The number of apoptosis and the expression of apoptosis-related protein caspase-3 in HBP group were significantly decreased [(10.0±1.2) in S group vs. (57.3±5.5) in SCS group, (40.1±4.6) in NMP group, (32.0±2.2) in BP group, (13.7±3.1) in HBP group on POD 14], the difference was statistically significant (all P<0.05). Compared with the BP group, the protective effect of the HBP group was more obvious, and the difference was statistically significant (P<0.05). Conclusion By the method of the BMMSCs modified by Ad/HO-1 combined with NMP in vitro preservation of rat, DCD donor liver can significantly improve the effect of BEC on rats and the survival rate after liver transplantation. Key words: Liver transplantation; Normothermic mechanical perfusion; Mesenchymal stromal cells; Biliary epithelial cells; Apoptosis
{"title":"The effect of optimized normothermic mechanical perfusion on biliary epithelial cells in liver graft by preserving the donation after cardiac death in rats","authors":"Bin Hou, H. Cao, Liu Yang, D. Sun, Yuan Shi, Z. Shen, Hongli Song","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.012","url":null,"abstract":"Objective \u0000To study the effect of bone marrow mesenchymal stem cells (BMMSCs) combined with normothermic mechanical perfusion (NMP) on biliary epithelial cells (BEC) after DCD donor liver transplantation in rats. \u0000 \u0000 \u0000Methods \u0000The third generation of BMMSCs and the BMMSCs modified by Ad/HO-1 (Ad/HO-1/BMMSCs) were cultured, identified and expanded in vitro. To establish a stable NMP system device in vitro. The DCD liver transplantation models were constructed in rats after cardiac ischemia for 30 minutes, 220 SD recipient rats were randomly divided into sham operation group (S group, n=44) static cold storage (SCS group, n=44) group, and simple NMP group (P group, n=44), BMMSCs combined with NMP group (BP group, n=44) and BMMSCs modified by Ad/HO-1 combine with NMP group (HBP group, n=44), NMP group, BP group and HBP group were subjected to vitro perfusion for 4h. The group were taken at 0, 1, 7 and 14 days after transplantation and the relevant indicators were detected, n=6 in each group. The survival rate of the recipient rats, liver function and pathological changes of the bile duct were observed. The expression of cytokeratin 19 (CK19) protein in BEC was detected by immunohistochemistry and Western blot. Apoptotic biliary epithelial cells were detected by TUNEL staining and the expression of apoptosis-related protein caspase-3 was detected by immunohistochemistry. \u0000 \u0000 \u0000Results \u0000The survival time of HBP group was significantly prolonged for (5.6±0.8) d in SCS group vs. (18.4±2.0) d in NMP group, (20.5±1.5) d in BP group, (82.5±3.2) d in HBP group, the differences were statistically significant (all P<0.05). Compared with other groups, the HBP group and the BP group were significantly improved in liver function and biliary pathology, and the expression of CK19 protein in BEC was significantly increased [(0.81±0.02) in S group vs. (0.35±0.03) in SCS group, (0.47±0.02) in NMP group, (0.63±0.02) in BP group, (0.77±0.01) in HBP group on postoperative day (POD) 14], the differences were statistically significant (all P<0.05). The number of apoptosis and the expression of apoptosis-related protein caspase-3 in HBP group were significantly decreased [(10.0±1.2) in S group vs. (57.3±5.5) in SCS group, (40.1±4.6) in NMP group, (32.0±2.2) in BP group, (13.7±3.1) in HBP group on POD 14], the difference was statistically significant (all P<0.05). Compared with the BP group, the protective effect of the HBP group was more obvious, and the difference was statistically significant (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000By the method of the BMMSCs modified by Ad/HO-1 combined with NMP in vitro preservation of rat, DCD donor liver can significantly improve the effect of BEC on rats and the survival rate after liver transplantation. \u0000 \u0000 \u0000Key words: \u0000Liver transplantation; Normothermic mechanical perfusion; Mesenchymal stromal cells; Biliary epithelial cells; Apoptosis","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"139-144"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46484547","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 : 2020-02-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2020.02.006
Zong-ming Zhang, Yue Zhao, Fangcai Lin, Chong Zhang, Zhuo Liu, Li-min Liu, Mingwen Zhu, H. Deng
Objective To study protective and therapeutic measures to improve perioperative safety in extremely elderly patients with biliary diseases. Methods A retrospective case-control study was conducted. The clinical data of elderly patients with biliary diseases treated at the Department of General Surgery, Beijing Electric Power Hospital, from July 2013 to December 2018, were collected. According to age, the patients were divided into the high age (HA) group (≥80.0 years) and the middle-low age (MLA) group (60.0~79.0 years). The related indexes of perioperative safety such as preoperative coexisting diseases, functions of liver, kidney, heart and lung, surgical procedures, intraoperative blood loss, operation time, postoperative hospital stay and postoperative hospital stay were analyzed and compared between the two groups. Results Of the 372 included patients, there were 168 males and 204 females, aged 60.0 to 96.0(72.0±8.6) years. There were 69 elderly patients (37 males and 32 females) aged 80.0 to 96.0(84.4±3.8) years in the HA group. There were 303 patients in the middle and lower age group (131 men and 172 women), aged 60.0 to 79.0(68.4±5.8) years (MLA group). (1) Preoperative coexisting diseases were significantly increased in the HA compared with the MLA group (all P 0.05). Conclusions Operation in extremely elderly patients with biliary diseases is safe and feasible. The key is to take measures such as actively treating preoperative coexisting diseases, strictly mastering operative indications, reasonably selecting surgical procedures, accurately carrying out precise operation, strictly monitoring and dealing with intraoperative emergency, timely preventing and treating postoperative complications, and especially focusing on maintaining cardiopulmonary function during the perioperative period. Key words: Biliary diseases; Perioperative period; Extremely elderly patients; Safety
{"title":"Preventive and therapeutic measures to improve perioperative safety in extremely elderly patients with biliary diseases","authors":"Zong-ming Zhang, Yue Zhao, Fangcai Lin, Chong Zhang, Zhuo Liu, Li-min Liu, Mingwen Zhu, H. Deng","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.006","url":null,"abstract":"Objective \u0000To study protective and therapeutic measures to improve perioperative safety in extremely elderly patients with biliary diseases. \u0000 \u0000 \u0000Methods \u0000A retrospective case-control study was conducted. The clinical data of elderly patients with biliary diseases treated at the Department of General Surgery, Beijing Electric Power Hospital, from July 2013 to December 2018, were collected. According to age, the patients were divided into the high age (HA) group (≥80.0 years) and the middle-low age (MLA) group (60.0~79.0 years). The related indexes of perioperative safety such as preoperative coexisting diseases, functions of liver, kidney, heart and lung, surgical procedures, intraoperative blood loss, operation time, postoperative hospital stay and postoperative hospital stay were analyzed and compared between the two groups. \u0000 \u0000 \u0000Results \u0000Of the 372 included patients, there were 168 males and 204 females, aged 60.0 to 96.0(72.0±8.6) years. There were 69 elderly patients (37 males and 32 females) aged 80.0 to 96.0(84.4±3.8) years in the HA group. There were 303 patients in the middle and lower age group (131 men and 172 women), aged 60.0 to 79.0(68.4±5.8) years (MLA group). (1) Preoperative coexisting diseases were significantly increased in the HA compared with the MLA group (all P 0.05). \u0000 \u0000 \u0000Conclusions \u0000Operation in extremely elderly patients with biliary diseases is safe and feasible. The key is to take measures such as actively treating preoperative coexisting diseases, strictly mastering operative indications, reasonably selecting surgical procedures, accurately carrying out precise operation, strictly monitoring and dealing with intraoperative emergency, timely preventing and treating postoperative complications, and especially focusing on maintaining cardiopulmonary function during the perioperative period. \u0000 \u0000 \u0000Key words: \u0000Biliary diseases; Perioperative period; Extremely elderly patients; Safety","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"108-114"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49061610","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 : 2020-02-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2020.02.009
L. Tao, Yadong Dong, Haibo Yu, Kunfu Da, Jianhao Ma, Gang Jia, S. Cang, Jianping Cai, Erwei Xiao, Deyu Li
Objective To evaluate the clinical application value of portal vein implantation pump for chemotherapy in patients with intrahepatic cholangiocarcinoma (ICC)after radical surgery. Methods The clinical data of 97 patients with ICC who underwent radical surgery in Henan People's Hospital from June 2012 to June 2016 were retrospectively analyzed. Results Among the 97 patients, 14 patients received portal venous pump chemotherapy (portal group), 33 patients received peripheral venous chemotherapy (peripheral group), and 50 patients did not receive postoperative chemotherapy (control group). There were no statistically significant differences in gender and age between the three groups. The results of survival analysis indicated that the disease-free survival (DFS) period and overall survival (OS) time in the portal group and the peripheral group were significantly better than that in control group (both P 0.05), for the control of intrahepatic metastasis, portal vein pump chemotherapy was better than that of systemic chemotherapy via peripheral vein, and almost all side effects of chemotherapy in the portal group were lower than those in the peripheral group. Conclusion Portal vein pump chemotherapy can improve the prognosis of intrahepatic bile duct patients, especially for the control of intrahepatic metastasis, and can reduce systemic side effects of chemotherapy. Key words: Bile duct neoplasms; Intrahepatic cholangiocarcinoma; Portal vein pump; Prognosis; Chemotherapy
{"title":"Efficacy of intrahepatic cholangiocarcinoma treated with chemotherapy through portal vein pump after radical surgery","authors":"L. Tao, Yadong Dong, Haibo Yu, Kunfu Da, Jianhao Ma, Gang Jia, S. Cang, Jianping Cai, Erwei Xiao, Deyu Li","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.009","url":null,"abstract":"Objective \u0000To evaluate the clinical application value of portal vein implantation pump for chemotherapy in patients with intrahepatic cholangiocarcinoma (ICC)after radical surgery. \u0000 \u0000 \u0000Methods \u0000The clinical data of 97 patients with ICC who underwent radical surgery in Henan People's Hospital from June 2012 to June 2016 were retrospectively analyzed. \u0000 \u0000 \u0000Results \u0000Among the 97 patients, 14 patients received portal venous pump chemotherapy (portal group), 33 patients received peripheral venous chemotherapy (peripheral group), and 50 patients did not receive postoperative chemotherapy (control group). There were no statistically significant differences in gender and age between the three groups. The results of survival analysis indicated that the disease-free survival (DFS) period and overall survival (OS) time in the portal group and the peripheral group were significantly better than that in control group (both P 0.05), for the control of intrahepatic metastasis, portal vein pump chemotherapy was better than that of systemic chemotherapy via peripheral vein, and almost all side effects of chemotherapy in the portal group were lower than those in the peripheral group. \u0000 \u0000 \u0000Conclusion \u0000Portal vein pump chemotherapy can improve the prognosis of intrahepatic bile duct patients, especially for the control of intrahepatic metastasis, and can reduce systemic side effects of chemotherapy. \u0000 \u0000 \u0000Key words: \u0000Bile duct neoplasms; Intrahepatic cholangiocarcinoma; Portal vein pump; Prognosis; Chemotherapy","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"124-127"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44904324","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 : 2020-02-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2020.02.016
Xiao Liang, L. Tao
Although surgical resection is currently recognized as the only effective treatment for intrahepatic cholangiocarcinoma (ICC), it is extremely difficult to diagnose because there are no obvious clinical symptoms at the early stage. Patients are often diagnosed at the advanced stage and the lesion cannot be resected which leads to limited systemic chemotherapy. So the mortality is still high. Accurate treatment is a hot topic in the medical field, and more and more attentions have been paid to enhance the treatments of patients. This article reviewed the issues related to surgical treatment, chemotherapy, molecular targeted therapy, and immunotherapy in patients with ICC, and focuses on the latest progress of molecular targeted therapy. Key words: Bile duct neoplasms; Intrahepatic cholangiocarcinoma; Precise treatment; Molecular targeted therapy
{"title":"Precise treatment of intrahepatic cholangiocarcinoma","authors":"Xiao Liang, L. Tao","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.016","url":null,"abstract":"Although surgical resection is currently recognized as the only effective treatment for intrahepatic cholangiocarcinoma (ICC), it is extremely difficult to diagnose because there are no obvious clinical symptoms at the early stage. Patients are often diagnosed at the advanced stage and the lesion cannot be resected which leads to limited systemic chemotherapy. So the mortality is still high. Accurate treatment is a hot topic in the medical field, and more and more attentions have been paid to enhance the treatments of patients. This article reviewed the issues related to surgical treatment, chemotherapy, molecular targeted therapy, and immunotherapy in patients with ICC, and focuses on the latest progress of molecular targeted therapy. \u0000 \u0000Key words: \u0000Bile duct neoplasms; Intrahepatic cholangiocarcinoma; Precise treatment; Molecular targeted therapy","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"151-154"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46601096","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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