Pub Date : 2020-01-01DOI: 10.3760/cma.j.cn115610-20200402-00224
RenDong Liu, F. Huo, Shao-ping Wang, Yujian Zheng, Qing Ouyang, Bao Zhang, ZhiPing Cai
Objective: To investigate the clinical evaluation effects of Corona Virus Disease 2019 (COVID-19) risk assessment scale on preoperative and surgical risk of liver transplantation during the COVID-19 outbreak
{"title":"A single center experience in prevention and control of infection risk related to liver transplantation during the COVID-19 outbreak","authors":"RenDong Liu, F. Huo, Shao-ping Wang, Yujian Zheng, Qing Ouyang, Bao Zhang, ZhiPing Cai","doi":"10.3760/cma.j.cn115610-20200402-00224","DOIUrl":"https://doi.org/10.3760/cma.j.cn115610-20200402-00224","url":null,"abstract":"Objective: To investigate the clinical evaluation effects of Corona Virus Disease 2019 (COVID-19) risk assessment scale on preoperative and surgical risk of liver transplantation during the COVID-19 outbreak","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"182 1","pages":"673-679"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70011371","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 : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1673-9752.2019.12.014
Lun Wang, Shixing Li, Yang Yu, Jinfa Wang, Yuhui Zhao, Linfeng Bai, Shu Chen
Objective To investigate the clinical efficacy of laparoscopic stomach intestinal pylorus sparing surgery (SIPS) in the treatment of severe obesity. Methods The retrospective and descriptive study was conducted. The clinical data of 5 patients with severe obesity who were admitted to the China-Japan Union Hospital Affiliated to Jilin University from October to November 2018 were collected. There was 1 male and 4 females, aged from 18 to 55 years, with an average age of 33 years. All the 5 patients underwent laparoscopic SIPS. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was performed by outpatient examination, telephone interview and Wechat up to February 2019, including general condition, changes in body weight, body mass index, waistline, blood pressure, percentage of excess weight loss, fasting plasma glucose, glycosylated hemoglobin, blood lipid, and uric acid at 3 months after surgery. Measurement data with normal distribution were represented as Mean±SD, and they were tested with Hotelling T2 test. Measurement data with skewed distribution were represented as M (range). Results (1) Surgical situations: 5 patients underwent successfully laparoscopic SIPS under clear surgical field, without obvious bleeding, conversion to open surgery or perioperative death. The operation time was 240 minutes (range, 165-345 minutes). (2) Postoperative situations: the time to initial out-of-bed activity, time to first and flatus, and time to initial drinking and liquid intake were 2 days (range, 2-3 days), 3 days (range, 2-3 days), and 3 days (range, 3-4 days), respectively. On the third day after surgery, all the 5 patients were confirmed anastomotic patency, without gastric leakage, stenosis, or obstruction by upper gastrointestinal contrast. The abdominal drainage-tube was removed on the fourth day after feeding without obvious discomfort and foreign substances extraction from the drainage-tube. The duration of postoperative hospital stay was 6 days (range, 6-7 days). (3) Follow-up: 5 patients with severe obesity were successfully followed up for 3 months. During the follow-up, one patient had significantly increased frequency of defecation, roughly 5-8 times a day, especially after eating greasy food. According to the dietary guidance of the case manager, diarrhea was improved significantly after reducing the intake of oily food. Of the 5 patients with severe obesity, color doppler ultrasonography examination revealed that cholestasis was found in 2 patients at 3 months after operation, which may be related to significant weight loss, ratio imbalance of bile acid to and cholesterol, intestinal microbiota, injury of vagus nerve, significant increasing in mucin of gallbladder, and without oral ursodeoxycholic acid as prescribed by the doctor. The body weight, body mass index, waistline, systolic blood pressure, and diastolic blood pressure of 5 patients with severe obesity were (100±15)
{"title":"Clinical efficacy of laparoscopic stomach intestinal pylorus sparing surgery in the treatment of severe obesity","authors":"Lun Wang, Shixing Li, Yang Yu, Jinfa Wang, Yuhui Zhao, Linfeng Bai, Shu Chen","doi":"10.3760/CMA.J.ISSN.1673-9752.2019.12.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2019.12.014","url":null,"abstract":"Objective \u0000To investigate the clinical efficacy of laparoscopic stomach intestinal pylorus sparing surgery (SIPS) in the treatment of severe obesity. \u0000 \u0000 \u0000Methods \u0000The retrospective and descriptive study was conducted. The clinical data of 5 patients with severe obesity who were admitted to the China-Japan Union Hospital Affiliated to Jilin University from October to November 2018 were collected. There was 1 male and 4 females, aged from 18 to 55 years, with an average age of 33 years. All the 5 patients underwent laparoscopic SIPS. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was performed by outpatient examination, telephone interview and Wechat up to February 2019, including general condition, changes in body weight, body mass index, waistline, blood pressure, percentage of excess weight loss, fasting plasma glucose, glycosylated hemoglobin, blood lipid, and uric acid at 3 months after surgery. Measurement data with normal distribution were represented as Mean±SD, and they were tested with Hotelling T2 test. Measurement data with skewed distribution were represented as M (range). \u0000 \u0000 \u0000Results \u0000(1) Surgical situations: 5 patients underwent successfully laparoscopic SIPS under clear surgical field, without obvious bleeding, conversion to open surgery or perioperative death. The operation time was 240 minutes (range, 165-345 minutes). (2) Postoperative situations: the time to initial out-of-bed activity, time to first and flatus, and time to initial drinking and liquid intake were 2 days (range, 2-3 days), 3 days (range, 2-3 days), and 3 days (range, 3-4 days), respectively. On the third day after surgery, all the 5 patients were confirmed anastomotic patency, without gastric leakage, stenosis, or obstruction by upper gastrointestinal contrast. The abdominal drainage-tube was removed on the fourth day after feeding without obvious discomfort and foreign substances extraction from the drainage-tube. The duration of postoperative hospital stay was 6 days (range, 6-7 days). (3) Follow-up: 5 patients with severe obesity were successfully followed up for 3 months. During the follow-up, one patient had significantly increased frequency of defecation, roughly 5-8 times a day, especially after eating greasy food. According to the dietary guidance of the case manager, diarrhea was improved significantly after reducing the intake of oily food. Of the 5 patients with severe obesity, color doppler ultrasonography examination revealed that cholestasis was found in 2 patients at 3 months after operation, which may be related to significant weight loss, ratio imbalance of bile acid to and cholesterol, intestinal microbiota, injury of vagus nerve, significant increasing in mucin of gallbladder, and without oral ursodeoxycholic acid as prescribed by the doctor. The body weight, body mass index, waistline, systolic blood pressure, and diastolic blood pressure of 5 patients with severe obesity were (100±15)","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"18 1","pages":"1171-1177"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46012542","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 : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1673-9752.2019.12.012
Zhi-gang Zhang, H. Jiao, S. Zhuang, Jian Li, Hai-ming Lu, Zuoqian Wang, Jing Wang, Suxi Huang
Objective To investigate the clinical efficacy of percutaneous nephroscopy in the treatment of retroperitioneal abscess after common bile duct exploration. Methods The retrospective and descriptive study was conducted. The clinical data of 13 patients with retroperitioneal abscess after common bile duct exploration who were admitted to Xinjiang Autonomous Region Hospital of Chinese People′s Armed Forces between January 2004 and December 2018 were collected.There were 5 males and 8 females, aged from 34 to 81 years, with an average age of 57 years. All the 13 patients underwent debridement and drainage for retroperitioneal abscess under percutaneous nephroscope. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up was performed using outpatient examination and telephone interview to detect postoperative choledocholithiasis recurrence up to September 2019. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers. Results (1) Surgical and postoperative situations: all the 13 patients underwent successfully debridement and drainage for retroperitioneal abscess under percutaneous nephroscope, without kidney injury, pancreatic damage, vascular injury or peritoneal damage. There were 11 cases with 1 drainage tube, and 2 cases with 2 drainage tubes. The operation time, volume of intraoperative pus extracted, time to body temperature resuming to normal of 13 patients were 41 minutes (range, 24-77 minutes), 241 mL (range, 110-640 mL), 1.5 days (range, 1.0-4.0 days), respectively. The time to postoperative removal of drainage tube of 13 patients was 42 days(range, 5-94 days), in which the time to postoperative removal of drainage tube at right iliac region was 5 days and 11 days in 2 patients, and at lower back was 23-94 days in 11 patients, respectively. Duration of postoperative hospital stay was 42 days (range, 26-67 days). All the 13 patients had pleural effusion disappeared, and were cured and discharged. (2) Follow-up: 13 patients were followed up for 6-48 months, with a median time of 18 months. No recurrence occurred. Conclusion The treatment with percutaneous nephroscopy is safe and effective for retroperitioneal abscess after common bile duct exploration. Key words: Retroperitioneal abscess; Hepatolithiasis; Percutaneous nephroscope; Common bile duct exploration; Postoperative complications; Treatment
{"title":"Clinical efficacy of percutaneous nephroscopy in the treatment of retroperitioneal abscess after common bile duct exploration","authors":"Zhi-gang Zhang, H. Jiao, S. Zhuang, Jian Li, Hai-ming Lu, Zuoqian Wang, Jing Wang, Suxi Huang","doi":"10.3760/CMA.J.ISSN.1673-9752.2019.12.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2019.12.012","url":null,"abstract":"Objective \u0000To investigate the clinical efficacy of percutaneous nephroscopy in the treatment of retroperitioneal abscess after common bile duct exploration. \u0000 \u0000 \u0000Methods \u0000The retrospective and descriptive study was conducted. The clinical data of 13 patients with retroperitioneal abscess after common bile duct exploration who were admitted to Xinjiang Autonomous Region Hospital of Chinese People′s Armed Forces between January 2004 and December 2018 were collected.There were 5 males and 8 females, aged from 34 to 81 years, with an average age of 57 years. All the 13 patients underwent debridement and drainage for retroperitioneal abscess under percutaneous nephroscope. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up was performed using outpatient examination and telephone interview to detect postoperative choledocholithiasis recurrence up to September 2019. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers. \u0000 \u0000 \u0000Results \u0000(1) Surgical and postoperative situations: all the 13 patients underwent successfully debridement and drainage for retroperitioneal abscess under percutaneous nephroscope, without kidney injury, pancreatic damage, vascular injury or peritoneal damage. There were 11 cases with 1 drainage tube, and 2 cases with 2 drainage tubes. The operation time, volume of intraoperative pus extracted, time to body temperature resuming to normal of 13 patients were 41 minutes (range, 24-77 minutes), 241 mL (range, 110-640 mL), 1.5 days (range, 1.0-4.0 days), respectively. The time to postoperative removal of drainage tube of 13 patients was 42 days(range, 5-94 days), in which the time to postoperative removal of drainage tube at right iliac region was 5 days and 11 days in 2 patients, and at lower back was 23-94 days in 11 patients, respectively. Duration of postoperative hospital stay was 42 days (range, 26-67 days). All the 13 patients had pleural effusion disappeared, and were cured and discharged. (2) Follow-up: 13 patients were followed up for 6-48 months, with a median time of 18 months. No recurrence occurred. \u0000 \u0000 \u0000Conclusion \u0000The treatment with percutaneous nephroscopy is safe and effective for retroperitioneal abscess after common bile duct exploration. \u0000 \u0000 \u0000Key words: \u0000Retroperitioneal abscess; Hepatolithiasis; Percutaneous nephroscope; Common bile duct exploration; Postoperative complications; Treatment","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"18 1","pages":"1158-1162"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43445354","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 : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1673-9752.2019.12.005
Wang Jian, Chen Wei
Complicated extrahepatic bile duct stone is defined as not easy to achieve the treatment standard of total stone clearance, stricture removal, unobstructed drainage and recurrence preventing in a single operation or combined with other liver diseases, which include hepatic hilar bile duct stones incarceration, distal bile duct stone incarceration, Mirizzi syndrome, residual cystic duct stones, recurrent extrahepatic bile duct stones, and combined with portal hypertension or intrahepatic bile duct stones. Through comprehensive and meticulous preoperative evaluation, we can clarify the cause of extrahepatic bile duct stones, the location of stones and bile duct stenosis, the variability of bile duct, the anatomy of the hepatoduodenal ligament, the condition of liver function and biliary tract infection, and make the proper surgery plan. During the surgery, we apply the perihilar surgical techniques, pancreatic hilar plate reduction techniques, Oddi sphincter incision and shaping, and choledochoscopic lithotripsy and lithotomy comprehensively to achieve the goal of reducing residual stone rate and recurrence rate. It is important that reasonably select endoscopic retrograde cholangiopancreatography indications, correctly hold indications of bilioenteric anastomosis, and prevent iatrogenic injury of extrahepatic bile ducts on the premise of clearing stones. Key words: Hepatolithiasis; Extrahepatic bileduct stone; Perihilar surgical techniques; Pancreatic hilar plate reduction techniques; Choledochoscope; Lithotripsy
{"title":"Treatment strategies of complicated extrahepatic bileduct stones","authors":"Wang Jian, Chen Wei","doi":"10.3760/CMA.J.ISSN.1673-9752.2019.12.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2019.12.005","url":null,"abstract":"Complicated extrahepatic bile duct stone is defined as not easy to achieve the treatment standard of total stone clearance, stricture removal, unobstructed drainage and recurrence preventing in a single operation or combined with other liver diseases, which include hepatic hilar bile duct stones incarceration, distal bile duct stone incarceration, Mirizzi syndrome, residual cystic duct stones, recurrent extrahepatic bile duct stones, and combined with portal hypertension or intrahepatic bile duct stones. Through comprehensive and meticulous preoperative evaluation, we can clarify the cause of extrahepatic bile duct stones, the location of stones and bile duct stenosis, the variability of bile duct, the anatomy of the hepatoduodenal ligament, the condition of liver function and biliary tract infection, and make the proper surgery plan. During the surgery, we apply the perihilar surgical techniques, pancreatic hilar plate reduction techniques, Oddi sphincter incision and shaping, and choledochoscopic lithotripsy and lithotomy comprehensively to achieve the goal of reducing residual stone rate and recurrence rate. It is important that reasonably select endoscopic retrograde cholangiopancreatography indications, correctly hold indications of bilioenteric anastomosis, and prevent iatrogenic injury of extrahepatic bile ducts on the premise of clearing stones. \u0000 \u0000 \u0000Key words: \u0000Hepatolithiasis; Extrahepatic bileduct stone; Perihilar surgical techniques; Pancreatic hilar plate reduction techniques; Choledochoscope; Lithotripsy","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"18 1","pages":"1113-1117"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44067151","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 : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1673-9752.2019.12.102
Linlin Shen, Liang Xia, Yulin Zhang, J. Huo, P. Jiang, Yingfen Zou, D. Tao
{"title":"Minutes of the third conference of the third editorial board of Chinese journal of digestive surgery","authors":"Linlin Shen, Liang Xia, Yulin Zhang, J. Huo, P. Jiang, Yingfen Zou, D. Tao","doi":"10.3760/CMA.J.ISSN.1673-9752.2019.12.102","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2019.12.102","url":null,"abstract":"","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43767311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the effects of definitive repair surgery on health-related quality of life (HRQOL) in patients with bile duct injury after laparoscopic cholecystectomy (LC). Methods The retrospective case-control study was conducted. The clinicopathological data of 181 patients with bile duct injury caused by LC for benign gallbladder diseases who underwent definitive repair surgery and 50 patients without complications after LC for benign gallbladder diseases in the Mianyang Central Hospital from January 2000 to December 2017 were collected. There were 82 males and 99 females of 181 patients with bile duct injury, aged from 31 to 68 years, with an average age of 47 years. Definitive repair surgery was performed according to different types of bile duct injury, and questionnaire of HRQOL was conducted preoperatively and one year after operation. There were 18 males and 32 females of 50 patients without complications after LC, aged from 35 to 69 years, with an average age of 41 years. Questionnaire of HRQOL was conducted on LC patients without complications one year after operation. Observation indicators: (1) classification of bile duct injury; (2) intraoperative situations of definitive repair surgery; (3) postoperative situations of definitive repair surgery; (4) follow-up; (5) results of the SF-36 scale assessment. Follow-up was conducted by outpatient examination and telephone interview up to December 2018. Patients were reexamined liver function and color Doppler ultrasonography once every 6-12 months, and further magnetic resonance cholangiopancreatography (MRCP) or computed tomography examination to detect recurrence of anastomotic biliary stricture and cholangitis. Measurement data with normal distribution were expressed as Mean±SD, and comparison between groups was analyzed by the paired t test. Measurement data with skewed distribution were described as M (range), and count data were described as absolute numbers. Results (1) Classification of bile duct injury: of the 181 patients with bile duct injury, there were 64 cases of E1 type, 70 cases of E2 type, 35 cases of E3 type, 9 cases of E4 type, and 3 cases of E5 type. (2) Intraoperative situations of definitive repair surgery: all the 181 patinets with bile duct injury underwent definitive repair surgery successfully, including 61 undergoing end-to-end biliary anastomosis, 109 undergoing Roux-en-Y choledojejunostomy, 11 undergoing hemi-hepatectomy combined with Roux-en-Y anastomosis. There were 52 patients combined with hilar cholangioplasty. The operation time and volume of intraoperative blood loss of 181 patients were (190±126) minutes and 601.5 mL (range, 150.0-2 100.0 mL). There were 24 cases with blood transfusion and 18 cases with T-tube stent. (3) Postoperative situations of definitive repair surgery: 40 of 181 patients had complications, including 14 cases of incisional infection, 10 cases of bile leakage, 8 cases of perihepatic effusion, 7 cases of pulmo
{"title":"Effects of definitive repair surgery on health-related quality of life in patients with bile duct injury after laparoscopic cholecystectomy","authors":"Xintao Zeng, Pei-min Yang, Hua-xin Luo, Wei Zhang, Sirui Chen, Junyang Peng, Wentao Wang","doi":"10.3760/CMA.J.ISSN.1673-9752.2019.12.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2019.12.010","url":null,"abstract":"Objective \u0000To investigate the effects of definitive repair surgery on health-related quality of life (HRQOL) in patients with bile duct injury after laparoscopic cholecystectomy (LC). \u0000 \u0000 \u0000Methods \u0000The retrospective case-control study was conducted. The clinicopathological data of 181 patients with bile duct injury caused by LC for benign gallbladder diseases who underwent definitive repair surgery and 50 patients without complications after LC for benign gallbladder diseases in the Mianyang Central Hospital from January 2000 to December 2017 were collected. There were 82 males and 99 females of 181 patients with bile duct injury, aged from 31 to 68 years, with an average age of 47 years. Definitive repair surgery was performed according to different types of bile duct injury, and questionnaire of HRQOL was conducted preoperatively and one year after operation. There were 18 males and 32 females of 50 patients without complications after LC, aged from 35 to 69 years, with an average age of 41 years. Questionnaire of HRQOL was conducted on LC patients without complications one year after operation. Observation indicators: (1) classification of bile duct injury; (2) intraoperative situations of definitive repair surgery; (3) postoperative situations of definitive repair surgery; (4) follow-up; (5) results of the SF-36 scale assessment. Follow-up was conducted by outpatient examination and telephone interview up to December 2018. Patients were reexamined liver function and color Doppler ultrasonography once every 6-12 months, and further magnetic resonance cholangiopancreatography (MRCP) or computed tomography examination to detect recurrence of anastomotic biliary stricture and cholangitis. Measurement data with normal distribution were expressed as Mean±SD, and comparison between groups was analyzed by the paired t test. Measurement data with skewed distribution were described as M (range), and count data were described as absolute numbers. \u0000 \u0000 \u0000Results \u0000(1) Classification of bile duct injury: of the 181 patients with bile duct injury, there were 64 cases of E1 type, 70 cases of E2 type, 35 cases of E3 type, 9 cases of E4 type, and 3 cases of E5 type. (2) Intraoperative situations of definitive repair surgery: all the 181 patinets with bile duct injury underwent definitive repair surgery successfully, including 61 undergoing end-to-end biliary anastomosis, 109 undergoing Roux-en-Y choledojejunostomy, 11 undergoing hemi-hepatectomy combined with Roux-en-Y anastomosis. There were 52 patients combined with hilar cholangioplasty. The operation time and volume of intraoperative blood loss of 181 patients were (190±126) minutes and 601.5 mL (range, 150.0-2 100.0 mL). There were 24 cases with blood transfusion and 18 cases with T-tube stent. (3) Postoperative situations of definitive repair surgery: 40 of 181 patients had complications, including 14 cases of incisional infection, 10 cases of bile leakage, 8 cases of perihepatic effusion, 7 cases of pulmo","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"18 1","pages":"1142-1148"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46504592","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 : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1673-9752.2019.12.016
Yan Xu, Xiaoling Hu, R. Dong, Jiangbin Li, Chen Yafeng, Nianan Luo, Li He
{"title":"Diagnosis and treatment of small bowel volvulus comorbid with abdominal chylous ascites","authors":"Yan Xu, Xiaoling Hu, R. Dong, Jiangbin Li, Chen Yafeng, Nianan Luo, Li He","doi":"10.3760/CMA.J.ISSN.1673-9752.2019.12.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2019.12.016","url":null,"abstract":"","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"18 1","pages":"1185-1188"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46328643","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 : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1673-9752.2019.12.015
Jun-da Wang, Yanyang Li, Yu Fang, He Ren, Ying-jiang Liu, Huiping Yang, Xiu-ting Mei, Hua Yang
Objective To investigate the application value of magnetic resonance imaging (MRI) in the classification diagnosis of rectal mucinous adenocarcinoma. Methods The retrospective and descriptive study was conducted. The clinical data of 74 patients with rectal mucinous adenocarcinoma who were admitted to Chongqing Traditional Chinese Medicine Hospital from July 2009 and February 2019 were collected. There were 40 males and 34 females, aged (46±8)years, with a range from 32 to 82 years. Among the 74 patients, 41 were simple mucinous adenocarcinoma, 26 were partial mucinous adenocarcinoma, and 7 were focal or small foci mucinous adenocarcinoma. All patients underwent MRI plain scan and dynamic enhanced scan. Observation indicators: (1) morphology of rectal mucinous adenocarcinoma; (2) the lesion margin of rectal mucinous adenocarcinoma; (3) the value of apparent diffusion coefficient (ADC) of rectal mucinous adenocarcinoma; (4) internal enhancement features of rectal mucinous adenocarcinoma; (5) timesignal intensity curve of rectal mucinous adenocarcinoma. Measurement data with normal distribution were represented as Mean±SD, and count data were described as absolute numbers. Results (1) Morphology of rectal mucinous adenocarcinoma: 74 patients had different morphological changes. Among the 41 cases of simple mucinous adenocarcinoma, 22 were oval, 8 were round, and 11 were irregular. Among the 26 patients with partial mucinous adenocarcinoma, 15 were oval, 8 were round and 3 were irregular. Among the 7 patients with focal or small foci mucinous adenocarcinoma, 2 were oval, 1 was round and 4 were irregular. (2) The lesion margin of rectal mucinous adenocarcinoma: the lesion margin of 74 patients was mainly unclear and irregular. Among the 41 cases of simple mucinous adenocarcinoma, 32 had unclear and irregular margin, 7 had clear margin, and 2 had unclear margin combined with fissure. Among the 26 cases of partial mucinous adenocarcinoma, 20 had unclear margin combined with fissure, 5 had unclear margin and irregular margin, and 1 had clear margin. Among the 7 patients with focal or small foci mucinous adenocarcinoma, 5 had unclear or irregular margin, 1 had unclear or irregular margin, and 1 had clear margin. (3) The value of ADC of rectal mucinous adenocarcinoma: diffusion weighted imaging of 74 patients showed diffused limited changes. The average ADC value was (1.24±0.23)×10-3 mm2/s of 41 patients with simple mucinous adenocarcinoma, (0.91±0.42)×10-3 mm2/s of 26 patients with partial mucinous adenocarcinoma, and (1.07±0.24)×10-3 mm2/s of 7 patients with focal or small mucinous adenocarcinoma. (4) Internal enhancement features of rectal mucinous adenocarcinoma: 74 patients showed delayed heterogeneous enhancement and marginal enhancement. Among 41 cases of simple mucinous adenocarcinoma, 24 showed delayed heterogeneous enhancement, 17 showed marginal enhancement, and none showed homogeneous enhancement. Among 26 patients with partial mu
{"title":"Application value of MRI examination in classification diagnosis of rectal mucinous adenocarcinoma","authors":"Jun-da Wang, Yanyang Li, Yu Fang, He Ren, Ying-jiang Liu, Huiping Yang, Xiu-ting Mei, Hua Yang","doi":"10.3760/CMA.J.ISSN.1673-9752.2019.12.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2019.12.015","url":null,"abstract":"Objective \u0000To investigate the application value of magnetic resonance imaging (MRI) in the classification diagnosis of rectal mucinous adenocarcinoma. \u0000 \u0000 \u0000Methods \u0000The retrospective and descriptive study was conducted. The clinical data of 74 patients with rectal mucinous adenocarcinoma who were admitted to Chongqing Traditional Chinese Medicine Hospital from July 2009 and February 2019 were collected. There were 40 males and 34 females, aged (46±8)years, with a range from 32 to 82 years. Among the 74 patients, 41 were simple mucinous adenocarcinoma, 26 were partial mucinous adenocarcinoma, and 7 were focal or small foci mucinous adenocarcinoma. All patients underwent MRI plain scan and dynamic enhanced scan. Observation indicators: (1) morphology of rectal mucinous adenocarcinoma; (2) the lesion margin of rectal mucinous adenocarcinoma; (3) the value of apparent diffusion coefficient (ADC) of rectal mucinous adenocarcinoma; (4) internal enhancement features of rectal mucinous adenocarcinoma; (5) timesignal intensity curve of rectal mucinous adenocarcinoma. Measurement data with normal distribution were represented as Mean±SD, and count data were described as absolute numbers. \u0000 \u0000 \u0000Results \u0000(1) Morphology of rectal mucinous adenocarcinoma: 74 patients had different morphological changes. Among the 41 cases of simple mucinous adenocarcinoma, 22 were oval, 8 were round, and 11 were irregular. Among the 26 patients with partial mucinous adenocarcinoma, 15 were oval, 8 were round and 3 were irregular. Among the 7 patients with focal or small foci mucinous adenocarcinoma, 2 were oval, 1 was round and 4 were irregular. (2) The lesion margin of rectal mucinous adenocarcinoma: the lesion margin of 74 patients was mainly unclear and irregular. Among the 41 cases of simple mucinous adenocarcinoma, 32 had unclear and irregular margin, 7 had clear margin, and 2 had unclear margin combined with fissure. Among the 26 cases of partial mucinous adenocarcinoma, 20 had unclear margin combined with fissure, 5 had unclear margin and irregular margin, and 1 had clear margin. Among the 7 patients with focal or small foci mucinous adenocarcinoma, 5 had unclear or irregular margin, 1 had unclear or irregular margin, and 1 had clear margin. (3) The value of ADC of rectal mucinous adenocarcinoma: diffusion weighted imaging of 74 patients showed diffused limited changes. The average ADC value was (1.24±0.23)×10-3 mm2/s of 41 patients with simple mucinous adenocarcinoma, (0.91±0.42)×10-3 mm2/s of 26 patients with partial mucinous adenocarcinoma, and (1.07±0.24)×10-3 mm2/s of 7 patients with focal or small mucinous adenocarcinoma. (4) Internal enhancement features of rectal mucinous adenocarcinoma: 74 patients showed delayed heterogeneous enhancement and marginal enhancement. Among 41 cases of simple mucinous adenocarcinoma, 24 showed delayed heterogeneous enhancement, 17 showed marginal enhancement, and none showed homogeneous enhancement. Among 26 patients with partial mu","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"18 1","pages":"1178-1184"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48036878","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 : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1673-9752.2019.12.017
Jia Tang
Severe acute pancreatitis (SAP) is an acute abdominal disease characterized by acute onset, serious illness, multiple complications, and high mortality. Surgical interventions have been used throughout the treatment of SAP for a long time, including traditional surgical treatments led by laparotomy and modern surgical treatments led by minimally invasive surgery. Especially in the past 10 years, with the deep understanding of the etiology and pathology of SAP and the increasing complications of traditional surgical treatments, a series of minimally invasive surgical techniques are widely applied in the clinical treatment of SAP, which achieved satisfactory clinical results. Among them, ultrasonic intervention technology plays a key role in the advantages of convenience, minimal invasiveness and strong repeatability. Based on recent literatures at home and abroad, this article reviews the application value of ultrasound interventional techniques in the treatment of SAP. Key words: Minimally invasive surgery; Severe acute pancreatitis; Ultrasonic intervention; Tube drainage; Treatment
{"title":"Application value of ultrasound interventional technique in the treatment of severe acute pancreatitis","authors":"Jia Tang","doi":"10.3760/CMA.J.ISSN.1673-9752.2019.12.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2019.12.017","url":null,"abstract":"Severe acute pancreatitis (SAP) is an acute abdominal disease characterized by acute onset, serious illness, multiple complications, and high mortality. Surgical interventions have been used throughout the treatment of SAP for a long time, including traditional surgical treatments led by laparotomy and modern surgical treatments led by minimally invasive surgery. Especially in the past 10 years, with the deep understanding of the etiology and pathology of SAP and the increasing complications of traditional surgical treatments, a series of minimally invasive surgical techniques are widely applied in the clinical treatment of SAP, which achieved satisfactory clinical results. Among them, ultrasonic intervention technology plays a key role in the advantages of convenience, minimal invasiveness and strong repeatability. Based on recent literatures at home and abroad, this article reviews the application value of ultrasound interventional techniques in the treatment of SAP. \u0000 \u0000 \u0000Key words: \u0000Minimally invasive surgery; Severe acute pancreatitis; Ultrasonic intervention; Tube drainage; Treatment","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"18 1","pages":"1189-1192"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45510017","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 : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1673-9752.2019.12.009
Jiang Guo-qing, Bai Dousheng, Qian Jianjun, Jin Shengjie, Z. Chi, W. Qian, Zhou Baohuan, Wang Aoqing
Objective To investigate the clinical efficacy of laparoscopic splenectomy combined with pericardial devascularization in the treatment of cirrhotic patients with cirrhotic portal hypertension. Methods The retrospective and descriptive study was conducted. The clinicopathological data of 425 patients with cirrhotic portal hypertension who were admitted to Northern Jiangsu People′s Hospital Affiliated to Yangzhou University were collected. There were 289 males and 136 females, aged (53±11)years, with a range from 21 to 79 years. All the patients were allocated into 3 periods according to the operation time, including 100 patients of early period from February 2012 to March 2014, 156 patients of mature technology period from April 2014 to August 2016, and 169 patients of technology innovation period from september 2016 to December 2018. The patients of early period and mature technology period underwent laparoscopic splenectomy combined with pericardial devascularization, and the patients of technology innovation period underwent vagus nerve-preserving laparoscopic splenectomy combined with pericardial devascularization. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Patients were followed up by outpatient examination to detect the upper digestive rebleeding, gastric retention, and diarrhea up to March 2019. Sequential therapy of endoscopic variceal ligation (EVL) was slectively performed on patients based on results of gastroscopy. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using ANOVA, and paired comparison was analyzed using the t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was anlyzed using the Kruskal-Wallis rank sum test, and paired comparison was analyzed using the rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test and Fisher exact probability. Results (1) Surgical situations: the operation time, volume of intraoperative blood loss, cases with intraoperative blood transfusion, cases with conversion to open surgery, and cases with emergency operation for bleeding were (187±46)minutes, 150 mL (range, 50-1 300 mL), 2, 2 , 1 for patients of early period, (164±22)minutes, 50 mL (range, 30-100 mL), 1, 1, 1 for patients of mature technology period, and (150±18)minutes, 50 mL (range, 10-300 mL), 0 , 0 , 0 for patients of technology innovation period, respectively. There were significant differences in the operation time and volume of intraoperative blood loss between the three groups (F=55.482, χ2=94.620, P 0.05). (2) Postoperative situations: 425 patients had oral aspirin enteric-coated tablets for prevention of thrombus, with no perioperative death. Duration of postoperative hospital stay, cases with portal vein thrombosis at postoperative 7 days, cases with pan
{"title":"Clinical efficacy of laparoscopic splenectomy combined with pericardial devascularization in the treatment of cirrhotic portal hypertension: a report of 425 cases","authors":"Jiang Guo-qing, Bai Dousheng, Qian Jianjun, Jin Shengjie, Z. Chi, W. Qian, Zhou Baohuan, Wang Aoqing","doi":"10.3760/CMA.J.ISSN.1673-9752.2019.12.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2019.12.009","url":null,"abstract":"Objective \u0000To investigate the clinical efficacy of laparoscopic splenectomy combined with pericardial devascularization in the treatment of cirrhotic patients with cirrhotic portal hypertension. \u0000 \u0000 \u0000Methods \u0000The retrospective and descriptive study was conducted. The clinicopathological data of 425 patients with cirrhotic portal hypertension who were admitted to Northern Jiangsu People′s Hospital Affiliated to Yangzhou University were collected. There were 289 males and 136 females, aged (53±11)years, with a range from 21 to 79 years. All the patients were allocated into 3 periods according to the operation time, including 100 patients of early period from February 2012 to March 2014, 156 patients of mature technology period from April 2014 to August 2016, and 169 patients of technology innovation period from september 2016 to December 2018. The patients of early period and mature technology period underwent laparoscopic splenectomy combined with pericardial devascularization, and the patients of technology innovation period underwent vagus nerve-preserving laparoscopic splenectomy combined with pericardial devascularization. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Patients were followed up by outpatient examination to detect the upper digestive rebleeding, gastric retention, and diarrhea up to March 2019. Sequential therapy of endoscopic variceal ligation (EVL) was slectively performed on patients based on results of gastroscopy. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using ANOVA, and paired comparison was analyzed using the t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was anlyzed using the Kruskal-Wallis rank sum test, and paired comparison was analyzed using the rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test and Fisher exact probability. \u0000 \u0000 \u0000Results \u0000(1) Surgical situations: the operation time, volume of intraoperative blood loss, cases with intraoperative blood transfusion, cases with conversion to open surgery, and cases with emergency operation for bleeding were (187±46)minutes, 150 mL (range, 50-1 300 mL), 2, 2 , 1 for patients of early period, (164±22)minutes, 50 mL (range, 30-100 mL), 1, 1, 1 for patients of mature technology period, and (150±18)minutes, 50 mL (range, 10-300 mL), 0 , 0 , 0 for patients of technology innovation period, respectively. There were significant differences in the operation time and volume of intraoperative blood loss between the three groups (F=55.482, χ2=94.620, P 0.05). (2) Postoperative situations: 425 patients had oral aspirin enteric-coated tablets for prevention of thrombus, with no perioperative death. Duration of postoperative hospital stay, cases with portal vein thrombosis at postoperative 7 days, cases with pan","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"18 1","pages":"1136-1141"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46178553","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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