{"title":"Missed diagnosis of hemophilia A found after splenectomy: a case report","authors":"Xiaoti Liu, Y. Shen, Xiaohui Duan, Hui Zhang, X. Mao, R. Wei","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.015","url":null,"abstract":"患者男性，47岁，因\"反复左下腹痛3 d，脾切除术后1 d\"入湖南省人民医院治疗。查体：贫血貌，腹部稍膨隆，腹肌稍紧，全腹压痛，无反跳痛，移动性浊音阴性，听诊肠鸣音减弱。CT血管造影提示脾脏切除术后脾区出血。详细追问患者病史及完善相关检查后发现为轻型甲型血友病，予以输注去白悬浮红细胞、冷沉淀及凝血因子Ⅷ替代治疗后患者出血停止，腹腔内积血、积液逐步消失，住院13天后病情好转出院。","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"149-150"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44817263","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.1007-8118.2020.02.008
Xin-wei Yang, Yu-long Li, Jing Du, Zhi-jian Wen, Jue Yang, P. Yang, Bao-hua Zhang
Objective To compare the tumor characteristics and survival between postoperative incidentally discovered gallbladder cancer (ID-GBC) and preoperatively suspected gallbladder cancer (PS-GBC). Methods The data of 276 GBC patients who underwent surgical resection with curative intent between January 2004 and December 2014 at the Eastern Hepatobiliary Surgery Hospital were retrospectively analyzed. Results The 1-, 3-, and 5-year cumulative survival rates of the ID-GBC group (88.8%, 52.2%, and 33.0%, respectively) were significantly better than those in the PS-GBC group (57.5%, 25.7%, and 16.6%, P 0.05). Conclusions Postoperative ID-GBC had significantly better survival outcomes than PS-GBC. Reoperation within two weeks in patients with ID-GBC is a good strategy. Key words: Gallbladder neoplasms; Prognosis; Incidental gallbladder cancer; Treatment strategy; Reoperation
{"title":"Timing of radical surgery in patients with postoperative incidentally discovered gallbladder cancer","authors":"Xin-wei Yang, Yu-long Li, Jing Du, Zhi-jian Wen, Jue Yang, P. Yang, Bao-hua Zhang","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.008","url":null,"abstract":"Objective \u0000To compare the tumor characteristics and survival between postoperative incidentally discovered gallbladder cancer (ID-GBC) and preoperatively suspected gallbladder cancer (PS-GBC). \u0000 \u0000 \u0000Methods \u0000The data of 276 GBC patients who underwent surgical resection with curative intent between January 2004 and December 2014 at the Eastern Hepatobiliary Surgery Hospital were retrospectively analyzed. \u0000 \u0000 \u0000Results \u0000The 1-, 3-, and 5-year cumulative survival rates of the ID-GBC group (88.8%, 52.2%, and 33.0%, respectively) were significantly better than those in the PS-GBC group (57.5%, 25.7%, and 16.6%, P 0.05). \u0000 \u0000 \u0000Conclusions \u0000Postoperative ID-GBC had significantly better survival outcomes than PS-GBC. Reoperation within two weeks in patients with ID-GBC is a good strategy. \u0000 \u0000 \u0000Key words: \u0000Gallbladder neoplasms; Prognosis; Incidental gallbladder cancer; Treatment strategy; Reoperation","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"119-123"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47893033","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.1007-8118.2020.02.018
Baiyu Yao, Z. Tian
Bile acids are the end product of cholesterol metabolism, which is the main component of bile. Bile acids can not only promote the absorption of fat and fat-soluble vitamins but also be used as the important signal molecules to activate nuclear receptors. It regulates metabolism of bile acids and intestinal homeostasis. The bile acids’ effect on intestinal mucosal barrier function has been controversial until now. Bile acids is both hydrophilic and hydrophobic simultaneously. Hydrophilic bile acid can promote cell proli-feration, while hydrophobic bile acid can promote cell apoptosis. The stronger the hydrophobicity is, the greater the cellular damage effect will be. The activation of nuclear receptor by bile acids can protect intestinal mucosal barrier. New research progress of the bile acid regulation in intestinal mucosal barrier function is reviewed in this article. Key words: Bile acids and salt; Intestinal mucosal barrier; Nuclear receptors
{"title":"Effects of bile acids and their related nuclear receptors on intestinal mucosal barrier","authors":"Baiyu Yao, Z. Tian","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.018","url":null,"abstract":"Bile acids are the end product of cholesterol metabolism, which is the main component of bile. Bile acids can not only promote the absorption of fat and fat-soluble vitamins but also be used as the important signal molecules to activate nuclear receptors. It regulates metabolism of bile acids and intestinal homeostasis. The bile acids’ effect on intestinal mucosal barrier function has been controversial until now. Bile acids is both hydrophilic and hydrophobic simultaneously. Hydrophilic bile acid can promote cell proli-feration, while hydrophobic bile acid can promote cell apoptosis. The stronger the hydrophobicity is, the greater the cellular damage effect will be. The activation of nuclear receptor by bile acids can protect intestinal mucosal barrier. New research progress of the bile acid regulation in intestinal mucosal barrier function is reviewed in this article. \u0000 \u0000Key words: \u0000Bile acids and salt; Intestinal mucosal barrier; Nuclear receptors","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"158-160"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42416142","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.1007-8118.2020.02.007
Guotai Wang, Xingwu Yang, Qing Wang, Xin Wang, Ning Li
Objective To compare the clinical efficacy of one-stage laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct exploration (LCBDE) with primary suture (PS) versus two-stage endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy(EST) followed by LC in treatment of cholecystolithiasis complicated with choledocholithiasis. Methods The clinical data of 171 patients with cholecystolithiasis complicated with choledocholithiasis, who underwent minimally invasive surgical treatment from January 2016 to December 2017, were retrospectively analyzed. Of these patients, 90 underwent one-stage LC+ LCBDE+ PS (the one-stage group), and 81 underwent two-stage ERCP/EST followed by LC (the two-stage group). The main clinical variables between the two groups of patients were compared. Results The surgical success rates (94.4% vs. 95.1%), residual stone rates (3.3% vs. 4.9%) and incidences of postoperative complications (6.7% vs.8.6%) showed no significant difference (all P>0.05) between the one-stage and two-stage groups. Compared with the two-stage group, the operative time was shorter (110.4 vs. 135.7 min), the length of postoperative hospital stay was shorter (3.3 vs. 7.1 d) and the total hospitalization cost was reduced (22 756.2 vs. 31 429.3 yuan) in the one-stage group. The incidence of long-term complications (2.2% vs.9.9%) in the one-stage group was also lower than that in the two-stage group (both P<0.05). Conclusions Both one-stage LC+ LCBDE+ PS and two-stage ERCP/EST+ LC are safe and effective in the treatment of cholecystolithiasis complicated with choledocholithiasis. One-stage LC+ LCBDE+ PS shows obvious advantages in hospitalization stay, hospitalization cost and in the preservation of function of the Oddi sphincter, and therefore should be the first choice in most cases. Key words: Cholecystolithiasis; Choledocholithiasis; Cholecystectomy, Laparoscopic; Cholangiopancreatography, endoscopic retrograde
目的比较一期腹腔镜胆囊切除术(LC)加腹腔镜胆总管探查(LCBDE)加一期缝合(PS)与二期内镜逆行胆管造影(ERCP)/内镜下括括肌切开术(EST)加LC治疗胆囊结石合并胆总管结石的临床疗效。方法回顾性分析2016年1月至2017年12月行微创手术治疗的171例胆囊结石合并胆总管结石患者的临床资料。在这些患者中，90例接受了一期LC+ LCBDE+ PS(一期组)，81例接受了两期ERCP/EST后再进行LC(两期组)。比较两组患者的主要临床指标。结果两组手术成功率(94.4%比95.1%)、结石残留率(3.3%比4.9%)、术后并发症发生率(6.7%比8.6%)差异无统计学意义(P < 0.05)。与两期组相比，一期组手术时间短(110.4 min vs. 135.7 min)，住院时间短(3.3 d vs. 7.1 d)，总住院费用低(22 756.2 vs. 31 429.3元)。一期组长期并发症发生率(2.2% vs.9.9%)也低于两期组(P<0.05)。结论一期LC+ LCBDE+ PS和二期ERCP/EST+ LC治疗胆囊结石合并胆总管结石均安全有效。一期LC+ LCBDE+ PS在住院时间、住院费用和保留Oddi括约肌功能方面具有明显优势，在大多数情况下应作为首选。关键词:胆囊结石;黄疸;胆囊切除术,腹腔镜;胆管造影，内窥镜逆行
{"title":"One-stage laparoscopic versus two-stage endoscopic followed by laparoscopic treatment for cholecystolithiasis complicated with choledocholithiasis","authors":"Guotai Wang, Xingwu Yang, Qing Wang, Xin Wang, Ning Li","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.007","url":null,"abstract":"Objective \u0000To compare the clinical efficacy of one-stage laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct exploration (LCBDE) with primary suture (PS) versus two-stage endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy(EST) followed by LC in treatment of cholecystolithiasis complicated with choledocholithiasis. \u0000 \u0000 \u0000Methods \u0000The clinical data of 171 patients with cholecystolithiasis complicated with choledocholithiasis, who underwent minimally invasive surgical treatment from January 2016 to December 2017, were retrospectively analyzed. Of these patients, 90 underwent one-stage LC+ LCBDE+ PS (the one-stage group), and 81 underwent two-stage ERCP/EST followed by LC (the two-stage group). The main clinical variables between the two groups of patients were compared. \u0000 \u0000 \u0000Results \u0000The surgical success rates (94.4% vs. 95.1%), residual stone rates (3.3% vs. 4.9%) and incidences of postoperative complications (6.7% vs.8.6%) showed no significant difference (all P>0.05) between the one-stage and two-stage groups. Compared with the two-stage group, the operative time was shorter (110.4 vs. 135.7 min), the length of postoperative hospital stay was shorter (3.3 vs. 7.1 d) and the total hospitalization cost was reduced (22 756.2 vs. 31 429.3 yuan) in the one-stage group. The incidence of long-term complications (2.2% vs.9.9%) in the one-stage group was also lower than that in the two-stage group (both P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Both one-stage LC+ LCBDE+ PS and two-stage ERCP/EST+ LC are safe and effective in the treatment of cholecystolithiasis complicated with choledocholithiasis. One-stage LC+ LCBDE+ PS shows obvious advantages in hospitalization stay, hospitalization cost and in the preservation of function of the Oddi sphincter, and therefore should be the first choice in most cases. \u0000 \u0000 \u0000Key words: \u0000Cholecystolithiasis; Choledocholithiasis; Cholecystectomy, Laparoscopic; Cholangiopancreatography, endoscopic retrograde","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"115-118"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48226830","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.1007-8118.2020.02.010
Yiming Chen, Yun-jie Wang, Deng-qiu Zhao, Delin Kong, Yong Wang
Objective To investigate the clinical significance of serum miR-187 and miR-143 in the development and diagnosis of gallbladder cancer. Methods 75 serum samples in patients with gallbladder cancer were selected as gallbladder cancer group. 75 serum samples in patients with gallbladder benign disease and 45 serum samples in healthy physical examinations at same period were selected as the benign gallbladder disease group and healthy control group. Quantitative RT-PCR was used to detect the serum miR-187 and miR-143 expression in each group, and the expression of those related with the clinicopathological factors, the proliferation and migration of gallbladder cancer cells, and the efficacy in diagnosis of gallbladder cancer was observed. Results The serum miR-187 expression in gallbladder cancer group was significantly higher than that in benign gallbladder disease and healthy control; the serum expression of that in benign gallbladder disease was significantly higher than that in healthy control; after surgery , the expression of that was significantly lower than that before treatment (all P 0.05), and were significantly correlated with Nevin stage, TNM stage, differentiation and lymphatic metastasis (all P<0.05). Furthermore, it was confirmed that miR-187 promoted the proliferation and migration of gallbladder cancer cells in vitro, while miR-143 inhibited the proliferation and migration. In the diagnosis of gallbladder, the diagnostic efficacy of miR-187 and miR-143 was significantly better than that of CA199 and CA242 (both P<0.05). Combined detection could further improve the efficacy in diagnosis of gallbladder cancer. Conclusions miR-187 and miR-143 are involved in the development of gallbladder cancer. Combined detection of serum miR-187 and miR-143 in gallbladder cancer has a high diagnostic efficiency in the diagnosis of gallbladder cancer. Key words: Gall bladder neoplasm; MiR-187; MiR-143; Diagnosis; Real-time -PCR
{"title":"Clinical significance of serum miR-187 and miR-143 in the diagnosis of gallbladder cancer","authors":"Yiming Chen, Yun-jie Wang, Deng-qiu Zhao, Delin Kong, Yong Wang","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.010","url":null,"abstract":"Objective \u0000To investigate the clinical significance of serum miR-187 and miR-143 in the development and diagnosis of gallbladder cancer. \u0000 \u0000 \u0000Methods \u000075 serum samples in patients with gallbladder cancer were selected as gallbladder cancer group. 75 serum samples in patients with gallbladder benign disease and 45 serum samples in healthy physical examinations at same period were selected as the benign gallbladder disease group and healthy control group. Quantitative RT-PCR was used to detect the serum miR-187 and miR-143 expression in each group, and the expression of those related with the clinicopathological factors, the proliferation and migration of gallbladder cancer cells, and the efficacy in diagnosis of gallbladder cancer was observed. \u0000 \u0000 \u0000Results \u0000The serum miR-187 expression in gallbladder cancer group was significantly higher than that in benign gallbladder disease and healthy control; the serum expression of that in benign gallbladder disease was significantly higher than that in healthy control; after surgery , the expression of that was significantly lower than that before treatment (all P 0.05), and were significantly correlated with Nevin stage, TNM stage, differentiation and lymphatic metastasis (all P<0.05). Furthermore, it was confirmed that miR-187 promoted the proliferation and migration of gallbladder cancer cells in vitro, while miR-143 inhibited the proliferation and migration. In the diagnosis of gallbladder, the diagnostic efficacy of miR-187 and miR-143 was significantly better than that of CA199 and CA242 (both P<0.05). Combined detection could further improve the efficacy in diagnosis of gallbladder cancer. \u0000 \u0000 \u0000Conclusions \u0000miR-187 and miR-143 are involved in the development of gallbladder cancer. Combined detection of serum miR-187 and miR-143 in gallbladder cancer has a high diagnostic efficiency in the diagnosis of gallbladder cancer. \u0000 \u0000 \u0000Key words: \u0000Gall bladder neoplasm; MiR-187; MiR-143; Diagnosis; Real-time -PCR","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"128-133"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44176382","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.1007-8118.2020.02.017
Pengcheng Zhang, K. Dou, Zhao-rui Yang, Ruohan Zhang, Hongtao Zhang, W. Peng, Yanbing Cao, Weiming Li
Non-alcoholic fatty liver disease (NAFLD) is characterized by increased fat depositions in the liver while the patients do not have drinking history. NAFLD has a prevalence of 10%~40% in global, 25%~26% in Western populations. From 2004 to 2013, the numbers of new patients on the waitlist who had NASH increased by 170% in America. The prevalence of NAFLD in China is 20%. With the decrease of HBV and HCV and the increase of diabetes mellitus type 2 and obesity, NAFLD will become the most common chronic liver disease in China over the next 20 years. NAFLD related end-stage liver disease will become the most common indication of liver transplantation. In this paper, the epidemiological features, pathogenesis, indication and prognosis of liver transplantation are reviewed. Key words: Liver transplantation; Metabolic syndrome; Fatty liver, non-alcoholic
{"title":"Non-alcoholic fatty liver disease and liver transplantation","authors":"Pengcheng Zhang, K. Dou, Zhao-rui Yang, Ruohan Zhang, Hongtao Zhang, W. Peng, Yanbing Cao, Weiming Li","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.017","url":null,"abstract":"Non-alcoholic fatty liver disease (NAFLD) is characterized by increased fat depositions in the liver while the patients do not have drinking history. NAFLD has a prevalence of 10%~40% in global, 25%~26% in Western populations. From 2004 to 2013, the numbers of new patients on the waitlist who had NASH increased by 170% in America. The prevalence of NAFLD in China is 20%. With the decrease of HBV and HCV and the increase of diabetes mellitus type 2 and obesity, NAFLD will become the most common chronic liver disease in China over the next 20 years. NAFLD related end-stage liver disease will become the most common indication of liver transplantation. In this paper, the epidemiological features, pathogenesis, indication and prognosis of liver transplantation are reviewed. \u0000 \u0000Key words: \u0000Liver transplantation; Metabolic syndrome; Fatty liver, non-alcoholic","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"155-157"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42273573","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.1007-8118.2020.02.004
Sheng-long Zhang, Anping Chen, Yun-sheng Suo, Jinheng Liu
Objective To study the advantages of laparoscopic primary suturing of common bile duct plus transabdominal nasobiliary drainage in reducing the rate of bile leakage. Methods The clinical data of laparoscopic primary suturing of common bile duct with or without nasal bile duct drainage in Second People's Hospital of Chengdu were analyzed retrospectively. Results During laparoscopic common bile duct exploration, 286 patients were treated by primary suturing without nasobiliary drainage (group without drainage), including 32 (11.2%) patients with bile leakage; 350 patients were treated by primary suturing with transabdominal nasobiliary drainage (group with drainage), including 11 (3.1%) patients with bile leakage. The incidences of bile leakage of the two groups were significantly different (P 0.05). Conclusions The choice after laparoscopic primary suturing of common bile duct between with or without nasobiliary drainage should be determined according to the diameter of common bile duct. When a common bile duct diameter of less than 11.0 mm, nasobiliary drainage is recommended to reduce the rate of bile leakage. Key words: Choledocholithiasis; Laparoscope; Choledochoscope; Nasobiliary duct
{"title":"Prevention of bile leakage after laparoscopic primary suturing of common bile duct by transabdominal placement of nasal bile duct","authors":"Sheng-long Zhang, Anping Chen, Yun-sheng Suo, Jinheng Liu","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.004","url":null,"abstract":"Objective \u0000To study the advantages of laparoscopic primary suturing of common bile duct plus transabdominal nasobiliary drainage in reducing the rate of bile leakage. \u0000 \u0000 \u0000Methods \u0000The clinical data of laparoscopic primary suturing of common bile duct with or without nasal bile duct drainage in Second People's Hospital of Chengdu were analyzed retrospectively. \u0000 \u0000 \u0000Results \u0000During laparoscopic common bile duct exploration, 286 patients were treated by primary suturing without nasobiliary drainage (group without drainage), including 32 (11.2%) patients with bile leakage; 350 patients were treated by primary suturing with transabdominal nasobiliary drainage (group with drainage), including 11 (3.1%) patients with bile leakage. The incidences of bile leakage of the two groups were significantly different (P 0.05). \u0000 \u0000 \u0000Conclusions \u0000The choice after laparoscopic primary suturing of common bile duct between with or without nasobiliary drainage should be determined according to the diameter of common bile duct. When a common bile duct diameter of less than 11.0 mm, nasobiliary drainage is recommended to reduce the rate of bile leakage. \u0000 \u0000 \u0000Key words: \u0000Choledocholithiasis; Laparoscope; Choledochoscope; Nasobiliary duct","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"100-102"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42072346","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.1007-8118.2020.02.011
Songling Xie, Zheng Jang, T. Zhao, Gaosheng Wang, Songzi Xie
Objective To study the role of Th17 cells proportions and the cytokines levels in the diagnosis and treatment of acute pancreatitis (AP). Methods Patients with AP (n=82) treated in our hospital between August 2017 and August 2018 were divided into the mild AP group (MAP, n=36), the moderately severe AP group (MSAP, n=26) and the severe AP group (SAP, n=20). Twenty-five healthy subjects were chosen as the control group. The proportions of Th17 cells and the levels of cytokines including IL-17, IL-21, IL-22 and IL-23 in peripheral blood from the four groups were analyzed. The APACHE II and Ranson scores were used to evaluate the illness severity. Spearman correlation analysis was conducted to detect the correlation between the Th17 cells, cytokines, and inflammatory factor, APACHE II and Ranson scores. Results Compared with the control group, the proportion of Th17 cells and the levels of IL-17, IL-21, IL-22 and IL-23 in the peripheral blood of MAP, MSAP and SAP groups were significantly increased (SAP>MSAP>MAP, P<0.05). The levels of inflammatory cytokines IL-6, IL-8 and TNF-α, and the scores of APACHE II and Ranson in the SAP group were significantly higher than those in the MSAP group and MAP group (P<0.05). The proportion of Th17 cells and their cytokine levels were positively correlated with IL-6, IL-8, TNF-α, APACHE II and Ranson scores. The levels of Th17 cytokines returned to normal in AP patients after treatment. Conclusion Th17 cells and the cytokines have certain clinical significance in evaluating early inflammatory response, severity of illness, and therapeutic effect in AP patients. Key words: Pancreatitis, acute; Th17 cells; Cytokines; Inflammatory response; Disease assessment
{"title":"The role of Th17 cells and cytokines in the diagnosis and treatment of acute pancreatitis","authors":"Songling Xie, Zheng Jang, T. Zhao, Gaosheng Wang, Songzi Xie","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.011","url":null,"abstract":"Objective \u0000To study the role of Th17 cells proportions and the cytokines levels in the diagnosis and treatment of acute pancreatitis (AP). \u0000 \u0000 \u0000Methods \u0000Patients with AP (n=82) treated in our hospital between August 2017 and August 2018 were divided into the mild AP group (MAP, n=36), the moderately severe AP group (MSAP, n=26) and the severe AP group (SAP, n=20). Twenty-five healthy subjects were chosen as the control group. The proportions of Th17 cells and the levels of cytokines including IL-17, IL-21, IL-22 and IL-23 in peripheral blood from the four groups were analyzed. The APACHE II and Ranson scores were used to evaluate the illness severity. Spearman correlation analysis was conducted to detect the correlation between the Th17 cells, cytokines, and inflammatory factor, APACHE II and Ranson scores. \u0000 \u0000 \u0000Results \u0000Compared with the control group, the proportion of Th17 cells and the levels of IL-17, IL-21, IL-22 and IL-23 in the peripheral blood of MAP, MSAP and SAP groups were significantly increased (SAP>MSAP>MAP, P<0.05). The levels of inflammatory cytokines IL-6, IL-8 and TNF-α, and the scores of APACHE II and Ranson in the SAP group were significantly higher than those in the MSAP group and MAP group (P<0.05). The proportion of Th17 cells and their cytokine levels were positively correlated with IL-6, IL-8, TNF-α, APACHE II and Ranson scores. The levels of Th17 cytokines returned to normal in AP patients after treatment. \u0000 \u0000 \u0000Conclusion \u0000Th17 cells and the cytokines have certain clinical significance in evaluating early inflammatory response, severity of illness, and therapeutic effect in AP patients. \u0000 \u0000 \u0000Key words: \u0000Pancreatitis, acute; Th17 cells; Cytokines; Inflammatory response; Disease assessment","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"134-138"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43178127","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.1007-8118.2020.02.002
Xiaopeng Wang, P. Liang, Rui Li, P. Hou, Jianbo Gao
Objective To study the use of abdominal enhanced CT imaging and quantitative index analysis in the differential diagnosis of hepatic epithelioid hemangioendothelioma (HEH) and hepatic metastasis. Methods A study group of 12 patients with HEH who underwent abdominal enhanced CT scanning at the First Affiliated Hospital of Zhengzhou University from February 2014 to October 2018 was retrospectively compared with a control group of 52 patients with hepatic metastases diagnosed clinically and by imaging examinations. The general information and imaging data of these patients were collected and analyzed. Results The lesions in the 2 groups mainly presented as multiple and diffuse lesions. The diffuse lesions of HEH often fused into strips. The hepatic metastasis group showed a higher CT attenuation and TNR in the portal vein phase than the HEH group (P<0.05). The area under the ROC curves of the two indexes were 0.756 and 0.841 respectively. The centers of the lesions showed almost no or slightly homogeneous enhancement in the HEH group, while the liver metastasis group showed slightly and moderately heterogeneous enhancement, with a significant difference between the two groups (P<0.05). Female, subcapsular distribution, capsular contraction, target ring sign and lollipop sign were independent risk factors for HEH (P<0.05), while a high CT attenuation and TNR in the portal vein phase, elevated tumor markers and lymph node metastasis were independent risk factors for liver metastasis on logistic regression analysis (P<0.05). Conclusions CT attenuation, TNR, central enhancement features in the portal vein phase, special signs and secondary changes of lesions were helpful for the differential diagnosis between HEH and liver metastasis. Key words: Hemangioendothelioma, epithelioid; Hepatoma; Tomography, X-ray computed; Tumor metastasis; Differential diagnosis
{"title":"CT imaging and quantitative analysis in the differential diagnosis of hepatic epithelioid hemangioendothelioma and hepatic metastasis","authors":"Xiaopeng Wang, P. Liang, Rui Li, P. Hou, Jianbo Gao","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.02.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.02.002","url":null,"abstract":"Objective \u0000To study the use of abdominal enhanced CT imaging and quantitative index analysis in the differential diagnosis of hepatic epithelioid hemangioendothelioma (HEH) and hepatic metastasis. \u0000 \u0000 \u0000Methods \u0000A study group of 12 patients with HEH who underwent abdominal enhanced CT scanning at the First Affiliated Hospital of Zhengzhou University from February 2014 to October 2018 was retrospectively compared with a control group of 52 patients with hepatic metastases diagnosed clinically and by imaging examinations. The general information and imaging data of these patients were collected and analyzed. \u0000 \u0000 \u0000Results \u0000The lesions in the 2 groups mainly presented as multiple and diffuse lesions. The diffuse lesions of HEH often fused into strips. The hepatic metastasis group showed a higher CT attenuation and TNR in the portal vein phase than the HEH group (P<0.05). The area under the ROC curves of the two indexes were 0.756 and 0.841 respectively. The centers of the lesions showed almost no or slightly homogeneous enhancement in the HEH group, while the liver metastasis group showed slightly and moderately heterogeneous enhancement, with a significant difference between the two groups (P<0.05). Female, subcapsular distribution, capsular contraction, target ring sign and lollipop sign were independent risk factors for HEH (P<0.05), while a high CT attenuation and TNR in the portal vein phase, elevated tumor markers and lymph node metastasis were independent risk factors for liver metastasis on logistic regression analysis (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000CT attenuation, TNR, central enhancement features in the portal vein phase, special signs and secondary changes of lesions were helpful for the differential diagnosis between HEH and liver metastasis. \u0000 \u0000 \u0000Key words: \u0000Hemangioendothelioma, epithelioid; Hepatoma; Tomography, X-ray computed; Tumor metastasis; Differential diagnosis","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"90-95"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46172134","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":"Intrahepatic biliary cystadenoma misdiagnosed as hepatic echinococcosis: a case report","authors":"W. Yan, H. Fan, Wengang Chai, Lu Sun, Junfeng Ye, Ping Zhang","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.01.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.01.015","url":null,"abstract":"肝内胆管囊腺瘤是一种比较罕见的肝内囊性病变，具有一定的恶变倾向及较高的复发率。该病多发于中年女性，早期不易察觉，缺少特异性临床表现及实验室检查结果，易造成误诊。本文报道了1例误诊为肝包虫病的肝内胆管囊腺瘤病例。患者女性，38岁，有牧区生活史，影像学检查提示肝包虫病。患者行肿物完整切除术，术中发现肿物囊泡不同于传统肝包虫囊泡，术后病理诊断为肝内胆管囊腺瘤。","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"63-64"},"PeriodicalIF":0.0,"publicationDate":"2020-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45485623","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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