Pub Date : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.12.007
Z. Chong, Chen Sisi, Wang Minghui, Li Jisheng, Tian Xuechang
Objective To compare laparoscopic cholecystectomy (LC) with or without percutaneous transhepatic gallbladder drainage (PTGD) for acute severe cholecystitis. Methods According to the predefined inclusion and exclusion criteria, 23 articles were selected for this meta-analysis. All patients were treated with LC with or without PTGD. A meta-analysis was used to analyze the clinical efficacy. Results Compared with LC, all the surgical indicators of LC with PTGD were significantly better than LC alone (all P≤0.05), including the operation time: 95%CI(-27.24, -9.27); intraoperative blood loss: 95%CI(-50.25, -40.19); postoperative hospital stay: 95%CI(-3.63, -0.64); rates of conversion to open abdomen: OR=0.48, 95%CI(0.32, 0.74); rates of incision infection: OR=0.49, 95%CI(0.25, 0.99); drainage tube indwelling time: 95%CI(-2.07, -1.19); gastrointestinal function recovery time: 95%CI(-1.73, -0.77); rates of bile leakage: OR=0.23, 95%CI(0.12, 0.44); and rates of complications: OR=0.36, 95%CI(0.27, 0.48). Conclusion Compared with LC alone, PTGD+ LC is the preferred treatment for acute severe cholecystitis. Key words: Cholecystitis, acute; Cholecystectomy, laparoscopic; Treatment outcome; Percutaneous transhepatic gallbladder drainage; Meta-analysis
{"title":"Laparoscopic cholecystectomy with or without percutaneous transhepatic gallbladder drainage for acute severe cholecystitis:a meta-analysis","authors":"Z. Chong, Chen Sisi, Wang Minghui, Li Jisheng, Tian Xuechang","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.007","url":null,"abstract":"Objective \u0000To compare laparoscopic cholecystectomy (LC) with or without percutaneous transhepatic gallbladder drainage (PTGD) for acute severe cholecystitis. \u0000 \u0000 \u0000Methods \u0000According to the predefined inclusion and exclusion criteria, 23 articles were selected for this meta-analysis. All patients were treated with LC with or without PTGD. A meta-analysis was used to analyze the clinical efficacy. \u0000 \u0000 \u0000Results \u0000Compared with LC, all the surgical indicators of LC with PTGD were significantly better than LC alone (all P≤0.05), including the operation time: 95%CI(-27.24, -9.27); intraoperative blood loss: 95%CI(-50.25, -40.19); postoperative hospital stay: 95%CI(-3.63, -0.64); rates of conversion to open abdomen: OR=0.48, 95%CI(0.32, 0.74); rates of incision infection: OR=0.49, 95%CI(0.25, 0.99); drainage tube indwelling time: 95%CI(-2.07, -1.19); gastrointestinal function recovery time: 95%CI(-1.73, -0.77); rates of bile leakage: OR=0.23, 95%CI(0.12, 0.44); and rates of complications: OR=0.36, 95%CI(0.27, 0.48). \u0000 \u0000 \u0000Conclusion \u0000Compared with LC alone, PTGD+ LC is the preferred treatment for acute severe cholecystitis. \u0000 \u0000 \u0000Key words: \u0000Cholecystitis, acute; Cholecystectomy, laparoscopic; Treatment outcome; Percutaneous transhepatic gallbladder drainage; Meta-analysis","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"910-914"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46323771","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}
Advanced hepatic alveolar echinococcosis (HAE) is still mainly treated with surgery. Due to the unfavorable location of some lesions for liver resection, microwave ablation has become a preferred alternative treatment method. Microwave ablation has a good effect on the treatment of HAE, but the occurrence of serious complications cannot be ignored. This article reports on a 54 year old patient with acute kidney injury who underwent simultaneous liver resection and microwave ablation for HAE.
{"title":"Acute renal injury after microwave ablation of hepatic alveolar echinococcosis: a case report","authors":"Haiwen Ye, Yong Deng, Lingqiang Zhang, Xiaolei Xu, Hai-jiu Wang, Ying Zhou, C. Yangdan, H. Fan","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.015","url":null,"abstract":"晚期肝泡型包虫病(HAE)目前仍以手术治疗为主。由于一些病灶位置不利于肝切除，微波消融成为一种优先替补的治疗方式。微波消融对HAE的治疗具有较好的效果，但其严重并发症的发生不可忽视。本文报道了一例54岁HAE同时行肝切除和微波消融术后出现的急性肾损伤患者情况。","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"945-946"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46307289","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 : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.12.010
Fei Liu, Bo Liu, C. Qi, Yu-long Yang, Jing-yi Li, Mei-ju Lin, Yue-feng Ma
Objective To study the impact of aging on pancreatic atrophy, fibrosis and exocrine hypofunction in patients with post-ERCP pancreatitis (PEP) and its severity. Methods A retrospective study was conducted on 786 patients who underwent ERCP at the Affiliated Zhongshan Hospital of Dalian University from June 2011 to April 2018. Patients who were aged over 75 years were grouped into the elderly group while those aged less than 75 years were grouped into the younger group. The incidences and severity of post-ERCP pancreatitis in the two groups were analyzed. Results In the elderly group, there were 308 patients. The average age was (81.8±4.8) years. In the younger group, there were 478 patients. The average age was (57.7±12.0) years. The average operation time for the elderly group was (52.5±14.1) minutes, and that for the younger group was (50.7±14.9) minutes. There were no significant differences in operation time and in the related factors between the two groups (P>0.05). There was no significant difference in the rates of hyperamylasemia between the two groups (29.9% vs 30.1%, P>0.05). The overall rate of PEP was 11.3% (89/786). In the elderly group, the rate of PEP was 6.5% (20/308), which was significantly lower than that in the younger group (χ2=11.765, P<0.05). The rates of mild, moderate and severe PEP in the elderly group was significantly lower than those in the younger group (all P<0.05). Hyperamylasemia and pancreatitis in the 2 groups were alleviated after conservative treatment. Conclusions Aging (≥75 years) resulted in pancreatic atrophy, fibrosis, exocrine hypofunction which had a protective effect on PEP. Key words: Pancreatitis; Hyperamylasemia; Cholangiopancreatography, endoscopic retrograde; Jaundice, obstructive; Biliary strictures
{"title":"The impact of aging on post-ERCP pancreatitis and its severity","authors":"Fei Liu, Bo Liu, C. Qi, Yu-long Yang, Jing-yi Li, Mei-ju Lin, Yue-feng Ma","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.010","url":null,"abstract":"Objective \u0000To study the impact of aging on pancreatic atrophy, fibrosis and exocrine hypofunction in patients with post-ERCP pancreatitis (PEP) and its severity. \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted on 786 patients who underwent ERCP at the Affiliated Zhongshan Hospital of Dalian University from June 2011 to April 2018. Patients who were aged over 75 years were grouped into the elderly group while those aged less than 75 years were grouped into the younger group. The incidences and severity of post-ERCP pancreatitis in the two groups were analyzed. \u0000 \u0000 \u0000Results \u0000In the elderly group, there were 308 patients. The average age was (81.8±4.8) years. In the younger group, there were 478 patients. The average age was (57.7±12.0) years. The average operation time for the elderly group was (52.5±14.1) minutes, and that for the younger group was (50.7±14.9) minutes. There were no significant differences in operation time and in the related factors between the two groups (P>0.05). There was no significant difference in the rates of hyperamylasemia between the two groups (29.9% vs 30.1%, P>0.05). The overall rate of PEP was 11.3% (89/786). In the elderly group, the rate of PEP was 6.5% (20/308), which was significantly lower than that in the younger group (χ2=11.765, P<0.05). The rates of mild, moderate and severe PEP in the elderly group was significantly lower than those in the younger group (all P<0.05). Hyperamylasemia and pancreatitis in the 2 groups were alleviated after conservative treatment. \u0000 \u0000 \u0000Conclusions \u0000Aging (≥75 years) resulted in pancreatic atrophy, fibrosis, exocrine hypofunction which had a protective effect on PEP. \u0000 \u0000 \u0000Key words: \u0000Pancreatitis; Hyperamylasemia; Cholangiopancreatography, endoscopic retrograde; Jaundice, obstructive; Biliary strictures","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"925-929"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45459752","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 : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.12.002
Liangen Yang, Yu-ming Gu, Hao Xu, Xun Wang, Jiao-feng Lu
Objective To study the efficacy of combined transcatheter arterial chemoembolization (TACE) with iodine-125 seed implantation in treating hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). Methods From January 2015 to January 2019, eighty patients with HCC and PVTT who were treated at Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. A total of 71 patients were male and 9 were female, aged (53.1±9.9) years. The patients included 48 patients (group A) who were treated with TACE alone and 32 patients (group B) with TACE combined with iodine-125 seed implantation. The survival time and disease control rate (DCR) of the intrahepatic lesions and PVTT in the two groups were compared. Results There were 32 patients who were successfully implanted with portal vein iodine-125 seed and stents. The DCR of PVTT in group B was significantly better than in group A (90.6% vs. 81.3%, P 0.05). The survival times of group A and group B were (8.0±0.6) and (16.0±2.1) months, respectively. The median survival times were (7.6±1.0) and (14.8±1.5) months respectively. Group B had significantly better survival time than Group A, (both P<0.05). Univariate and multivariate analysis showed that tumor size was an independent risk factor of prognosis (Regression coefficient: 0.960, HR: 0.383, 95% CI: 0.158-0.926, P<0.05). 125I treatment was a protective factor of prognosis (Regression coefficient: -1.525, HR: 0.218, 95% CI: 0.100-0.473, P<0.05). Conclusion For patients with HCC and PVTT, compared with TACE alone, TACE combined with iodine-125 seed implantation could safely and effectively control portal vein tumor thrombus, and prolonged patient survival. Key words: Carcinoma, hepatocellular; Portal vein tumor thrombus; Transcatheter arterial chemoembolization; Iodine radioisotopes
{"title":"Therapeutic effect of transcatheter arterial chemoembolization combined with iodine-125 seed strand implantation for treating hepatocellular carcinoma with portal vein tumor thrombus","authors":"Liangen Yang, Yu-ming Gu, Hao Xu, Xun Wang, Jiao-feng Lu","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.002","url":null,"abstract":"Objective \u0000To study the efficacy of combined transcatheter arterial chemoembolization (TACE) with iodine-125 seed implantation in treating hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). \u0000 \u0000 \u0000Methods \u0000From January 2015 to January 2019, eighty patients with HCC and PVTT who were treated at Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. A total of 71 patients were male and 9 were female, aged (53.1±9.9) years. The patients included 48 patients (group A) who were treated with TACE alone and 32 patients (group B) with TACE combined with iodine-125 seed implantation. The survival time and disease control rate (DCR) of the intrahepatic lesions and PVTT in the two groups were compared. \u0000 \u0000 \u0000Results \u0000There were 32 patients who were successfully implanted with portal vein iodine-125 seed and stents. The DCR of PVTT in group B was significantly better than in group A (90.6% vs. 81.3%, P 0.05). The survival times of group A and group B were (8.0±0.6) and (16.0±2.1) months, respectively. The median survival times were (7.6±1.0) and (14.8±1.5) months respectively. Group B had significantly better survival time than Group A, (both P<0.05). Univariate and multivariate analysis showed that tumor size was an independent risk factor of prognosis (Regression coefficient: 0.960, HR: 0.383, 95% CI: 0.158-0.926, P<0.05). 125I treatment was a protective factor of prognosis (Regression coefficient: -1.525, HR: 0.218, 95% CI: 0.100-0.473, P<0.05). \u0000 \u0000 \u0000Conclusion \u0000For patients with HCC and PVTT, compared with TACE alone, TACE combined with iodine-125 seed implantation could safely and effectively control portal vein tumor thrombus, and prolonged patient survival. \u0000 \u0000 \u0000Key words: \u0000Carcinoma, hepatocellular; Portal vein tumor thrombus; Transcatheter arterial chemoembolization; Iodine radioisotopes","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"885-889"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44427070","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 : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.12.008
Jianzeng Zhang, Haidong Hu, Zeng Zheng, Hailong Yu, Jinghui Dong, W. An, Yunfang Li
Objective To investigate the CT and MR imaging features of hepatic ischemia/necrosis after hepatosplenic surgery and upper gastrointestinal hemorrhage. Methods A total of 36 patients diagnosed with hepatic ischemia/necrosis by both medical imaging and clinical diagnosis shortly after hepatosplenic surgery and upper gastrointestinal hemorrhage were collected, including 9 patients with liver cancer resection, 5 patients with liver cancer ablation (microwave ablation/radiofrequency ablation, argon-helium knife, alcohol injection), 11 patients with spleen resection, and 11 patients with upper gastrointestinal bleeding. Conventional liver CT and / or MR plain and dynamic enhancement scan were performed to comprehensively analyze the morphology and density/signal performance of the lesions. Results (1) Number of lesions: All cases had multiple lesions. (2) Distribution of lesions: scattered in the liver lobes, clustered or regional distribution, mainly in the periphery of the liver. (3) Size of lesions: the boundary of the nodular lesion was clear, and the single maximum diameter was 1.0-1.5 cm. It can be fused into a wedge-shaped patch or a segmental/sub-segmental large patch with a slight mass effect. (4) CT density or MR signal characteristics: CT plain scan showed slightly low density; MR plain scan showed slightly low signal on T1WI, high signal on T2WI, slightly high signal on DWI and no lipid/fat on dual phase imaging; 24 out of 36 cases (66.7%) showed no enhancement, while some lesions showed thin ring enhancement on the edge; emboli were found in the main and/or branches of portal vein (21/36 cases, 58.3%). (5) In the short-term review (minimum 5 days), the lesions became smaller or disappeared, and the local liver volume became smaller or the surface was depressed. Conclusions Hepatic ischemia/necrosis occurs after hepatosplenic surgery and upper gastrointestinal hemorrhage. The imaging manifestations are multiple nodular or flaky hypovascular foci, and the short-term review shows a markedly improvement. It needs to be differentiated from infection and metastasis of malignant tumors after operation. Key words: Hepatectomy; Splenectomy; Upper gastrointestinal hemorrhage; Ischemia; Necrosis; Computed Tomography, X-ray; Magnetic resonance imaging
{"title":"CT and MR features of hepatic ischemia/necrosis after hepatosplenic surgery and upper gastrointestinal hemorrhage","authors":"Jianzeng Zhang, Haidong Hu, Zeng Zheng, Hailong Yu, Jinghui Dong, W. An, Yunfang Li","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.008","url":null,"abstract":"Objective \u0000To investigate the CT and MR imaging features of hepatic ischemia/necrosis after hepatosplenic surgery and upper gastrointestinal hemorrhage. \u0000 \u0000 \u0000Methods \u0000A total of 36 patients diagnosed with hepatic ischemia/necrosis by both medical imaging and clinical diagnosis shortly after hepatosplenic surgery and upper gastrointestinal hemorrhage were collected, including 9 patients with liver cancer resection, 5 patients with liver cancer ablation (microwave ablation/radiofrequency ablation, argon-helium knife, alcohol injection), 11 patients with spleen resection, and 11 patients with upper gastrointestinal bleeding. Conventional liver CT and / or MR plain and dynamic enhancement scan were performed to comprehensively analyze the morphology and density/signal performance of the lesions. \u0000 \u0000 \u0000Results \u0000(1) Number of lesions: All cases had multiple lesions. (2) Distribution of lesions: scattered in the liver lobes, clustered or regional distribution, mainly in the periphery of the liver. (3) Size of lesions: the boundary of the nodular lesion was clear, and the single maximum diameter was 1.0-1.5 cm. It can be fused into a wedge-shaped patch or a segmental/sub-segmental large patch with a slight mass effect. (4) CT density or MR signal characteristics: CT plain scan showed slightly low density; MR plain scan showed slightly low signal on T1WI, high signal on T2WI, slightly high signal on DWI and no lipid/fat on dual phase imaging; 24 out of 36 cases (66.7%) showed no enhancement, while some lesions showed thin ring enhancement on the edge; emboli were found in the main and/or branches of portal vein (21/36 cases, 58.3%). (5) In the short-term review (minimum 5 days), the lesions became smaller or disappeared, and the local liver volume became smaller or the surface was depressed. \u0000 \u0000 \u0000Conclusions \u0000Hepatic ischemia/necrosis occurs after hepatosplenic surgery and upper gastrointestinal hemorrhage. The imaging manifestations are multiple nodular or flaky hypovascular foci, and the short-term review shows a markedly improvement. It needs to be differentiated from infection and metastasis of malignant tumors after operation. \u0000 \u0000 \u0000Key words: \u0000Hepatectomy; Splenectomy; Upper gastrointestinal hemorrhage; Ischemia; Necrosis; Computed Tomography, X-ray; Magnetic resonance imaging","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"915-920"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45179161","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 : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.12.005
Kun Yan, Z. Ding, Guoping Chen, Jianjun Zheng, Yinhua Jin, Bibo Hu, Bin Chen, Jingfeng Zhang
Objective To investigate the use of conventional MR imaging to guide treatment in patients with cholecystolithiasis and diffuse inflammatory thickening of gallbladder wall. Methods The clinical data of patients who were treated in the Ningbo Huamei Hospital, University of the Chinese Academy of Sciences between January 2017 and January 2018 were analyzed. These patients were divided into two groups: patients with acute cholecystitis (n=139) and patients with viral hepatitis combined with cholecystolithiasis (n=67). Differences in the imaging signs in standardized upper abdominal contrast enhanced MRI examinations were retrospectively analyzed. Results The imaging signs, including stone location, continuity of gallbladder mucosa, exudation in peri-gallbladder space, edema of intrahepatic portal area showed significant differences between the two groups (all P<0.05). On stratification analysis, the type of thickened gallbladder wall, background of liver parenchyma and extent of edema in intrahepatic catchment area also showed significant differences (all P<0.05). The imaging signs, including non-gallbladder neck ductal stones, concentric thickening of gallbladder wall, continuous mucous membrane in gallbladder and no peri-gallbladder space exudation but diffuse edema of intrahepatic catchment area supported the diagnosis of viral hepatitis combined with gallstones. The imaging signs, including discontinuity of gallbladder mucosa, exudation of peri-gallbladder space, diffuse edema of gallbladder wall without a cirrhotic background and edema in intrahepatic portal area supported the diagnosis of acute calculous cholecystitis of gallbladder. Conclusions Routine upper abdominal contrast enhanced MRI plays an important role in demonstrating the underlying cause of gallbladder wall diffuse edema thickening in patients with gallstones. It provides an important reference for the choice of clinical treatment pathway. Key words: Cholecystolithiasis; Clinical protocols; Cholecystitis; Hepatitis B; Magnetic resonance imaging
{"title":"Magnetic resonance imaging in guiding choice of treatment pathway in patients with cholecystolithiasis and diffuse inflammatory thickening of gallbladder wall","authors":"Kun Yan, Z. Ding, Guoping Chen, Jianjun Zheng, Yinhua Jin, Bibo Hu, Bin Chen, Jingfeng Zhang","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.005","url":null,"abstract":"Objective \u0000To investigate the use of conventional MR imaging to guide treatment in patients with cholecystolithiasis and diffuse inflammatory thickening of gallbladder wall. \u0000 \u0000 \u0000Methods \u0000The clinical data of patients who were treated in the Ningbo Huamei Hospital, University of the Chinese Academy of Sciences between January 2017 and January 2018 were analyzed. These patients were divided into two groups: patients with acute cholecystitis (n=139) and patients with viral hepatitis combined with cholecystolithiasis (n=67). Differences in the imaging signs in standardized upper abdominal contrast enhanced MRI examinations were retrospectively analyzed. \u0000 \u0000 \u0000Results \u0000The imaging signs, including stone location, continuity of gallbladder mucosa, exudation in peri-gallbladder space, edema of intrahepatic portal area showed significant differences between the two groups (all P<0.05). On stratification analysis, the type of thickened gallbladder wall, background of liver parenchyma and extent of edema in intrahepatic catchment area also showed significant differences (all P<0.05). The imaging signs, including non-gallbladder neck ductal stones, concentric thickening of gallbladder wall, continuous mucous membrane in gallbladder and no peri-gallbladder space exudation but diffuse edema of intrahepatic catchment area supported the diagnosis of viral hepatitis combined with gallstones. The imaging signs, including discontinuity of gallbladder mucosa, exudation of peri-gallbladder space, diffuse edema of gallbladder wall without a cirrhotic background and edema in intrahepatic portal area supported the diagnosis of acute calculous cholecystitis of gallbladder. \u0000 \u0000 \u0000Conclusions \u0000Routine upper abdominal contrast enhanced MRI plays an important role in demonstrating the underlying cause of gallbladder wall diffuse edema thickening in patients with gallstones. It provides an important reference for the choice of clinical treatment pathway. \u0000 \u0000 \u0000Key words: \u0000Cholecystolithiasis; Clinical protocols; Cholecystitis; Hepatitis B; Magnetic resonance imaging","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"899-904"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44245820","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 : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.12.017
Ling Li, Binyao Chen, Huijia Zhao, Z. Fan, G. Sun, L. Dong, Jiang Yue, Q. Ye
Liver ischemia-reperfusion injury (IRI) is a major complication of hemorrhagic shock, liver transplantation, and other liver surgeries. It’s important to study the targets towards liver IRI for preventing and mitigating the clinical renal injury. It has been reported that the peroxisome proliferator activated receptor gamma (PPARγ) protects the liver against IRI by targeting family with sequence similarity 3 member A (FAM3A). At the meantime, noncoding RNAs, including lncRNAs and miRNAs, have also been reported to play important roles on the process of hepatic IRI. This review briefly discussed the roles and mechanisms of PPARγ, FAM3A and noncoding RNAs in liver IRI, to find potential targets of gene therapy, aiming to prevent and mitigate the liver IRI as well as to improve postoperative liver function. Key words: Reperfusion injury; Liver; Noncoding RNA; Therapy
{"title":"Novel targets for ischemia reperfusion injury therapy in the liver","authors":"Ling Li, Binyao Chen, Huijia Zhao, Z. Fan, G. Sun, L. Dong, Jiang Yue, Q. Ye","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.017","url":null,"abstract":"Liver ischemia-reperfusion injury (IRI) is a major complication of hemorrhagic shock, liver transplantation, and other liver surgeries. It’s important to study the targets towards liver IRI for preventing and mitigating the clinical renal injury. It has been reported that the peroxisome proliferator activated receptor gamma (PPARγ) protects the liver against IRI by targeting family with sequence similarity 3 member A (FAM3A). At the meantime, noncoding RNAs, including lncRNAs and miRNAs, have also been reported to play important roles on the process of hepatic IRI. This review briefly discussed the roles and mechanisms of PPARγ, FAM3A and noncoding RNAs in liver IRI, to find potential targets of gene therapy, aiming to prevent and mitigate the liver IRI as well as to improve postoperative liver function. \u0000 \u0000 \u0000Key words: \u0000Reperfusion injury; Liver; Noncoding RNA; Therapy","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"948-951"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43397572","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 : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.12.012
Jin Dong, Chan Wang, Yu Hu
Objective To investigate the effect of p38 mitogen-activated protein kinase (p38 MAPK) inhibitor on liver function and tissue in rats with hepatic hydatidosis. Methods A model of liver echinococcosis was established in 100 female Wistar rats, 60 of 100 were, randomly divided into three groups, Control group (0.3 ml normal saline), Low dose group (50 μmol/L p38MAPK inhibitor SB-202190), High dose group (100 μmol/L SB-202190B). The reagents were given via the hepatic artery 1, 3, 7, 14 and 42 days after the rat model was generated. Rats were sacrificed 42 days after the intervention, liver tissue and blood samples were collected for liver function study. Results Alanine aminotransferase levels were (49.58±2.38) U/L, (38.35±1.34) U/L and (30.93±1.51) U/L and aspartic aminotransferase levels were (67.45±5.14) U/L, (54.86±1.09) U/L and (45.76±1.04) U/L in the Control group, the Low-dose group and High-dose group, showing a decreasing trend, with statistically significant differences (all P<0.05). Triglycerides in the Low-dose group were higher than those in Control group and the High-dose group, with statistically significant differences (all P<0.05). In the Control group, the hepatocytes were severely injured, with almost no normal hepatocytes left, and the normal hepatocyte boundaries were also disrupted, he normal hepatic lobule was replaced by the pseudolobules. In the Low-dose group, there were more inflammatory cells, and less replacement of normal liver cells by pseudolobules. High dose group of a small amount of inflammatory cells infiltration, roughly normal liver cells, normal liver cell line is clear, visible central vein of liver cells. Conclusion p38MAPK inhibitor SB-202190 improved liver function and reduced liver tissue damage in rats with hepatic hydatidosis. Key words: Echinococcosis, hepatic; P38 mitogen-activated protein kinases; Inhibitors; Liver function
{"title":"Effect of p38 mitogen-activated protein kinase inhibitor on liver function and tissue in rats with hepatic hydatidosis","authors":"Jin Dong, Chan Wang, Yu Hu","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.012","url":null,"abstract":"Objective \u0000To investigate the effect of p38 mitogen-activated protein kinase (p38 MAPK) inhibitor on liver function and tissue in rats with hepatic hydatidosis. \u0000 \u0000 \u0000Methods \u0000A model of liver echinococcosis was established in 100 female Wistar rats, 60 of 100 were, randomly divided into three groups, Control group (0.3 ml normal saline), Low dose group (50 μmol/L p38MAPK inhibitor SB-202190), High dose group (100 μmol/L SB-202190B). The reagents were given via the hepatic artery 1, 3, 7, 14 and 42 days after the rat model was generated. Rats were sacrificed 42 days after the intervention, liver tissue and blood samples were collected for liver function study. \u0000 \u0000 \u0000Results \u0000Alanine aminotransferase levels were (49.58±2.38) U/L, (38.35±1.34) U/L and (30.93±1.51) U/L and aspartic aminotransferase levels were (67.45±5.14) U/L, (54.86±1.09) U/L and (45.76±1.04) U/L in the Control group, the Low-dose group and High-dose group, showing a decreasing trend, with statistically significant differences (all P<0.05). Triglycerides in the Low-dose group were higher than those in Control group and the High-dose group, with statistically significant differences (all P<0.05). In the Control group, the hepatocytes were severely injured, with almost no normal hepatocytes left, and the normal hepatocyte boundaries were also disrupted, he normal hepatic lobule was replaced by the pseudolobules. In the Low-dose group, there were more inflammatory cells, and less replacement of normal liver cells by pseudolobules. High dose group of a small amount of inflammatory cells infiltration, roughly normal liver cells, normal liver cell line is clear, visible central vein of liver cells. \u0000 \u0000 \u0000Conclusion \u0000p38MAPK inhibitor SB-202190 improved liver function and reduced liver tissue damage in rats with hepatic hydatidosis. \u0000 \u0000 \u0000Key words: \u0000Echinococcosis, hepatic; P38 mitogen-activated protein kinases; Inhibitors; Liver function","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"934-936"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44749052","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 : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.12.019
Yeming Zhou, Wei Jiang, Jing Huang, Y. Hua, Caide Lu
The incidence of intrahepatic cholangiocarcinoma (ICC) has been increasing year by year. For most patients, surgical resection is not suitable when they are diagnosed as ICC. Conventional chemotherapy and radiotherapy are not effective for the long-term survival rate of ICC patients and lead to the poor overall prognosis. In recent years, with the deepening understanding about the molecular mechanism of biliary malignant tumors, some key genes and signaling pathways related to the pathogenesis of ICC have been identified, providing new ideas for the targeted therapy. In this paper, major molecular mechanisms and targeted therapies of ICC are reviewed. Key words: Bile duct neoplasm; Cholangiocarcinoma; Intrahepatic cholangiocarcinoma; Molecular targeted therapy; Progress
{"title":"Progress of targeted therapy of intrahepatic cholangiocarcinoma","authors":"Yeming Zhou, Wei Jiang, Jing Huang, Y. Hua, Caide Lu","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.019","url":null,"abstract":"The incidence of intrahepatic cholangiocarcinoma (ICC) has been increasing year by year. For most patients, surgical resection is not suitable when they are diagnosed as ICC. Conventional chemotherapy and radiotherapy are not effective for the long-term survival rate of ICC patients and lead to the poor overall prognosis. In recent years, with the deepening understanding about the molecular mechanism of biliary malignant tumors, some key genes and signaling pathways related to the pathogenesis of ICC have been identified, providing new ideas for the targeted therapy. In this paper, major molecular mechanisms and targeted therapies of ICC are reviewed. \u0000 \u0000 \u0000Key words: \u0000Bile duct neoplasm; Cholangiocarcinoma; Intrahepatic cholangiocarcinoma; Molecular targeted therapy; Progress","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"956-960"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49135319","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 : 2019-12-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.12.006
Xu Chang, Cheng Qing-bao, W. Xiaobing, Luo Xiang-ji, L. Bin, Liu Chen, Jiang Xiaoqing
Objective To study the use of MRCP digital quantitative diagnosis in the differential diagnosis of choledochal cyst type Ic. Methods The clinical data of 41 patients with choledochal cyst type Ic, 47 patients with distal choledochal obstruction and 43 patients with simple gallbladder stones or polyps who were treated at the Eastern Hepatobiliary Surgery Hospital, PLA Naval Medical University from January 2010 to June 2016 were retrospectively analyzed. The diameters of the common bile duct, the left and the right hepatic ducts were measured and compared. Results The maximum diameter of the left hepatic duct (LHD), right hepatic duct (RHD) and common bile duct (CBD) were significantly different (all P 0.05), while the ratios of CBD/LHD and CBD/RHD were significantly larger (P 0.05). The proportion of pancreaticobiliary maljunction (PBM) in patients with type Ic choledochal cyst was significantly higher than patients with distal choledochal obstruction and simple gallstone or polyp (P<0.05). Conclusions For patients with choledochal cyst type Ic, their CBD shows obvious dilation, while there is no obvious dilation in LHD and RHD. It is helpful to conduct differential diagnosis of choledochal cyst type Ic by the use of MRCP to observe the presence of PBM and to quantitatively compare the CBD/LHD and CBD/RHD ratios. Key words: Choledochal cyst; MRCP; Differential diagnosis; Digital quanlification
{"title":"Magnetic resonance cholangiopancreatography digital quantitative diagnosis in the differential diagnosis of choledochal cyst type Ic","authors":"Xu Chang, Cheng Qing-bao, W. Xiaobing, Luo Xiang-ji, L. Bin, Liu Chen, Jiang Xiaoqing","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.006","url":null,"abstract":"Objective \u0000To study the use of MRCP digital quantitative diagnosis in the differential diagnosis of choledochal cyst type Ic. \u0000 \u0000 \u0000Methods \u0000The clinical data of 41 patients with choledochal cyst type Ic, 47 patients with distal choledochal obstruction and 43 patients with simple gallbladder stones or polyps who were treated at the Eastern Hepatobiliary Surgery Hospital, PLA Naval Medical University from January 2010 to June 2016 were retrospectively analyzed. The diameters of the common bile duct, the left and the right hepatic ducts were measured and compared. \u0000 \u0000 \u0000Results \u0000The maximum diameter of the left hepatic duct (LHD), right hepatic duct (RHD) and common bile duct (CBD) were significantly different (all P 0.05), while the ratios of CBD/LHD and CBD/RHD were significantly larger (P 0.05). The proportion of pancreaticobiliary maljunction (PBM) in patients with type Ic choledochal cyst was significantly higher than patients with distal choledochal obstruction and simple gallstone or polyp (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000For patients with choledochal cyst type Ic, their CBD shows obvious dilation, while there is no obvious dilation in LHD and RHD. It is helpful to conduct differential diagnosis of choledochal cyst type Ic by the use of MRCP to observe the presence of PBM and to quantitatively compare the CBD/LHD and CBD/RHD ratios. \u0000 \u0000 \u0000Key words: \u0000Choledochal cyst; MRCP; Differential diagnosis; Digital quanlification","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"905-909"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44958191","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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