Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN113855-20191015-00599
Yonghan Zhang, Chi Zhang, Dexu Li
Objective To investigate the prognostic factors that influence Barcelona (Barcelona clinical liver cancer staging system, BCLC)stage B hepatocellular carcinoma patients after hepatectomy. Methods Retrospective analysis was made on clinical and pathological data of 50 standardized hemihepatectomy in Barcelona stage B hepatocellular carcinoma from 2013 to 2017. Results Single-factor results showed that high expression of tumor microvascular invasion (MVI) and proliferation of nuclear antigen (Ki-67) were the prognostic factors ( respectively χ2 =8.411, 10.939, all P<0.05). Multivariate analysis showed that the difference of high expression of Ki-67 and survival rate was statistically significant (respectively F=5.710, 8.254, all P<0.05). Ki-67 expression level and tumor differentiation were statistically significant (χ2=0.497, P<0.05). There was a statistically significant difference in survival between the high-risk group and the low-risk group according to the risk factors (χ2=12.152, P<0.05). Conclusions MVI and high expression of Ki-67 were high risk factors affecting the overall survival rate of liver cancer after hemihepatectomy. Key words: Carcinoma, hepatocellular; Hepatectomy; Prognosis
{"title":"Prognostic influencing factors in patients of Barcelona stage B hepatocellular carcinoma undergoing hepatectomy","authors":"Yonghan Zhang, Chi Zhang, Dexu Li","doi":"10.3760/CMA.J.CN113855-20191015-00599","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113855-20191015-00599","url":null,"abstract":"Objective \u0000To investigate the prognostic factors that influence Barcelona (Barcelona clinical liver cancer staging system, BCLC)stage B hepatocellular carcinoma patients after hepatectomy. \u0000 \u0000 \u0000Methods \u0000Retrospective analysis was made on clinical and pathological data of 50 standardized hemihepatectomy in Barcelona stage B hepatocellular carcinoma from 2013 to 2017. \u0000 \u0000 \u0000Results \u0000Single-factor results showed that high expression of tumor microvascular invasion (MVI) and proliferation of nuclear antigen (Ki-67) were the prognostic factors ( respectively χ2 =8.411, 10.939, all P<0.05). Multivariate analysis showed that the difference of high expression of Ki-67 and survival rate was statistically significant (respectively F=5.710, 8.254, all P<0.05). Ki-67 expression level and tumor differentiation were statistically significant (χ2=0.497, P<0.05). There was a statistically significant difference in survival between the high-risk group and the low-risk group according to the risk factors (χ2=12.152, P<0.05). \u0000 \u0000 \u0000Conclusions \u0000MVI and high expression of Ki-67 were high risk factors affecting the overall survival rate of liver cancer after hemihepatectomy. \u0000 \u0000 \u0000Key words: \u0000Carcinoma, hepatocellular; Hepatectomy; Prognosis","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48135144","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 ulinastatin on liver function in patients with liver cancer after major hepatectomy. Methods The clinical data of 232 patients with major liver resection due to liver cancer were retrospectively analyzed. According to whether ulinastatin was applied after operation, patients were divided into treatment group (105 cases) and control group (127 cases). The postoperative inflammatory factors, liver function, postoperative complications and hospital stay were compared. Results The levels of CRP、IL-6 and TBIL、ALT、AST were significantly lower than the control group 3 days after surgery (CRP: t=4.520, P=0.000; IL-6: t=17.982, P=0.000; TBIL: t=9.843, P=0.000; ALT: t=11.913, P=0.000; AST: t=4.520, P=0.000). The incidence of massive ascites in the treatment group (χ2=4.212, P=0.040) and the average postoperative hospital stay (t=9.994, P=0.000) were significantly lower than that in the control group. Conclusion Early application of ulinastatin effectively inhibits the inflammatory process, protects liver function, reduces the incidence of massive ascites, and shortens the postoperative hospital stay. Key words: Hepatectomy; Inflammation; Liver function tests
{"title":"The protective effects of ulinastatin on liver function in patients with liver cancer after major hepatectomy","authors":"Yi-lei Deng, Zhiwei Liang, Shuai Du, Weibo Zhang, Wei Feng, Menghao Zhou, Longshuan Zhao","doi":"10.3760/CMA.J.CN113855-20190620-00339","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113855-20190620-00339","url":null,"abstract":"Objective \u0000To investigate the effects of ulinastatin on liver function in patients with liver cancer after major hepatectomy. \u0000 \u0000 \u0000Methods \u0000The clinical data of 232 patients with major liver resection due to liver cancer were retrospectively analyzed. According to whether ulinastatin was applied after operation, patients were divided into treatment group (105 cases) and control group (127 cases). The postoperative inflammatory factors, liver function, postoperative complications and hospital stay were compared. \u0000 \u0000 \u0000Results \u0000The levels of CRP、IL-6 and TBIL、ALT、AST were significantly lower than the control group 3 days after surgery (CRP: t=4.520, P=0.000; IL-6: t=17.982, P=0.000; TBIL: t=9.843, P=0.000; ALT: t=11.913, P=0.000; AST: t=4.520, P=0.000). The incidence of massive ascites in the treatment group (χ2=4.212, P=0.040) and the average postoperative hospital stay (t=9.994, P=0.000) were significantly lower than that in the control group. \u0000 \u0000 \u0000Conclusion \u0000Early application of ulinastatin effectively inhibits the inflammatory process, protects liver function, reduces the incidence of massive ascites, and shortens the postoperative hospital stay. \u0000 \u0000 \u0000Key words: \u0000Hepatectomy; Inflammation; Liver function tests","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45515798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-27DOI: 10.3760/CMA.J.CN113855-20200216-00086
J. Bai, L. Qu, Jie Jin, Jianjin Wu
Objective To explore a safe, effective and rapid rescue method and key points for the management of vascular surgical emergencies in an area under guaranting Covid-19 (corona virus disease 2019) . Methods Under the guidance of COVID-19 diagnosis and treatment guidelines , 4 cases of vascular surgical emergency patients admitted to our department from Feb 1 to Feb 10, 2020 were screened for COVID-19 and given emergency vascular surgical treatment. Results Two patients had acute thoracic aortic dissection, one patient had acute left foot ulcer with infection, one patient had severe carotid artery stenosis and frequent TIA. All patients were diagnosed quickly according to the three-level triage process. Endovascular repair (TEVAR) was performed in 2 cases, carotid stenting in 1 case, and left foot amputation in 1 case. Two patients running postoperative fever below 38℃ were safely excluded COVID-19 and cured. There were no other major morbidities nor mortality. Conclusions Under the COVID-19 prevention and control guidelines, the establishing of a comprehensive prevention and control system of patient-medicine-care-management helps to perform confine operation on vascular surgical emergency. Key words: Coronavirus Infection; Vascular surgical procedures; Emergency treatment
{"title":"Diagnosis and rational approach to emergency vascular surgery in the shadow of novel coronavirus pneumonia/ 中华普通外科杂志","authors":"J. Bai, L. Qu, Jie Jin, Jianjin Wu","doi":"10.3760/CMA.J.CN113855-20200216-00086","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113855-20200216-00086","url":null,"abstract":"Objective \u0000To explore a safe, effective and rapid rescue method and key points for the management of vascular surgical emergencies in an area under guaranting Covid-19 (corona virus disease 2019) . \u0000 \u0000 \u0000Methods \u0000Under the guidance of COVID-19 diagnosis and treatment guidelines , 4 cases of vascular surgical emergency patients admitted to our department from Feb 1 to Feb 10, 2020 were screened for COVID-19 and given emergency vascular surgical treatment. \u0000 \u0000 \u0000Results \u0000Two patients had acute thoracic aortic dissection, one patient had acute left foot ulcer with infection, one patient had severe carotid artery stenosis and frequent TIA. All patients were diagnosed quickly according to the three-level triage process. Endovascular repair (TEVAR) was performed in 2 cases, carotid stenting in 1 case, and left foot amputation in 1 case. Two patients running postoperative fever below 38℃ were safely excluded COVID-19 and cured. There were no other major morbidities nor mortality. \u0000 \u0000 \u0000Conclusions \u0000Under the COVID-19 prevention and control guidelines, the establishing of a comprehensive prevention and control system of patient-medicine-care-management helps to perform confine operation on vascular surgical emergency. \u0000 \u0000 \u0000Key words: \u0000Coronavirus Infection; Vascular surgical procedures; Emergency treatment","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42065519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.02.008
Zhao Liu, Wenwen Wang, Yuelin Zhu, Tong Yu, Xin Zhang, Chen Liu, Min Zhou, Chang-jian Liu, Xiaoqiang Li
Objective To summarize the brain protection application experiences of combined internal and external blood shunt technologies for the in-situ three-fenestration revascularization of aortic arch. Methods From Feb 2017 to Jun 2018, 8 patients with aortic arch leisons were treated by the in-situ three-fenestration techniques, including 3 aortic dissection, 2 aortic aneurysm, 3 postoperative TEVAR patients .We adopt the method of internal and external blood shunt technologies for brain protection using the vascular sheath for fenestration combined with carotid shunt tube skills, and used TCD to monitor the blood flow of brain. Results All operations completed successfully, and TCD showed no significant cerebral ischemia when aortic stent was used to cover the three branches of the aortic . The mean time of brain protection was (17.62±6.87) minutes. One patient developed transient cerebral ischemia after surgery, and another one developed cerebral infarction. Conclusions The brain protection strategy of internal bypass combined with external converter technology maintain the brain blood flow, while is simple and feasible, it cannot completely avoid neurological complications. Key words: Aortic diseases; Stents; Brain protection; Shunt
{"title":"Combined internal and external blood shunt technologies for the in-situ three-fenestration revascularization of aortic arch","authors":"Zhao Liu, Wenwen Wang, Yuelin Zhu, Tong Yu, Xin Zhang, Chen Liu, Min Zhou, Chang-jian Liu, Xiaoqiang Li","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.02.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.02.008","url":null,"abstract":"Objective \u0000To summarize the brain protection application experiences of combined internal and external blood shunt technologies for the in-situ three-fenestration revascularization of aortic arch. \u0000 \u0000 \u0000Methods \u0000From Feb 2017 to Jun 2018, 8 patients with aortic arch leisons were treated by the in-situ three-fenestration techniques, including 3 aortic dissection, 2 aortic aneurysm, 3 postoperative TEVAR patients .We adopt the method of internal and external blood shunt technologies for brain protection using the vascular sheath for fenestration combined with carotid shunt tube skills, and used TCD to monitor the blood flow of brain. \u0000 \u0000 \u0000Results \u0000All operations completed successfully, and TCD showed no significant cerebral ischemia when aortic stent was used to cover the three branches of the aortic . The mean time of brain protection was (17.62±6.87) minutes. One patient developed transient cerebral ischemia after surgery, and another one developed cerebral infarction. \u0000 \u0000 \u0000Conclusions \u0000The brain protection strategy of internal bypass combined with external converter technology maintain the brain blood flow, while is simple and feasible, it cannot completely avoid neurological complications. \u0000 \u0000 \u0000Key words: \u0000Aortic diseases; Stents; Brain protection; Shunt","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46057964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.02.010
X. Dang, Qingbo Meng, Luhao Li
Objective To explore the clinical significance of large spontaneous portosystemic shunts ( L-SPSS ) in Budd-Chiari syndrome ( B-CS ). Methods Clinical data of 382 B-CS patients treated at The First Affiliated Hospital of Zhengzhou University from Apr 2012 to Dec 2018 were analyzed retrospectively and we included 32 patients with B-CS complicated L-SPSS ( diameter>8 mm ). 65 patients without L-SPSS were selected randomly to form the control group. The correlation between L-SPSS and liver function, upper gastrointestinal bleeding, ascites, hepatic encephalopathy, inferior vena cava thrombosis , portal vein diameter and splenic vein diameter were analyzed. Results TBil, Child-Pugh scores, incidence of hepatic encephalopathy, ascites and inferior vena cava thrombosis in the B-CS complicated L-SPSS group were higher than that in the B-CS without L-SPSS group . The percentage of Child-Pugh grade B and C patients in the B-CS complicated L-SPSS group were also higher than that in the B-CS without L-SPSS group. The level of ALB and hepatic volume per unit surface area were both significantly less in the experimental group.( P 0.05 ) . Conclusions For those B-CS patients complicated L-SPSS , hepatic encephalopathy and ascites are more frequent, and they usually have poorer liver function. Key words: Budd-Chiari syndrome; Hypertension, portal; Collateral circulation
{"title":"Clinical significance of large spontaneous portosystemic shunts in Budd-Chiari syndrome","authors":"X. Dang, Qingbo Meng, Luhao Li","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.02.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.02.010","url":null,"abstract":"Objective \u0000To explore the clinical significance of large spontaneous portosystemic shunts ( L-SPSS ) in Budd-Chiari syndrome ( B-CS ). \u0000 \u0000 \u0000Methods \u0000Clinical data of 382 B-CS patients treated at The First Affiliated Hospital of Zhengzhou University from Apr 2012 to Dec 2018 were analyzed retrospectively and we included 32 patients with B-CS complicated L-SPSS ( diameter>8 mm ). 65 patients without L-SPSS were selected randomly to form the control group. The correlation between L-SPSS and liver function, upper gastrointestinal bleeding, ascites, hepatic encephalopathy, inferior vena cava thrombosis , portal vein diameter and splenic vein diameter were analyzed. \u0000 \u0000 \u0000Results \u0000TBil, Child-Pugh scores, incidence of hepatic encephalopathy, ascites and inferior vena cava thrombosis in the B-CS complicated L-SPSS group were higher than that in the B-CS without L-SPSS group . The percentage of Child-Pugh grade B and C patients in the B-CS complicated L-SPSS group were also higher than that in the B-CS without L-SPSS group. The level of ALB and hepatic volume per unit surface area were both significantly less in the experimental group.( P 0.05 ) . \u0000 \u0000 \u0000Conclusions \u0000For those B-CS patients complicated L-SPSS , hepatic encephalopathy and ascites are more frequent, and they usually have poorer liver function. \u0000 \u0000 \u0000Key words: \u0000Budd-Chiari syndrome; Hypertension, portal; Collateral circulation","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48414622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.02.002
H. Sheng, Yu-lin Fan, Meng Ding, Yanjun Sun, Dengqun Sun
Objective To investigate the excretion probability, clinical characteristics of gallstones with small common bile duct stone. Methods The clinical data of 216 patients were analyzed retrospectively. The relevant clinical characteristics of small common bile duct stone′s excretion were analyzed. χ2 and Pearson correlation coefficient were used to analyze correlation between small common bile duct stone′s excretion and relevant clinical characteristics, Multiple logistic regression analysis was performed to identify these excretion related factors. Results Univariate analysis showed that patients of age less than 50 years, female sex, abdominal pain relieved and liver function recovered rapidly in 3 days of treatment, normal or slightly dilated diameter of common bile duct, single or multiple stones located in one place, stones completely located in the common bile duct or completely within the sphincter were more likely to be discharged. Multivariate analysis indicated that rapid relief of abdominal pain, rapid recovery of liver function, single or multiple stones located in one place were independently correlated with small common bile duct stone′s excretion. Conclusion Small stones in common bile duct have a high probability of spontaneous removal in patients with gallstones and small common bile duct stone. Key words: Choledocholithiasis; Cholecystectomy, laparoscopic
{"title":"Cinical characteristics of small common bile duct stone′s spontaneous excretion","authors":"H. Sheng, Yu-lin Fan, Meng Ding, Yanjun Sun, Dengqun Sun","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.02.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.02.002","url":null,"abstract":"Objective \u0000To investigate the excretion probability, clinical characteristics of gallstones with small common bile duct stone. \u0000 \u0000 \u0000Methods \u0000The clinical data of 216 patients were analyzed retrospectively. The relevant clinical characteristics of small common bile duct stone′s excretion were analyzed. χ2 and Pearson correlation coefficient were used to analyze correlation between small common bile duct stone′s excretion and relevant clinical characteristics, Multiple logistic regression analysis was performed to identify these excretion related factors. \u0000 \u0000 \u0000Results \u0000Univariate analysis showed that patients of age less than 50 years, female sex, abdominal pain relieved and liver function recovered rapidly in 3 days of treatment, normal or slightly dilated diameter of common bile duct, single or multiple stones located in one place, stones completely located in the common bile duct or completely within the sphincter were more likely to be discharged. Multivariate analysis indicated that rapid relief of abdominal pain, rapid recovery of liver function, single or multiple stones located in one place were independently correlated with small common bile duct stone′s excretion. \u0000 \u0000 \u0000Conclusion \u0000Small stones in common bile duct have a high probability of spontaneous removal in patients with gallstones and small common bile duct stone. \u0000 \u0000 \u0000Key words: \u0000Choledocholithiasis; Cholecystectomy, laparoscopic","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44761979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.02.007
Shifeng Yang, Guangming Sun, F. Tian, Jisheng Hu, Hua Chen, X. Lyu, Bei Sun, R. Kong
Objective To summarize the clinical characteristics of autoimmune pancreatitis (AIP) and discuss the role and significance of surgical intervention in the treatment of AIP. Methods The clinical data of 11 patients with preoperative confirmed AIP and 8 patients with preoperative suspected AIP receiving surgical intervention at the First Affiliated Hospital of Harbin Medical University from 2011 to 2017 were retrospectively analyzed. Results Among 11 preoperatively confirmed AIP patients, 9(47.4%)underwent endoscopic retrograde cholangiopancreatography (ERCP)with nasal bile duct implantation or biliary stent drainage, and 2(10.5%)underwent choledochojejunostomy.Among 8 putative AIP patients in which a cancer was suspected 4 (21.1%)underwent choledochojejunostomy, 3(15.8%) did pancreaticoduodenectomy, and 1(5.3%) had distal pancreatectomy plus splenectomy.Postoperative pathology confirmed pancreatic cancer in 3 cases, IPMN in 1 case, AIP in 2 cases, and chronic pancreatitis in 2 cases. Conclusion While autoimmune pancreatitis is IgG4 related disease, surgical intervention is indicated when there is poor response to drug treatment or when a cancer is to be ruled out. Key words: Pancreatitis; Pathology, clinical; Surgical intervention
{"title":"The role and significance of surgical intervention in the diagnosis and treatment of autoimmune pancreatitis","authors":"Shifeng Yang, Guangming Sun, F. Tian, Jisheng Hu, Hua Chen, X. Lyu, Bei Sun, R. Kong","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.02.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.02.007","url":null,"abstract":"Objective \u0000To summarize the clinical characteristics of autoimmune pancreatitis (AIP) and discuss the role and significance of surgical intervention in the treatment of AIP. \u0000 \u0000 \u0000Methods \u0000The clinical data of 11 patients with preoperative confirmed AIP and 8 patients with preoperative suspected AIP receiving surgical intervention at the First Affiliated Hospital of Harbin Medical University from 2011 to 2017 were retrospectively analyzed. \u0000 \u0000 \u0000Results \u0000Among 11 preoperatively confirmed AIP patients, 9(47.4%)underwent endoscopic retrograde cholangiopancreatography (ERCP)with nasal bile duct implantation or biliary stent drainage, and 2(10.5%)underwent choledochojejunostomy.Among 8 putative AIP patients in which a cancer was suspected 4 (21.1%)underwent choledochojejunostomy, 3(15.8%) did pancreaticoduodenectomy, and 1(5.3%) had distal pancreatectomy plus splenectomy.Postoperative pathology confirmed pancreatic cancer in 3 cases, IPMN in 1 case, AIP in 2 cases, and chronic pancreatitis in 2 cases. \u0000 \u0000 \u0000Conclusion \u0000While autoimmune pancreatitis is IgG4 related disease, surgical intervention is indicated when there is poor response to drug treatment or when a cancer is to be ruled out. \u0000 \u0000 \u0000Key words: \u0000Pancreatitis; Pathology, clinical; Surgical intervention","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45342246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.02.014
Min Lu, Xinglei Qin, Chaoyang Liu, Yajun Zhou, Gang Li, Lian-cai Wang, Senmao Mu
Objective To explore the technical knowhow and experience of mesohepatectomy for central region liver disease. Methods The clinical data of 86 patients with liver disease in central region undergoing mesohepatectomy were retrospectively analysed in Henan provincial People′s Hospital, including 49 males and 37 females. There were 47 cases of central liver cancer, 15 cases of hilar cholangiocarcinoma, 4 cases of hepatic hemangioma, 13 cases of gallbladder cancer, and 7 cases of intrahepatic cholangiolithiasis in central liver. 25 cases received accurate hepatectomy (group A) and 61 cases did irregular hepatectomy (group B). Results In group A , 15 cases did IV, V and VIII lobectomy, 10 cases underwent IV and V partial Lobectomy. Among the irregular hepatectomy group (group B), 35 were treated with hepatic middle lobe resection, 26 with local middle liver resection. There were significant differences in operation time, degree of postoperative liver function damage between the two groups (P<0.05) , while there was no difference in postoperative complications (P<0.05). Conclusions The accurate mesohepatectomy can reduce the incidence of postoperative liver function damage and surgical complications. Key words: Liver neoplasms; Cholelithiasis; Hepatectomy
{"title":"Experiences in middle lobe hepatectomy","authors":"Min Lu, Xinglei Qin, Chaoyang Liu, Yajun Zhou, Gang Li, Lian-cai Wang, Senmao Mu","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.02.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.02.014","url":null,"abstract":"Objective \u0000To explore the technical knowhow and experience of mesohepatectomy for central region liver disease. \u0000 \u0000 \u0000Methods \u0000The clinical data of 86 patients with liver disease in central region undergoing mesohepatectomy were retrospectively analysed in Henan provincial People′s Hospital, including 49 males and 37 females. There were 47 cases of central liver cancer, 15 cases of hilar cholangiocarcinoma, 4 cases of hepatic hemangioma, 13 cases of gallbladder cancer, and 7 cases of intrahepatic cholangiolithiasis in central liver. 25 cases received accurate hepatectomy (group A) and 61 cases did irregular hepatectomy (group B). \u0000 \u0000 \u0000Results \u0000In group A , 15 cases did IV, V and VIII lobectomy, 10 cases underwent IV and V partial Lobectomy. Among the irregular hepatectomy group (group B), 35 were treated with hepatic middle lobe resection, 26 with local middle liver resection. There were significant differences in operation time, degree of postoperative liver function damage between the two groups (P<0.05) , while there was no difference in postoperative complications (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The accurate mesohepatectomy can reduce the incidence of postoperative liver function damage and surgical complications. \u0000 \u0000 \u0000Key words: \u0000Liver neoplasms; Cholelithiasis; Hepatectomy","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46000304","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 clinical effect of three-dimensional laparoscopic splenectomy for massive splenomegaly secondary to liver cirrhosis. Methods The clinical data of 67 patients who underwent laparoscopic splenectomy for massive splenomegaly at Henan Province People′s Hospital from Jan 2013 to Dec 2018 were collected. Results Operation time, volume of intraoperative blood loss and blood transfusion, number of patients with intraoperative blood transfusion, and conversion to laparotomy in 2D group were in favor of 3D group, with statistically differences (t=12.90, 18.255, 19.711, χ2=10.747, 0.685, P 0.05) and resolved with oral coumarin. Conclusions Three-dimensional laparoscopic splenectomy can provide more realistic visual effects of surgical procedures and has an obvious advantage in laparoscopic splenectomy for massive splenomegaly secondary to liver cirrhosis. Key words: Laparoscopes; Imaging, three-dimensional; Splenectomy
{"title":"Clinical evaluation on three-dimensional laparoscopic splenectomy for massive splenomegaly secondary to liver cirrhosis","authors":"Guangjin Tian, Yuting He, Haibo Yu, Yadong Dong, Xiaopei Hao, Kunfu Dai, Deyu Li","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.02.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.02.013","url":null,"abstract":"Objective \u0000To investigate the clinical effect of three-dimensional laparoscopic splenectomy for massive splenomegaly secondary to liver cirrhosis. \u0000 \u0000 \u0000Methods \u0000The clinical data of 67 patients who underwent laparoscopic splenectomy for massive splenomegaly at Henan Province People′s Hospital from Jan 2013 to Dec 2018 were collected. \u0000 \u0000 \u0000Results \u0000Operation time, volume of intraoperative blood loss and blood transfusion, number of patients with intraoperative blood transfusion, and conversion to laparotomy in 2D group were in favor of 3D group, with statistically differences (t=12.90, 18.255, 19.711, χ2=10.747, 0.685, P 0.05) and resolved with oral coumarin. \u0000 \u0000 \u0000Conclusions \u0000Three-dimensional laparoscopic splenectomy can provide more realistic visual effects of surgical procedures and has an obvious advantage in laparoscopic splenectomy for massive splenomegaly secondary to liver cirrhosis. \u0000 \u0000 \u0000Key words: \u0000Laparoscopes; Imaging, three-dimensional; Splenectomy","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47128802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.02.005
S. Wei, Yi Wang, Z. Ye, Yi Zeng, Zhenmeng Lin, Zhitao Lin, Shu Chen, Xiaoling Chen, Luchuan Chen
Objective To analyze the risk factor of delayed gastric emptying (DGE) and the impact of DGE on prognosis after radical gastrectomy of distal gastric carcinoma. Methods The clinical and pathological data of 1447 distant gastric cancer patients undergoing gastrectomy from Jul 2007 to Jan 2018 at Fujian Tumour Hospital was analyzed retrospectively. Result DGE was found in 101 patients (7.0%), occurring at a median of (6.0±2.1)d after surgery. It was significantly correled with age, diabetes, hypoproteinemia, preoperative pyloric obstruction, operation time, surgical mode, anastomotic procedure, postoperative analgesia(all P 0.05) Conclusion DGE prolonged hospital stay, but did not influence patients′ prognosis. Key words: Stomach neoplasms; Gastric emptying; Risk factors; Prognosis; Gastrectomy
{"title":"Risk factors of delayed gastric emptying and its influence on the prognosis after radical gastrectomy for distant gastric cancer","authors":"S. Wei, Yi Wang, Z. Ye, Yi Zeng, Zhenmeng Lin, Zhitao Lin, Shu Chen, Xiaoling Chen, Luchuan Chen","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.02.005","url":null,"abstract":"Objective \u0000To analyze the risk factor of delayed gastric emptying (DGE) and the impact of DGE on prognosis after radical gastrectomy of distal gastric carcinoma. \u0000 \u0000 \u0000Methods \u0000The clinical and pathological data of 1447 distant gastric cancer patients undergoing gastrectomy from Jul 2007 to Jan 2018 at Fujian Tumour Hospital was analyzed retrospectively. \u0000 \u0000 \u0000Result \u0000DGE was found in 101 patients (7.0%), occurring at a median of (6.0±2.1)d after surgery. It was significantly correled with age, diabetes, hypoproteinemia, preoperative pyloric obstruction, operation time, surgical mode, anastomotic procedure, postoperative analgesia(all P 0.05) \u0000 \u0000 \u0000Conclusion \u0000DGE prolonged hospital stay, but did not influence patients′ prognosis. \u0000 \u0000 \u0000Key words: \u0000Stomach neoplasms; Gastric emptying; Risk factors; Prognosis; Gastrectomy","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47829785","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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