ABSTRACT
Objective To compare the therapeutic results of photodynamic therapy (PDT) combined with biliary stenting versus biliary stenting alone in the treatment of nonresectable bile duct cholangiocarcinoma.Methods The PubMed,CBM,CNKI,VIP and WanFang Data were searched from January 1990 to December 2017.Two researchers independently screened the literatures,extracted the data and performed the quality evaluation.The meta-analysis was carried out using the RevMan software 5.3.0.Results Eleven controlled clinical trials were included in the meta-analysis.There were only two randomized controlled trials.The remaining studies were non-randomized controlled trials.Finally,659 patients were enrolled in this study.293 patients were treated with photodynamic therapy and biliary stenting while 366 patients were treated with stenting alone.Analysis showed that photodynamic therapy combined with stenting significantly extended the overall survival when compared with stenting alone (P＜0.01).There was no significant differences in the incidences of cholangitis (P＞0.05),but PDT and stenting had a significantly higher total complication rate (P＜0.05).Conclusions This meta-analysis showed that photodynamic therapy combined with stenting significantly improved the survival rate of patients with nonresectable ductal cholangiocarcinoma when compared with stenting alone.Photodynamic therapy did not increase the incidence of cholangitis.
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Objective To investigate the incidence and CT imaging features of abdominal splenosis with a previous splenectomy.Methods 94 consecutive patients with a history of splenectomy underwent abdominal contrast CT examination between April 2010 and December 2012 and were recruited for this study.These patients were devided into two groups according to the reason for which splenectomy was performed.Descriptive statistics were calculated for clinical incidence of abdominal splenosis,and subsequently CT imaging features and diagnosis of abdominal splenosis were discussed.Results In this series,29 cases (30.85％) with abdominal splenosis were found in 94 patients.Abdominal splenosis was found in all of 20 cases with more than one year history of posttraumatic splenectomy,and in 17.31％ (9 of 52) of cases with more than one year history of non-traumatic splenectomy (P ＜ 0.05).There were 60 nodules found on CT examinations in these 29 cases.All nodules were 50 mm or smaller.All nodules appeared of homogeneous soft-tissue density on plain CT scan.The nodules showed significant enhancement during arterial phase on postcontrast CT scan,with continuous significant homogeneous enhancement during portal venous phase.Conclusions Abdominal splenosis following posttraumatic splenectomy are more common than previously suggested.Knowledge of typical CT imaging appearances and the history of splenectomy may prevent mistaking as tumors.
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Objective To summarize the clinical experience of laparoscopic cholecystectomy (LC) for acute cholecystitis. Methods Clinical records of 79 cases of acute cholecystitis treated by LC from September 2002 to August 2003 were respectively reviewed. Results Intraoperative cholangiography (IOC) was successfully conducted in 75 cases, 6 of which were found common bile duct stones. Of the 6 cases, 4 underwent LC combined with intraoperative endoscopic sphincterotomy and 2 underwent a conversion to open choledochotomy with T-tube drainage. The rest of 73 cases were diagnosed as simple gallbladder stones: LC was successfully accomplished in 70 cases and a conversion to open surgery was required in 3 cases because of serious inflammatory adhesion. In the study no severe complications occurred. Conclusions LC can be performed safely in the majority of cases of acute cholecystitis.