ABSTRACT
Objective@#To explore the clinical effect and safety of minor liver resection for hilar cholangiocarcinoma (HC) of Bismuth-Corlette type Ⅲ and Ⅳ.@*Methods@#From May 2007 to May 2017, the clinical data of 108 patients with Bismuth-Corlette type Ⅲ and Ⅳ HC underwent hepatectomy were collected and analyzed retrospectively.There were 56 males and 52 females, aged (57.2±5.3) years (ranged 48-76 years) .Among the 108 cases, there were 51 cases of type Ⅲa, 40 cases of type Ⅲb and 17 cases of type Ⅳ. Small-scale hepatectomy (≤3 hepatectomy) was performed in 70 cases, including 8 cases of 4b segment resection, 28 cases of 4b segment+5 segment resection, and 34 cases of partial 4 segment+partial 7 segment+partial 1 segment resection. Large-scale hepatectomy was performed in 38 cases (>3 segments) , of which 30 cases were treated with 2 segments+3 segments+4 segments+1 segment, and 8 cases were treated with 5 segments+7 segments+8 segments+1 segment. t′ test was used to analyze the data which did not conform to the normal distribution, and χ2 test was used to calculate the incidence of postoperative complications and the 1, 3, and 5-year cumulative overall survival rate.@*Results@#(1) The operation time of minor liver resection group ((180±25)minutes) was shorter than that of major liver resection group ((210±35)minutes) (t′=4.676, P<0.05) , the amount of blooding operation time of minor liver resection group ((310±80)ml) was less than that of major liver resection group ((500±110)ml)in the operation (t′=9.385, P<0.05) , and the difference was statistically significant. (2) The incidence of complications was lower in minor liver resection group and major liver resection group, and the difference was statistically significant (χ2=5.230, P<0.05) . (3) The actual 1-, 3- and 5-year survival rates were 87.1%, 58.4%, 30.0% and 84.2%, 57.9%,31.6%, respectively. There were no significant differences in survival rates in two groups in 1-, 3- and 5-year survival rates (χ2=0.177, P=0.674; χ2=0.005, P=0.946; χ2=0.029, P=0.865) .@*Conclusions@#Compared to patients with major liver resection, Minor liver resection for selected patients with HC of Bismuth-Corlette Ⅲ and Ⅳaccording to our criteria achieved better long-term outcomes. Chen′s biliojejunostomy is a simple, effective and safe method, which can be widely used when there are multiple biliary intestinal anastomosese.
ABSTRACT
Objective To study the effect of the modality of subtotal splenectomy with retroperitoneal splenic transposition combined with devascularization on portal hypertensive gastropahy(PHG). Methods Subtotal splenectomy with retroperitoneal splenic transposition combined with devascularization was performed in 48 cirrhotic patients with portal hypertension. Forty seven patients were followed up for 2 years to 13 years (average 91 months). PHG were observed by gastroscopy.Results At 2 months postoperation ,PHG was significantly aggravated compared with that of preoperation (P
ABSTRACT
0.05).(4) Free pressure of portal vein(FPP) significantly declined at post-operation in the two groups(P
ABSTRACT
The spleen cells from the BALB/C mouse immunized with the type B toxoid were fused with aNS-1 myeloma cell line. The superatant containing the hybridoma-formed cells with growing pores wasscreened by EL1SA, in which 66.7% the pores could secrete the specific antibodies against botulin.After a Subclonizing culture by the limiting dilution technique four hybridoma cell lines(3B10, 3B11, 3G12 and 4A5) were established and could secrete the specific antibodies persistently in the culture medium. in which antibody titers came to 10-3-10-5, while they were injected into the BALB/C mice intrape ritoneally ascites rich in antibodies with a titer of 10-5-10-8 was produced. The results testing the (our monoclonal antibodies with the type A and B toxoids showed that the antibodies of 3G12and 4A5 were specific for the type B toxoid, and those of 3B10 and 3B11 had light cross reaction with the type A toxoid. Identification of 1g showed that the antibodies of 3B10 and 3G12 were of IgG1, while those of 3B11 and 4A5 of IgG2. The chromosomal assay confirmed the four cell lines to be hybridoma. The neutroligation test in mice revealed that those four monoclonal antibodies did not show any protective effects on botulin.