{"title":"Removal of liver foreign body under laparoscopy: a case report","authors":"Yuwei Tan, Shengyong Liu, Yue Zhang, Dong Zhang, Xuemin Chen","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.016","url":null,"abstract":"患者男性，35岁，因\"上腹疼痛不适10 h\"入院。查X光片示上腹部异物。CT示肝左叶异物可能。查体未见腹膜炎体征。实验室检查血常规示白细胞10.7×109/L，中性粒细胞8.6×109/L，其余未见异常。遂行腹腔镜下肝脏异物取出术，见左肝外叶与膈肌局部粘连，超声刀分离粘连见一针状金属异物，用分离钳完整取出。患者术后无并发症。","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"947-947"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43836418","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.1007-8118.2019.12.003
Yun Chen, Song Zhou, Xin Li, Fang-yi Liu, Zhigang Cheng, Jie Yu, Z. Han, Li-nan Dong, P. Liang, Xiaoling Yu
Objective To study the use of a three dimensional (3D) visualization operative planning system in Ultrasound-guided percutaneous microwave ablation (US-PMWA) for large hepatic hemangiomas (LHHs). Methods A total of 50 patients with LHHs from January 2011 to August 2018 were included in Department of Interventional Ultrasound, the First Medical Center, Chinese PLA General Hospital, including 12 males and 38 females (age from 28.0~60.0, mean age was 43.0). Fifty patients with LHHs were divided into the 3D and 2D groups (25 cases in each group). The therapeutic efficacy was assessed by contrast-enhanced imagings on follow-up. Hepatic and renal functions were studied. The complete ablation, tumor volume shrinkage and complication rates were analyzed. Results The levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and creatinine after ablation in the 3D group were significantly lower than the 2D group [(126.7±56.4)U/L vs. (204.7±76.5)U/L; (141.0±60.8)U/L vs. (206.6±77.4)U/L; (57.3±17.6)U/L vs. (86.2±46.1)U/L; (66.6±16.6)mmol/L vs. (86.8±42.8)mmol/L, P<0.05, respectively]. Compared with the 2D group, the ablation energy, ablation time and proportion of hemoglobinuria in the 3D group were all significantly less, while the complete ablation rate was significantly higher [(93.7±3.3)% vs. (97.7±2.4)%](all P<0.05). Conclusion The 3D visualization operative planning system provided a scientific, quantifiable, and individualized therapy for LHHs using US-PMWA. Key words: Ablation techniques; Hemangioma; Liver; Three dimensional visualization operative planning system
{"title":"A comparative study on the use of a three-dimensional visualization operative planning system in Ultrasound-guided percutaneous microwave ablation for large hepatic hemangiomas","authors":"Yun Chen, Song Zhou, Xin Li, Fang-yi Liu, Zhigang Cheng, Jie Yu, Z. Han, Li-nan Dong, P. Liang, Xiaoling Yu","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.003","url":null,"abstract":"Objective \u0000To study the use of a three dimensional (3D) visualization operative planning system in Ultrasound-guided percutaneous microwave ablation (US-PMWA) for large hepatic hemangiomas (LHHs). \u0000 \u0000 \u0000Methods \u0000A total of 50 patients with LHHs from January 2011 to August 2018 were included in Department of Interventional Ultrasound, the First Medical Center, Chinese PLA General Hospital, including 12 males and 38 females (age from 28.0~60.0, mean age was 43.0). Fifty patients with LHHs were divided into the 3D and 2D groups (25 cases in each group). The therapeutic efficacy was assessed by contrast-enhanced imagings on follow-up. Hepatic and renal functions were studied. The complete ablation, tumor volume shrinkage and complication rates were analyzed. \u0000 \u0000 \u0000Results \u0000The levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and creatinine after ablation in the 3D group were significantly lower than the 2D group [(126.7±56.4)U/L vs. (204.7±76.5)U/L; (141.0±60.8)U/L vs. (206.6±77.4)U/L; (57.3±17.6)U/L vs. (86.2±46.1)U/L; (66.6±16.6)mmol/L vs. (86.8±42.8)mmol/L, P<0.05, respectively]. Compared with the 2D group, the ablation energy, ablation time and proportion of hemoglobinuria in the 3D group were all significantly less, while the complete ablation rate was significantly higher [(93.7±3.3)% vs. (97.7±2.4)%](all P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The 3D visualization operative planning system provided a scientific, quantifiable, and individualized therapy for LHHs using US-PMWA. \u0000 \u0000 \u0000Key words: \u0000Ablation techniques; Hemangioma; Liver; Three dimensional visualization operative planning system","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"890-893"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44309321","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":"Intraductal papillary mucinous neoplasm: a report of 6 cases and literature review","authors":"Baochun Lu, Jian-he Yang, Haijun Tang, Yali Wang, C. Tong, Zhihong Shen","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.014","url":null,"abstract":"本文回顾分析了绍兴市人民医院收治疗的6例胆管内乳头状黏液性肿瘤(BT-IPMN)患者的临床资料，其中4例以发热、腹痛和黄疸等胆管炎表现就诊，2例仅表现为腹痛。患者术前CT、MRI检查均显示胆管扩张，其中2例合并左肝内胆管结石，3例胆管内可见肿物。5例患者术前行ERCP检查，十二指肠乳头处均见黄绿色胶冻样黏液。6例患者均接受手术治疗，术后淋巴结阳性比例为4.1%(1/24)。术后病理诊断为胆管内乳头状黏液性癌3例、胆管内乳头状黏液性瘤3例。对每例患者均进行随访，5例复查未见复发，1例术后13个月复查发现肝内转移。","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"942-944"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43310429","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.1007-8118.2019.12.001
Saisai Meng, H. Hao, Xiu-xian Ma
Objective To investigate the clinical characteristics, treatment and curative effect of primary hepatic angiosarcoma. Methods A retrospective study was conducted on 10 patients with primary hepatic angiosarcoma who were treated in the Department of Hepatobiliary Surgery, the First Affiliated Hospital of Zhengzhou University from April 2012 to July 2018. There were 6 males and 4 females, with an average age of 55.1 (range 39.0 to 71.0) years. The clinical features, imaging findings, treatment methods and survival time of the patients were analyzed. Results The clinical manifestations of 10 patients with primary hepatic angiosarcoma were non-specific and all were confirmed by pathology. Three cases had diffuse liver echo changes on ultrasound, and 7 cases had hypoechoic lesions with blurred borders. Space occupying lesions were found in 10 cases by CT. A total of five patients underwent partial hepatectomy, 1 case received chemotherapy, 1 case received transcatheter arterial chemoembolization (TACE), 2 case received molecular targeted therapy, and 1 case was untreated. From diagnosis to the last follow-up, the survival time of the 5 patients receiving surgical resection were 9 months, 15 months, 19 months, 21 months and 26 months. The survival time of the patient receiving chemotherapy was 7 months. The survival time of the patient receiving TACE was 3 months. Two patients were targeted for treatment, one survived for 32 months, another had been targeted for 15 months, and treatment was continuing. One patient survived for 1 month without treatment. Conclusions Primary hepatic angiosarcoma has a high degree of malignancy and a poor prognosis. No specific clinical manifestations and imaging findings, confirmed by pathological examination. Patients with partial hepatectomy have a better survival. Targeted therapy may be the most effective treatment for primary hepatic angiosarcoma in the future. Key words: Hemangiosarcoma; Liver; Diagnosis; Treatment outcome
{"title":"Clinical features and treatment of ten patients with primary hepatic angiosarcoma","authors":"Saisai Meng, H. Hao, Xiu-xian Ma","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.001","url":null,"abstract":"Objective \u0000To investigate the clinical characteristics, treatment and curative effect of primary hepatic angiosarcoma. \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted on 10 patients with primary hepatic angiosarcoma who were treated in the Department of Hepatobiliary Surgery, the First Affiliated Hospital of Zhengzhou University from April 2012 to July 2018. There were 6 males and 4 females, with an average age of 55.1 (range 39.0 to 71.0) years. The clinical features, imaging findings, treatment methods and survival time of the patients were analyzed. \u0000 \u0000 \u0000Results \u0000The clinical manifestations of 10 patients with primary hepatic angiosarcoma were non-specific and all were confirmed by pathology. Three cases had diffuse liver echo changes on ultrasound, and 7 cases had hypoechoic lesions with blurred borders. Space occupying lesions were found in 10 cases by CT. A total of five patients underwent partial hepatectomy, 1 case received chemotherapy, 1 case received transcatheter arterial chemoembolization (TACE), 2 case received molecular targeted therapy, and 1 case was untreated. From diagnosis to the last follow-up, the survival time of the 5 patients receiving surgical resection were 9 months, 15 months, 19 months, 21 months and 26 months. The survival time of the patient receiving chemotherapy was 7 months. The survival time of the patient receiving TACE was 3 months. Two patients were targeted for treatment, one survived for 32 months, another had been targeted for 15 months, and treatment was continuing. One patient survived for 1 month without treatment. \u0000 \u0000 \u0000Conclusions \u0000Primary hepatic angiosarcoma has a high degree of malignancy and a poor prognosis. No specific clinical manifestations and imaging findings, confirmed by pathological examination. Patients with partial hepatectomy have a better survival. Targeted therapy may be the most effective treatment for primary hepatic angiosarcoma in the future. \u0000 \u0000 \u0000Key words: \u0000Hemangiosarcoma; Liver; Diagnosis; Treatment outcome","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"881-884"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45428823","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.1007-8118.2019.12.004
Lian-Bao Kong, Xianzhou Zhang, H. Zhuang
Objective To investigate the correlations between the systemic immune inflammatory index (SII) and prognosis of patients with gallbladder cancer. Methods From April 2005 to January 2019, patients with gallbladder cancer underwent surgical treatment in the Department of Hepatobiliary and Pancreatic Surgery, Affiliated Tumor Hospital of Zhengzhou University were followed up and their SII values were analyzed. The receiver operating characteristic curve (ROC) was used to determine the best clinical boundary value of SII. According to the boundary value, patients were divided into two groups: low SII and high SII. Survival curves were drawn by Kaplan-Meier method. The overall survival time of the two groups was analyzed, and univariate analysis of postoperative survival was performed using log-rank test. Cox regression proportional hazard model was used for multivariate analysis of clinical prognosis. Results A total of 312 patients were included, including 120 males and 192 females, aged 30.0 to 86.0 (61.5±9.9) years. The best clinical cut off value of preoperative SII was determined by ROC curve to be 510.42. A total of 312 patients with gallbladder cancer were divided into low SII group (SII≤510.42) and high SII group (SII>510.42). Kaplan-Meier survival curve was used to analyze the 1, 3 and 5-year survival rates of gallbladder cancer patients in low SII group and high SII group after operation. The survival rates were 65.7%, 39.6% and 30.2%, and 27.9%, 12.0% and 9.6% respectively. The median survival time was 25 months (95% CI: 16.9-33.1) and 9 months (95% CI: 8.1-9.9), respectively. The survival rate of gallbladder cancer patients in low SII group was better. There were significant differences of the overall survival rate between the two groups (P 510.42 (HR=0.086, 95% CI: 0.032-0.289) was a risk factor for overall survival of gallbladder cancer patients. Cox multivariate analysis confirmed that preoperative SII (HR=2.649, 95% CI: 1.981-3.543) was an independent risk factor for overall survival of gallbladder cancer patients. Conclusions SII can be used as an independent prognostic factor to predict the prognosis of patients with gallbladder cancer. The higher the preoperative SII, the worse the prognosis of patients with gallbladder cancer. Key words: Gallbladder neoplasms; Systemic immune-inflammation index; Prognostic facts
{"title":"Correlations between systemic immune inflammation index and prognosis of patients with gallbladder carcinoma","authors":"Lian-Bao Kong, Xianzhou Zhang, H. Zhuang","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.004","url":null,"abstract":"Objective \u0000To investigate the correlations between the systemic immune inflammatory index (SII) and prognosis of patients with gallbladder cancer. \u0000 \u0000 \u0000Methods \u0000From April 2005 to January 2019, patients with gallbladder cancer underwent surgical treatment in the Department of Hepatobiliary and Pancreatic Surgery, Affiliated Tumor Hospital of Zhengzhou University were followed up and their SII values were analyzed. The receiver operating characteristic curve (ROC) was used to determine the best clinical boundary value of SII. According to the boundary value, patients were divided into two groups: low SII and high SII. Survival curves were drawn by Kaplan-Meier method. The overall survival time of the two groups was analyzed, and univariate analysis of postoperative survival was performed using log-rank test. Cox regression proportional hazard model was used for multivariate analysis of clinical prognosis. \u0000 \u0000 \u0000Results \u0000A total of 312 patients were included, including 120 males and 192 females, aged 30.0 to 86.0 (61.5±9.9) years. The best clinical cut off value of preoperative SII was determined by ROC curve to be 510.42. A total of 312 patients with gallbladder cancer were divided into low SII group (SII≤510.42) and high SII group (SII>510.42). Kaplan-Meier survival curve was used to analyze the 1, 3 and 5-year survival rates of gallbladder cancer patients in low SII group and high SII group after operation. The survival rates were 65.7%, 39.6% and 30.2%, and 27.9%, 12.0% and 9.6% respectively. The median survival time was 25 months (95% CI: 16.9-33.1) and 9 months (95% CI: 8.1-9.9), respectively. The survival rate of gallbladder cancer patients in low SII group was better. There were significant differences of the overall survival rate between the two groups (P 510.42 (HR=0.086, 95% CI: 0.032-0.289) was a risk factor for overall survival of gallbladder cancer patients. Cox multivariate analysis confirmed that preoperative SII (HR=2.649, 95% CI: 1.981-3.543) was an independent risk factor for overall survival of gallbladder cancer patients. \u0000 \u0000 \u0000Conclusions \u0000SII can be used as an independent prognostic factor to predict the prognosis of patients with gallbladder cancer. The higher the preoperative SII, the worse the prognosis of patients with gallbladder cancer. \u0000 \u0000 \u0000Key words: \u0000Gallbladder neoplasms; Systemic immune-inflammation index; Prognostic facts","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"894-898"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47830680","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.1007-8118.2019.12.018
G. Zhou, Zhi-jun Zhu
Hypersplenism is a common and serious complication in patients with cirrhosis and portal hypertension. Currently, the therapeutic options for severe hypersplenism mainly include total splenectomy, partial splenic embolization, local thermal ablation, splenic artery ligation, surgical shunt, and partial splenectomy. This article discussed the current progress in the relative mechanisms and invasive treatment of severe secondary hypersplenism in the patients with cirrhosis and portal hypertension. Key words: Liver cirrhosis; Hypertension, portal; Hypersplenism; Combined therapy; Occurrence mechanism
{"title":"The research advances on treatment of secondary hypersplenism in the patients with cirrhosis and portal hypertension","authors":"G. Zhou, Zhi-jun Zhu","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.12.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.12.018","url":null,"abstract":"Hypersplenism is a common and serious complication in patients with cirrhosis and portal hypertension. Currently, the therapeutic options for severe hypersplenism mainly include total splenectomy, partial splenic embolization, local thermal ablation, splenic artery ligation, surgical shunt, and partial splenectomy. This article discussed the current progress in the relative mechanisms and invasive treatment of severe secondary hypersplenism in the patients with cirrhosis and portal hypertension. \u0000 \u0000 \u0000Key words: \u0000Liver cirrhosis; Hypertension, portal; Hypersplenism; Combined therapy; Occurrence mechanism","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"952-956"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49259980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.007
Kun Xiong, Liping Zhu, Yong Lu, B. Shen, Di Xue
Objective To compare the efficacy and safety of surgical resection and thermal ablations in patients with hepatocellular carcinoma in China using a network Meta-analysis. Methods References related to eligible randomized controlled studies (RCTs) were searched from China Biology Medicine, China National Knowledge Infrastructure(CNKI), PubMed, Embase and Cochrane Library from 1st January 2010 to 1st December 2017, and were selected according to the criteria. The 1-year, 3-year, and 5-year survival rates and incidence of serious complications were compared among surgical resection (SR), radiofrequency ablation (RFA), and microwave ablation(MWA) by network Meta-analysis based frequency and Bayesian methods. Results A total of 24 RCTs were included in this study. The results of surface under the cumulative ranking probabilities (SUCRA) showed that when all RCTs were included, the frequency model supported MWA had the highest 5-year overall survival rate (66.1%), while the Bayesian model supported SR had the highest 5-year overall survival rate (64.7%). When the tumor diameter of hepatocellular carcinoma was less than 5 cm and the liver function was Child-Pugh A/B, the frequency and Bayesian model both supported SR had the highest 5-year overall survival rate (89.1% and 88.3%, respectively). When all RCTs or RCTs were included with the tumor diameter less than 5 cm and liver function was Child-Pugh A/B, both the frequency and the Bayesian model supported RFA had the best safety (serious complications rate) (16.4%, 18.7%, 12.6 and 12.8%, respectively). Conclusion SR should be the first choice for early and small hepatocellular carcinoma, while RFA and MWA have their own indications. Key words: Carcinoma, hepatocellular; Radiofrequency ablation; Microwave ablation; Surgical resection; Meta-analysis
{"title":"Network Meta-analysis on the efficacy and safety of surgical resection and thermal ablations for hepatocellular carcinoma in China","authors":"Kun Xiong, Liping Zhu, Yong Lu, B. Shen, Di Xue","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.007","url":null,"abstract":"Objective \u0000To compare the efficacy and safety of surgical resection and thermal ablations in patients with hepatocellular carcinoma in China using a network Meta-analysis. \u0000 \u0000 \u0000Methods \u0000References related to eligible randomized controlled studies (RCTs) were searched from China Biology Medicine, China National Knowledge Infrastructure(CNKI), PubMed, Embase and Cochrane Library from 1st January 2010 to 1st December 2017, and were selected according to the criteria. The 1-year, 3-year, and 5-year survival rates and incidence of serious complications were compared among surgical resection (SR), radiofrequency ablation (RFA), and microwave ablation(MWA) by network Meta-analysis based frequency and Bayesian methods. \u0000 \u0000 \u0000Results \u0000A total of 24 RCTs were included in this study. The results of surface under the cumulative ranking probabilities (SUCRA) showed that when all RCTs were included, the frequency model supported MWA had the highest 5-year overall survival rate (66.1%), while the Bayesian model supported SR had the highest 5-year overall survival rate (64.7%). When the tumor diameter of hepatocellular carcinoma was less than 5 cm and the liver function was Child-Pugh A/B, the frequency and Bayesian model both supported SR had the highest 5-year overall survival rate (89.1% and 88.3%, respectively). When all RCTs or RCTs were included with the tumor diameter less than 5 cm and liver function was Child-Pugh A/B, both the frequency and the Bayesian model supported RFA had the best safety (serious complications rate) (16.4%, 18.7%, 12.6 and 12.8%, respectively). \u0000 \u0000 \u0000Conclusion \u0000SR should be the first choice for early and small hepatocellular carcinoma, while RFA and MWA have their own indications. \u0000 \u0000 \u0000Key words: \u0000Carcinoma, hepatocellular; Radiofrequency ablation; Microwave ablation; Surgical resection; Meta-analysis","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"823-827"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41553742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.001
Huayong Cai, F. Meng, Shichun Lu
Objective To analyze the impact of Pringle’s maneuver on postoperative serum inflammatory mediator levels and prognosis in hepatitis B virus-related hepatocellular carcinoma (HBV related HCC) patients. Methods A retrospective study was conducted on 157 HBV related HCC patients who underwent treatment at the Chinese PLA General Hospital from January 2016 to December 2017. There were 128 males and 29 females. The mean age was (54.5±12.1) years. These patients were divided into 106 patients who underwent Pringle’s maneuver (the Pringle’s maneuver group). The remaining patients were in the Occlusion-free group. All patients were detected inflammatory mediator levels including the various interleukins (IL) and were regularly followed up. The recurrence-free survival was evaluated by the Kaplan-Meier method, and compared with the log-rank test. The relationship between the Pringle’s maneuver and risks of postoperative tumor recurrence of these patient were estimated by the univariate and multivariate Cox regression models. Results On postoperation day 1 and day 3, the serum IL-1 and IL-6 levels of the Pringle’s maneuver group were significantly higher than the Occlusion-free group [5.0(5.0, 12.0)ng/L vs. 5.0(5.0, 5.0)ng/L], [122.0(74.5, 173.8)ng/L vs. 80.0(40.0, 120.0)ng/L]; [5.0(5.0, 10.0)ng/L vs. 5.0(5.0, 5.0)ng/L], [78.3(42.8, 138.5)ng/L vs. 48.1(30.1, 75.0)ng/L]. On day 5, the serum IL-1 and IL-8 levels were also significantly higher than the Occlusion-free group [5.0(5.0, 5.3)ng/L vs. 5.0(5.0, 5.0)ng/L], [100.6 (44.2, 186.5)g/L vs. 68.0(36.3, 112.0)ng/L] (all P 0.05). The multivariate Cox regression model suggested that there was no significant correlation between Pringle’s maneuver and recurrence free survival of these patients with HBV related HCC. Conclusions Pringle’s maneuver could significantly elevate the postoperative serum IL-1, IL-6, IL-8 levels, but it was not related with an increased risk of postoperative tumor recurrence. Key words: Carcinoma, hepatocellular; Hepatitis B virus; Prognosis; Pringle maneuver; Inflammatory mediator
目的分析普林格尔手法对乙型肝炎病毒相关性肝细胞癌（HBV相关性HCC）患者术后血清炎症介质水平及预后的影响。方法对2016年1月至2017年12月在中国人民解放军总医院接受治疗的157例HBV相关HCC患者进行回顾性研究。其中男性128人，女性29人。平均年龄为（54.5±12.1）岁。这些患者被分为106名接受普林格尔手法治疗的患者（普林格尔动作组）。其余患者为无闭塞组。检测所有患者的炎症介质水平，包括各种白细胞介素（IL），并定期随访。采用Kaplan-Meier方法评估无复发生存率，并与log秩检验进行比较。通过单变量和多变量Cox回归模型估计这些患者的Pringle手法与术后肿瘤复发风险之间的关系。结果术后第1天和第3天，普林格尔手法组的血清IL-1和IL-6水平显著高于无闭塞组[5.0（5.0，12.0）ng/Lvs.5.0（5.0，5.0）ng/L]，[122.0（74.5，173.8）ng/L vs.80.0（40.0，120.0）ng/L]；[5.0（5.0，10.0）ng/L vs.5.0（5.0，5.0）ng/L]，[78.3（42.8，138.5）ng/Lvs.48.1（30.1，75.0）ng/L].在第5天，血清IL-1和IL-8水平也显著高于无闭塞组[5.0（5.0,5.3）ng/L vs 5.0（5.0,5.0）ng[L]，[100.6（44.2186.5）g/L vs.68.0（36.3112.0）ng/L]（均P 0.05）。多变量Cox回归模型表明，这些HBV相关HCC患者的Pringle策略与无复发生存率之间没有显著相关性。结论普林格尔手法可显著提高术后血清IL-1、IL-6、IL-8水平，但与术后肿瘤复发风险增加无关。关键词：肝癌；乙型肝炎病毒；预后；普林格尔机动；炎症介质
{"title":"Impact of Pringle’s maneuver on postoperative serum inflammatory mediator levels and prognosis of HBV-related HCC patients","authors":"Huayong Cai, F. Meng, Shichun Lu","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.001","url":null,"abstract":"Objective \u0000To analyze the impact of Pringle’s maneuver on postoperative serum inflammatory mediator levels and prognosis in hepatitis B virus-related hepatocellular carcinoma (HBV related HCC) patients. \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted on 157 HBV related HCC patients who underwent treatment at the Chinese PLA General Hospital from January 2016 to December 2017. There were 128 males and 29 females. The mean age was (54.5±12.1) years. These patients were divided into 106 patients who underwent Pringle’s maneuver (the Pringle’s maneuver group). The remaining patients were in the Occlusion-free group. All patients were detected inflammatory mediator levels including the various interleukins (IL) and were regularly followed up. The recurrence-free survival was evaluated by the Kaplan-Meier method, and compared with the log-rank test. The relationship between the Pringle’s maneuver and risks of postoperative tumor recurrence of these patient were estimated by the univariate and multivariate Cox regression models. \u0000 \u0000 \u0000Results \u0000On postoperation day 1 and day 3, the serum IL-1 and IL-6 levels of the Pringle’s maneuver group were significantly higher than the Occlusion-free group [5.0(5.0, 12.0)ng/L vs. 5.0(5.0, 5.0)ng/L], [122.0(74.5, 173.8)ng/L vs. 80.0(40.0, 120.0)ng/L]; [5.0(5.0, 10.0)ng/L vs. 5.0(5.0, 5.0)ng/L], [78.3(42.8, 138.5)ng/L vs. 48.1(30.1, 75.0)ng/L]. On day 5, the serum IL-1 and IL-8 levels were also significantly higher than the Occlusion-free group [5.0(5.0, 5.3)ng/L vs. 5.0(5.0, 5.0)ng/L], [100.6 (44.2, 186.5)g/L vs. 68.0(36.3, 112.0)ng/L] (all P 0.05). The multivariate Cox regression model suggested that there was no significant correlation between Pringle’s maneuver and recurrence free survival of these patients with HBV related HCC. \u0000 \u0000 \u0000Conclusions \u0000Pringle’s maneuver could significantly elevate the postoperative serum IL-1, IL-6, IL-8 levels, but it was not related with an increased risk of postoperative tumor recurrence. \u0000 \u0000 \u0000Key words: \u0000Carcinoma, hepatocellular; Hepatitis B virus; Prognosis; Pringle maneuver; Inflammatory mediator","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"801-805"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49596211","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}
Exploring the efficacy of in vitro liver resection and autologous liver transplantation with preservation of the posterior inferior vena cava in the treatment of end-stage hepatic alveolar echinococcosis. Retrospective analysis of the clinical data of three patients with hepatic alveolar hydatid cysts treated at the Hydatid Diagnosis and Treatment Center of Qinghai Provincial People's Hospital from January 2017 to March 2019, who underwent ex vivo liver resection and autologous liver transplantation with preservation of the posterior inferior vena cava. Two patients underwent complete dissection of the retrohepatic inferior vena cava from the hydatid lesion during the surgery, without undergoing retrohepatic inferior vena cava bypass or reconstruction. One patient underwent complete preservation of the posterior hepatic inferior vena cava during in vitro hydatid lesion resection, without undergoing artificial blood vessel reconstruction of the posterior hepatic inferior vena cava. Three patients experienced different types of complications after surgery and were successfully discharged after active treatment. After discharge, follow-up for 2-18 months showed that all 3 patients had no thrombotic complications. Among them, 1 patient had recurrent hydatid cysts in their healthy liver, and 2 patients had good liver regeneration and no recurrence of hydatid cysts. In this study, in vitro liver resection and autologous liver transplantation with preservation of the retrohepatic inferior vena cava were effective in treating end-stage hepatic alveolar echinococcosis.
{"title":"Clinical application of isolated hepatectomy with preservation of retrohepatic inferior vena cava and autologous liver transplantation in treating end-stage alveolar hepatic hydatid disease","authors":"A. Jide, J. Chai, Shunyun Zhao, Yamin Guo, Jinyu Yang","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.015","url":null,"abstract":"探讨保留肝后下腔静脉的离体肝切除、自体肝移植术在治疗终末期肝泡型包虫病中的疗效。回顾性分析青海省人民医院包虫诊疗中心自2017年1月至2019年3月收治的3例行保留肝后下腔静脉的离体肝切除、自体肝移植术的肝泡型包虫患者临床资料。术中2例患者肝后下腔静脉从包虫病灶完整剥离，未行肝后下腔静脉搭桥、重建。1例患者在离体包虫病灶切除时完整保留肝后下腔静脉，未行人工血管重建肝后下腔静脉。术后3例患者出现不同类型并发症，经积极处理后顺利出院。出院后随访2～18个月，3例患者均无血栓并发症，其中1例患者健肝再发包虫，2例患者肝再生良好、无包虫复发。保留肝后下腔静脉的离体肝切除、自体肝移植术在治疗终末期肝泡型包虫病在本研究中疗效较好。","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"860-862"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48923418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.010
Sun Xiaoqiang, Wang Liancai, Ma Jiahao, Xiao Qiangqiang, Wang Yafeng, Mu Senmao, Li Deyu
Objective To study the use of different techniques of pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD) for patients with slim pancreatic ducts. Methods The clinical data of 45 patients with slim pancreatic ducts (<3 mm) who underwent LPD in People's Hospital of Zhengzhou University from May 2017 to March 2019 were studied. These patients were divided into 2 groups: Chen's suturing technique (group A, n=31), and the imbedding pancreaticojejunostomy (group B, n=14). The postoperative pancreatic fistula (PF) rates, complication rate, pancreaticojejunostomy time, and length of postoperative hospital stay were compared between the 2 groups. Results There was no significant difference in the general data between the two groups (P>0.05). The incidence of postoperative pancreatic fistula in group A (4 cases) was significantly lower than that in group B (6 cases) (12.9% vs. 42.9%, P 0.05). Conclusion Chen's suturing technique was a safe and effective pancreaticojejunostomy technique in LPD carried out in patients with slim pancreatic duct patients. Key words: Pancreaticojejunostomy; Laparoscopes; Pancreaticoduodenectomy; Slim pancreatic duct; Chen's pancreaticojejunostomy; Pancreatic fistula
{"title":"Different techniques of pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy for patients with slim pancreatic ducts","authors":"Sun Xiaoqiang, Wang Liancai, Ma Jiahao, Xiao Qiangqiang, Wang Yafeng, Mu Senmao, Li Deyu","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.010","url":null,"abstract":"Objective \u0000To study the use of different techniques of pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD) for patients with slim pancreatic ducts. \u0000 \u0000 \u0000Methods \u0000The clinical data of 45 patients with slim pancreatic ducts (<3 mm) who underwent LPD in People's Hospital of Zhengzhou University from May 2017 to March 2019 were studied. These patients were divided into 2 groups: Chen's suturing technique (group A, n=31), and the imbedding pancreaticojejunostomy (group B, n=14). The postoperative pancreatic fistula (PF) rates, complication rate, pancreaticojejunostomy time, and length of postoperative hospital stay were compared between the 2 groups. \u0000 \u0000 \u0000Results \u0000There was no significant difference in the general data between the two groups (P>0.05). The incidence of postoperative pancreatic fistula in group A (4 cases) was significantly lower than that in group B (6 cases) (12.9% vs. 42.9%, P 0.05). \u0000 \u0000 \u0000Conclusion \u0000Chen's suturing technique was a safe and effective pancreaticojejunostomy technique in LPD carried out in patients with slim pancreatic duct patients. \u0000 \u0000 \u0000Key words: \u0000Pancreaticojejunostomy; Laparoscopes; Pancreaticoduodenectomy; Slim pancreatic duct; Chen's pancreaticojejunostomy; Pancreatic fistula","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"838-841"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41713799","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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