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Purpose@#This study was performed to analyze the rule of confluence of the caudate lobe bile duct (CLD) into the left hepatic duct (LHD) and to discuss the protective strategy during left hemihepatectomy. @*Methods@#MRI of 400 patients and T-tube angiography images of 100 patients were collected, and the imaging rules of the confluence of the CLD into the LHD were summarized. The clinical data of 33 patients who underwent left hemihepatectomy using the protective strategy were analyzed. @*Results@#MRI and T-tube angiography images showed that the length from the confluence point of the CLD into the LHD to the confluence of the left and right hepatic ducts was 1.19 ± 0.40 cm and 1.26 ± 0.39 cm, respectively. The average angle between the longitudinal axis of the 2 bile ducts was 68.27° ± 22.59° and 66.58 ± 22.88°, respectively. Coronal and cross-sectional images showed that inflow from the foot side to the cranial side was noted in 79.8% and 82.0% of patients, respectively, and inflow from the dorsal to the ventral side was observed in 84.5% and 88.0%, respectively. Based on these imaging rules, the safe transection length and plane were summarized, and the CLD was effectively protected in 33 cases of left hemihepatectomy. @*Conclusion@#In left hemihepatectomy, the LHD should be transected at least 1.5 cm away from the confluence of the left and right hepatic ducts, and the plane of transection should be oblique to the dorsal side at an angle of 45° with the LHD, these parameters represent an effective strategy to protect the CLD.
ABSTRACT
ObjectiveTo investigate the risk factors for the complications of transumbilical single-port laparoscopic cholecystectomy (TUSPLC) and to explore the prophylactic methods. MethodsThe clinical data of 120 patients undergoing TUSPLC in our hospital from January 2012 to December 2014 were retrospectively analyzed. The association of different factors with the complications was analyzed, including sex, age, body mass index (BMI), height, underlying diseases (hypertension, diabetes, and hyperthyroidism), surgeon level, operation time, and intraoperative blood loss. The risk factors were determined by univariate and multivariate logistic regression analyses. ResultsThe incidence of the complications of TUSPLC was 8.3% (10/120), including surgical site infection (4 cases), umbilical hernia (2 cases), hemorrhage (2 cases), and intra-abdominal organ injury (2 cases). The univariate logistic regression analysis indicated that BMI, height, underlying diseases, surgeon level, operation time, and intra-operative blood loss were risk factors for the complications of TUSPLC (all P＜0.05). The multivariate logistic regression analysis showed that underlying diseases and operation time were independent risk factors for the complications of TUSPLC (P＜0.01). ConclusionThe underlying diseases and operation time are independent risk factors for the complications of TUSPLC, so appropriate intervention strategies for these factors could be developed to reduce the incidence of the complications of TUSPLC.
ABSTRACT
ObjectiveTo investigate the risk factors for the complications of transumbilical single-port laparoscopic cholecystectomy (TUSPLC) and to explore the prophylactic methods. MethodsThe clinical data of 120 patients undergoing TUSPLC in our hospital from January 2012 to December 2014 were retrospectively analyzed. The association of different factors with the complications was analyzed, including sex, age, body mass index (BMI), height, underlying diseases (hypertension, diabetes, and hyperthyroidism), surgeon level, operation time, and intraoperative blood loss. The risk factors were determined by univariate and multivariate logistic regression analyses. ResultsThe incidence of the complications of TUSPLC was 8.3% (10/120), including surgical site infection (4 cases), umbilical hernia (2 cases), hemorrhage (2 cases), and intra-abdominal organ injury (2 cases). The univariate logistic regression analysis indicated that BMI, height, underlying diseases, surgeon level, operation time, and intra-operative blood loss were risk factors for the complications of TUSPLC (all P＜0.05). The multivariate logistic regression analysis showed that underlying diseases and operation time were independent risk factors for the complications of TUSPLC (P＜0.01). ConclusionThe underlying diseases and operation time are independent risk factors for the complications of TUSPLC, so appropriate intervention strategies for these factors could be developed to reduce the incidence of the complications of TUSPLC.
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An indirect square polarographic method was established f or the determination of ascorbic acid in pharmaceuticals using the oxidation-re duction action between Cu2＋ and ascorbic acid. There was a reduction wav e of Cu2＋ at about －0．24 V in buffer solution of NH3-NH4 Cl. The quantities of ascorbic acid is determination according to the decrement of peak heights when ascorbic acid was added. The linear range for ascrobic acid was 2.0×10－6～3．0×10－4 mol/L. Ascorbic acid in Vitami n C tablets was determined, the relative standard deviation is 2.9%.