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Objective To investigate the diagnosis and surgical management of ureteral obstruction after renal transplantation.Method A respective study was performed on 15 cases of ureteral obstruction who received renal allografts.All of the cases were confirmed,including 5 cases of stenosis of ureterovesical junction,4 cases of stenosis of distal ureter,2 cases of blood clot blockage,2 cases of edema due to perforation of distal ureter,1 case of ureteral calculi,and 1 case of extrinsic compression of hematoma.All 14 patients underwent open surgical management to reestablish ureter with D-J catheter as stent for 12-16 weeks.One patient was subjected to percutaneous nephrostomy followed by percutaneous ureteroscopy,the obstructed site was identified at ureterovesical junction and antegrade balloon dilation and D-J stent in ureter were performed subsequently.Result Fifteen patients were diagnosed as ureteral obstruction by colour Doppler ultrasound and MRU.All of the patients were resolved the obstructions after surgical managements and the renal function got improved.No reobstruction occured during one year follow-up period.Conclusion Colour Doppler ultrasound and MRU can definitely be used to diagnose ureteral obstruction after renal transplantation.Early diagnosis and surgical management are very important.Open surgical management of the obstructed ureter is an effective method.Antigrade balloon dilation is a therapeutic approach to treat ureteral obstruction.
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BACKGROUND: Organ for transplantation is insufficient, and primary transplant of nonfunction caused by perfusion cryopreservation occasionally occurs. It is clinically significant to reduce organ damage caused by perfusion preservation. OBJECTIVE: To explore the protective effect of hyperoxic perfusion fluid on liver transplantation in rats. METHODS: A total of 40 Wistar rats were randomly divided two groups (n = 20) and respectively poured with Ringer lactate solution or hyperoxic ringer lactate solution. Each group comprised equal number of donors and recipients to prepare liver, kidney, and pancreas transplantation models. Hyaluronic acid (HA), alanine aminotransferase (ALT) and CD8+CD28- T cells were compared between two groups at the end of perfusion, and 1st and 3rd days after liver transplantation. The acute rejection score of liver tissues were also compared after operation. RESULTS AND CONCLUSION: The HA, ALT and CD8+CD28-T cells were no significantly different between two groups before operation (P> 0.05). The HA and ALT of hyperoxic ringer lactate solution group was significantly Ringer lactate solution group after liver transplant (P < 0.05), but the CD8+CD28-T cells were greater (P < 0.05). The acute rejection scores for liver in hyperoxia liquid group were significantly less than the common liquid group (P< 0.05). Results show that hyperoxic solution can attenuate ischemia/reperfusion injury and protect rats undergoing liver transplantation.
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Objective To observe the incidence of residual gallbladder in patients undergone cholecystectomy through laparotomy (OC),mini-incision laparotomy cholecystectomy (MC) or laparoscopic cholecystectomy (LC),and to explore the causes,diagnosis,prevention and treatment of residual gallbladder.Methods The clinical data of 241 patients undergone laparotomy cholecystectomy (OC group),231 patients undergone mini-incision laparotomy cholecystectomy (MC group) and 290 patients undergone laparoscopic cholecystectomy (LC group) were retrospectively analyzed,and the incidence of residual gallbladder was compared among the three groups.Results Residual gallbladder was found in 32 patients after the surgical procedures,with 4 in OC group (1.7%),13 in MC group (5.6%) and 15 in LC group (5.2%),respectively.Statistical analysis showed that the incidence of residual gallbladder was lower in OC group than in MC and LC group (P0.05).Multivariate analysis showed that severity of inflammation before the operation,operative methods and operator's experience were correlated with the incidence of residual gallbladder.All the 32 cases were diagnosed by ultrasonography,computed tomography (CT),magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP).24 patients were cured with surgical procedure,and the symptoms disappeared during a follow-up period of 6 months to 9 years;other 8 cases were treated with conservative management and the results were unsatisfactory.The pathological examination showed no tumor or malignant change in the excised specimen.Conclusions Residual gallbladder is not a negligible complication of cholecystectomy.Effective control of inflammation of the gallbladder,selection of a proper time and procedure of operation,and the operation done by an experienced surgeon can reduce the incidence of residual gallbladder,and reoperation is the effective treatment for it.