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Objective To evaluate the safety and feasibility of single-port laparoscopic surgery (SPLS) for chronic appendicitis.Methods Data of patients who had undergone either conventional threeport surgery (n =58) or SPLS (n =63) for chronic appendicitis between January 2010 and November 2012 were analyzed retrospectively.The short-term outcomes of these 2 operative modalities were compared.Results The overall satisfaction score of SPLS group was significantly higher than that of the three-port group (4.5 ±0.7) vs.(3.0 ±0.6),t =13.50,P =0.00,there was less frequent use of parenteral narcotics in SPLS patients (1.2 ± 0.5) vs.(2.1 ± 0.7) times,t =-8.25,P =0.00,length of operation time was the same in SPLS group (40 ± 10) vs.(37 ±9) minutes,t =1.94,P =0.055.There was not different in postoperative recovery (1.4 ± 0.6) vs.(1.6 ± 0.7) d,t =-1.82,P =0.072,nor different in perioperative complications and intraoperative blood loss between groups (12 ± 6) vs.(13 ± 6) ml,t =-1.50,P =0.137.Conclusions SPLS is both safe and feasible in the treatment of chronic appendicitis.
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Objective To investigate the risk factors for pancreatic fistula after duct-to-mucosa pancreaticojejuuostomy (PD). Methods The clinical data of 101 cases undergoing duct-to-mucosa PD in our hospital from January 1994 to January 2008 were reviewed retrospectively. Results The incidence of pancreatic fistula was 9.9% (10/101). Univariate analysis showed level of preoperative jaundice(χ2=5.814, P= 0.016) , duration of jaundice (χ2= 4.17, P = 0.041 ), texture of the remnant pancreas (χ2=5.286, P = 0.021 ), diameter of pancreatic duct (χ2= 4.165, P = 0.041 ), blood loss during operation (χ2=5.273, P=0.022) were significantly associated with pancreatic fistula after duct-to-mucosa PD. Multivariate analysis regression revealed that texture of the remnant pancreas (OR = 13.355, P = 0.023), level of preoperative jaundice (OR = 12.126, P = 0.006), blood loss during operation (OR = 5.92, P =0.032 ) were independent risk factors. Logistic regression equation was as following: P=1/[<1+e-(-6.378+2.592 texture of the remrant pancress + 2.495 level of preopetative jaundice + 1.778 blood loss during operative)>]. The accuracy of the logistic equation was 92.1%. Conclusion Texture of the remnant pancreas, level of preoperative jaundice, blood loss during operation were the independent risk factors for the occurrence of PD after duct-to-mucosa PD. Improvement of operative technique and reduction of blood loss can decrease the incidence of pancreatic fistula.
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Objective To study the risk factors for intra-abdominal infection after pancreaticoduodenecto-my. Methods Clinical data of 101 cases undergoing pancreaticoduodenectomy in our hospital from January 1994 to January 2008 were reviewed retrospectively. The risk factors were analyzed. Results The incidence of intra-abdomi-hal infection was 12.9% (13/101). Univariate analysis showed postoperative pancreatic,biliary and intestinal fistu-la,pulmonary infection,preoperative acute cholangitis and texture of the remnant pancreas were the risk factors for intra-abdominal infection(P<0.05). Multivariate Logistic regression revealed that postoperative pancreatic, biliary and intestinal fistula, pulmonary infection, preoperative acute cholangitis were independent risk factors (OR = 11.914,9.891 and 7.197 ) of intra-abdominal infection after pancreaticoduodenectomy. Conclusion Preventing and curing pancreatic ,biliary and intestinal fistula, pulmonary infection, preoperative acute cholangitis can decrease the incidence of intra-abdominal infection.