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Objective:To investigate the characteristics and risk factors of local recurrence in resected pancreatic cancer.Methods:The clinicopathological data of 190 patients in whom recurrent sites can be identified after radical resection of pancreatic cancer from Sep 2013 to Aug 2020 at the Cangzhou Central Hospital were retrospectively analyzed. The survival time and clinicopathological characteristics of local recurrence were compared with those of other recurrence types. Cox risk regression model was used to analyze the risk factors of local recurrence.Results:The recurrence sites were local (49 cases, 25.8%), liver (53 cases, 27.9%), lung (35 cases, 18.4%), peritoneal (25 cases, 13.2%) and multiple sites (28 cases, 14.7%). Patients mRFS and mOS were 17.8 months and 30.9 months respectively. The clinicopathological features of patients with local recurrence were compared with those of other recurrence types [tumor diameter ( P=0.023), preoperative CA199 level ( P=0.021), peripancreatic nerve plexus invasion ( P=0.031), lymphovascular invasion ( P=0.004), surgical margin state ( P<0.001) and postoperative adjuvant chemotherapy ( P=0.038)]. Tumor diameter ( P=0.018), peripancreatic nerve plexus invasion ( P=0.002) and postoperative adjuvant chemotherapy ( P=0.004) were independent factors for local recurrence in resected pancreatic cancer, and only peripancreatic nerve plexus invasion was not associated with other recurrence types. Conclusions:Local recurrence in resected pancreatic cancer has important impact on the prognosis of patients. Peripancreatic nerve plexus invasion is an independent factor affecting local recurrence.
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Objective:To analyze the common complications of laparoscopic duodenum- preserving pancreatic head resection(LDPPHR).Methods:The clinical data of 32 patients undergoing LDPPHR from Jun 2018 to Jun 2021 in Cangzhou Central Hospital were analyzed retrospectively.Results:LDPPHR was successfully performed in all 32 patients without conversion to open surgery. The incidence of postoperative complications was 21.9% (7/32), 3 cases suffering from sever complications (1 case of long-term postoperative pancreatic fistula, 1 case of obstructive jaundice caused by duodenal papilla stenosis, 1 case of postoperative abdominal bleeding) were cured by laparotomy; 4 cases of minor complications were simple pancreatic fistula, which were cured by prolonging dranage.Conclusions:LDPPHR is technically feasible for isolated noncancerous lesions within pancreatic head and uncinate process,the complications were manageable.Its suggested benefits remain to be established by long term follow-up.
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Objective:To investigate the short-term outcome of Heidelberg triangle dissection in laparoscopic pancreaticoduodenectomy (LPD) for pancreatic cancer.Methods:The clinical data of 84 patients with pancreatic head cancer who underwent LPD from July 2015 to September 2020 in the Department of Hepatobiliary and Pancreatic Surgery of the Cangzhou Central Hospital were retrospectively analyzed. According to the scope of surgical dissection, the patients were divided into the control group ( n=45) and the Heidelberg group ( n=39). In the control group, routine lymph node dissection was performed, and in the Heidelberg group, all blood vessels, lymphatic tissue and nerve tissue in the Heidelberg triangle area were dissected on the basis of routine lymph node dissection. Operation-related indicators (operation duration, intraoperative blood loss, cases of patients with intraoperative blood transfusion, fasting time and hospitalization duration after operation), postoperative complications (pancreatic fistula, biliary fistula, lymphatic fistula, bleeding and delayed gastric emptying) and postoperative pathological parameters (surgical margin, degree of differentiation, tumor size, cases of nerve invasion, number of dissected lymph nodes, lymph node metastasis and TNM stage) were compared between the two groups. Results:Compared with the control group, the operation time of the Heidelberg group was longer [ (334.85±24.95)min vs (305.09±24.54)min], theincidence of lymphatic fistula was higher (15.4% vs 2.2%), the rate of >1 mm at surgical margin was higher (76.9% vs 53.3%), and the total number of lymph nodes dissection was more [ (11.31±2.46) vs (9.49±2.28)]. All the differences between the two groups were statistically significant ( P<0.05). However, there were no significant differences on the intraoperative blood loss, cases of patients with intraoperative blood transfusion, postoperative hospital stay and fasting time, incidence of pancreatic fistula and biliary fistula, bleeding, delayed gastric emptying, degree of differentiation, tumor size, cases of nerve invasion, lymph node metastasis and TNM stage between the two groups. Conclusions:LPD combined with Heidelberg triangle dissection for pancreatic cancer was feasible and safe, which can increase the R 0 resection rate, remove more lymph nodes, reduce the local recurrence of pancreatic cancer and improve the prognosis of patients.
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Objective To investigate the effect of end-to-side pancreaticojejunostomy with pocket-inser-tion on the incidence of pancreatic fistula after pancreaticoduodenectomy. Methods The clinical data of 581 patients undergoing pancreaticoduodenectomy from Dec. 2012 to Sep. 2018 in Cangzhou Central Hospital were retrospectively analyzed, including 327 cases of open pancreaticoduodenectomy(OPD), 175 cases of laparoscopic assisted pancreaticoduodenectomy (LAPD), and 79 cases of total laparoscopic pancreaticoduodenectomy. End-to-side pancreaticojejunostomy with pocket-insertion was used in all cases. The incidence of pancreatic fistula after operation was analyzed. Results The overall incidence of grade B or C pancreatic fistula was 3.10％ (18/581) after end-to-side pancreaticojejunostomy with purse-pocket insertion. The incidence of grade B or C pancreatic fistula in OPD group was 2.75％(9/327). The incidence of grade B or C pancreatic fistula in LAPD group was 2.29％ (4/175). The incidence of grade B or C pancreatic fistula in TLPD group was 6.33％ (5/79). The three groups were divided into two subgroups according to the pancreatic texture. There was significant difference in pancreatic duct diameter between subgroups(P<0.05), but there was no significant difference in the time of pan-creaticojejunostomy and the incidence of pancreatic fistula after operation (P>0.05). Conclusion End-to-side pan-creaticojejunostomy with pocket insertion has the advantages of simple operation, strong adaptability, safety and high efficiency, and can control the incidence of pancreatic fistula after pancreaticoduodenectomy at an ideal level.
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Objective@#To investigate the effect of end-to-side pancreaticojejunostomy with pocket-insertion on the incidence of pancreatic fistula after pancreaticoduodenectomy.@*Methods@#The clinical data of 581 patients undergoing pancreaticoduodenectomy from Dec. 2012 to Sep. 2018 in Cangzhou Central Hospital were retrospectively analyzed, including 327 cases of open pancreaticoduodenectomy (OPD) , 175 cases of laparoscopic assisted pancreaticoduodenectomy (LAPD) , and 79 cases of total laparoscopic pancreaticoduodenectomy. End-to-side pancreaticojejunostomy with pocket-insertion was used in all cases. The incidence of pancreatic fistula after operation was analyzed.@*Results@#The overall incidence of grade B or C pancreatic fistula was 3.10% (18/581) after end-to-side pancreaticojejunostomy with purse-pocket insertion. The incidence of grade B or C pancreatic fistula in OPD group was 2.75% (9/327) . The incidence of grade B or C pancreatic fistula in LAPD group was 2.29% (4/175) . The incidence of grade B or C pancreatic fistula in TLPD group was 6.33% (5/79) . The three groups were divided into two subgroups according to the pancreatic texture. There was significant difference in pancreatic duct diameter between subgroups (P<0.05) , but there was no significant difference in the time of pancreaticojejunostomy and the incidence of pancreatic fistula after operation (P>0.05) .@*Conclusion@#End-to-side pancreaticojejunostomy with pocket insertion has the advantages of simple operation, strong adaptability, safety and high efficiency, and can control the incidence of pancreatic fistula after pancreaticoduodenectomy at an ideal level.
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Objective To investigate the choice of surgical methods and short-term therapeutic efficacy of laparoscopic pancreaticoduodenectomy.Methods A retrospective analysis was performed on the clinical data of 188 cases who underwent laparoscopic pancreaticoduodenectomy (LPD) from December 2015 to December 2017 in Cangzhou Central Hospital.Total laparoscopic pancreaticoduodenectomy (TLPD) was performed in 102 patients whose diameter of pancreatic duct was greater than or equal to 3 mm,and end-to-side anastomosis of pancreatic duct and jejunum was used to reconstruct the digestive tract (TLPD group).Laparoscopic assisted pancreaticoduodenectomy (LAPD) was performed in 86 patients with pancreatic duct diameter less than 3 mm,and the digestive tract was reconstructed by end-to-side pancreaticoduodenectomy with pocket-insertion (LAPD group).The clinical data of the two groups were analyzed and compared.Results There were no significant differences on sex,age,ASA grade,preoperative total bilirubin,alanine aminotransferase and serum albumin levels between the two groups(P ＞0.05),which was comparable.The total incision length and hospitalization time in TLPD group were significantly shorter than those in LAPD group [(8.2± 1.4)cm vs (12.9±2.6) cm];[(10.9±5.9)d vs (14.3±6.5) d],while the time of pancreaticojejunostomy was significantly longer than that in LAPD group [(36.1 ± 14.7) min vs (14.0 ± 4.2) min].The incidence of pancreatic fistula after operation was significantly higher than that in LAPD group (30.4％ vs 10.5％).The difference was statistically significant (all P＜0.05).There were no significant differences on mean operation time,intraoperative bleeding volume,number of lymph node dissection,R0 resection rate,ICU admission time,eating time,total complication rate and 6-month disease-free survival rate between the two groups.Conclusions TLPD has the advantages of less trauma and quicker recovery.But for pancreatic duct diameter less than 3 mm,the choice of LAPD can increase the safety of operation and reduce the incidence of postoperative pancreatic fistula.
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Objective To investigate the clinical features of Menetrier disease and the related treatment progresses.Methods The clinical data of 7 patients with Menetrier disease who were admitted to Cangzhou Central Hospital from Jan 1997 to Mar 2018 were retrospectively analyzed.Results There were 3 males and 4 females.The main clinical manifestations were abdominal pain (n =5),loss of appetite (n =4),nausea and vomiting (n =2),weight loss (n =4),edema (n =3),hypoalbuminemia (n =6) and anemia (n =6).All patients had typical imaging findings.Two of the patients underwent non-surgical treatmen with temporary symptom reliefs.Finally,6 patients received surgical treatment including Subtotal gastrectomy in 1 patient,total gastrectomy in 5 patients.All the 6 cases underwent surgery successfully with no serious complications.5 cases were followed-up data until April 2018.All were in good condition,Hemoglobin and albumin levels were within the normal range.Conclusion According to the clinical manifestations and the related auxiliary examinations,this disease is easy to diagnose.Surgical treatment is the only way to cure Menetrier disease.
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Objective to investigate the feasibility of laparoscopic radical resection for hilar cholangiocarcinoma.Methods From June 2016 to June 2018,30 patients with hilar cholangiocarcinoma (HCC) underwent total laparoscopic radical resection.Results Surgery was successfully performed in all cases without conversion,15 cases underwent hilar bile duct resection,and hilar lymph node dissection,14 cases underwent left hemi-hepatectomy and caudate lobectomy,and 1 case underwent extrahepatic bile duct resection.The operation time was 258-336 min,(286.8 ± 18) min,intraoperative bleeding was 60-210 ml (139.7 ±38.0) ml.Postoperative bile fistula occurred in 5 cases,healed conservatively after 5 days,stress ulcer in 1 case,and intestinal anastomotic bleeding in 1 case,were all cured by themselves.Postoperative hospitalization was 7-12 days (mean 8.9 d).After 6-12 months follow-up,3 cases died of recurrent and metastatic cancer after 6 months of operation,27 cases were alive.Conclusion Total laparoscopic radical resection of hilar cholangiocarcinoma is safe and feasible.
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Objective To explore the safety and feasibility of laparoscopic radical resection of Bismuth-type Ⅲb hilar cholangiocarcinoma.Methods The clinical data of 109 patients with Bismuth-type Ⅲ b hilar cholangiocarcinoma in the Department of General Surgery of Cangzhou Central Hospital from Jan 2015 to Feb 2018 were retrospectively analyzed.Among those 17 patients undergoing total laparoscopic surgery were compared with 17 open cases.Results There were significant differences between the laparoscopic group and the control group in operation time [(420.8 ± 136.5) min vs (292.3 ± 65.6) min],total length of incision [(8.2 ± 4.7) cm vs (20.4 ± 5.8) cm],incidence of postoperative complications [29.4％ (5/17) vs 52.9％ (9/17)],postoperative feeding time,postoperative ICU stay and postoperative hospital stay (P ＜ 0.05).There were no significant difference in the amount of bleeding[(325.2 ± 98.7)ml vs(367.4 ±72.9)ml],pathological results,number of lymph node dissection,R0 resection rate and tumor recurrence rate (P ＞ 0.05).Conclusion Total laparoscopic radical resection of Bismuth-type Ⅲ b hilar cholangiocarcinoma is safe,feasible,and has the advantages of minimal invasion and rapid recovery.
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Objective To study and prepare the monoclonal antibody library against human FXYD6 functional region,to screen the hybridoma cell lines secreting the monoclonal antibodies against intracellular or extracellular region of human FXYD6,and to identify the biological function of monoclonal antibody against extracellular domain.Methods FXYD6 functional region recombinant protein which did not contain the transmembrane region was prokaryotically expressed,purified,and FXYD6 recombinant protein was used to immunize BALB/c mice.Then splenocytes after immunization were fused with myeloma cells SP2/0.After several rounds of screening and cloning,the hybridomas which secreted the antibodies against the extracellular domain or the intracellular domain of human FXYD6 were established.The antibody specificity and subtype were identified with indirect ELISA,western blot and immunohistochemistry.The monoclonal antibodies against the extracellular domain which recognized the native conformation were screened with flow cytometry.The antibody against extracellular region was prepared with the ascites revulsion method and purified.The affinity constants were measured with indirect ELISA.The function of extracellular monoclonal antibody was detected by HepG2 cell line with high expression of FXYD6.Results The hybridoma cell library which secreted the monoclonal antibody against extracellular domain or the intracellular domain of human FXYD6 was successfully obtained,and extracellular region monoclonal antibodies with the functional blocking were prepared.Conclusion The prepared anti-human FXYD6 extracellular monoclonal antibodies could inhibit HepG2 cell proliferation.
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Objective To compare the short-term efficacy of laparoscopic pancreaticoduodenectomy (LPD) with open pancreatoduodenectomy (OPD).Methods The clinical data of 122 LPD patients and 167 OPD patients at our department from 2015 to 2017 were analyzed retrospectively.Results There was no significant difference in demographic,ASA classification,preoperative liver function between the two groups (P ＞0.05).The operative time was (405 ± 109) min vs.(312 ±57) min,liquid diet intake time postoperatively was (5.4 ± 2.6) d vs.(7.9 ± 3.3) d,postoperative hospital stay was (10.4 ± 6.1) d vs.(14.5 ± 8.6) d,with all the difference statistically significant (P ＜ 0.05).Intraoperative blood loss was (290 ± 102) ml vs.(322 ± 75) ml,the number of lymph node dissection in malignant tumor cases was (14.7 ± 5.6) vs.(13.9 ± 7.3),R0 resection rate in malignant tumor cases was 97.9％ (96/98)vs.96.6％ (143/148),the incidence of postoperative complications was 39.3％ (48/122) vs.35.3％(59/167) (all P ＞0.05).All patients were followed up with a median time m group LPD and group OPD was 9 months and 11 months respectively,and the tumor free survival rate was 93.4％ (114/122) and 90.4％ (151/167) at 6 months (P ＞ 0.05).Conclusion LPD has the same safety and radical effect as the traditional OPD surgery,while of less trauma and quicker postoperative recovery.
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Objective To assess the value of endovascular management in treating long segment occlusion of femoral-popliteal artery by using retrograde puncture path.Methods The clinical data of a total of 46 patients with long segment occlusion of femoral-popliteal artery,who were admitted to authors' hospital during the period from June 2009 to January 2017 to receive endovascular treatment,were retrospectively analyzed.The patients included 27 males and 19 females,with a mean age of (69±8) years old.Grade Ⅲ of Rutherford classification was seen in 32 patients,grade ⅣV in 8 patients,and grade V in 6 patients.On CT angiography,the mean length of occluded lesion was (17±5) cm.Results In 46 patients of this series,the technical success rate was 100％.The average time used for making the small skin incision and puncturing the artery was (5.2±2.3) min.A 4-F artery sheath was employed in 7 patients,endovascular management with no use of artery sheath was carried out in 39 patients.The guide wire smoothly passed through the occluded segment of femoral-popliteal artery and entered the proximal true lumen in 41 patients.Subintimal arterial flossing with antegrade-retregrade intervention (SAFARI) technique was adopted to establish guide wire working track in 5 patients.On the third postoperative day,the ankle brachial index (ABI) was (0.71±0.12),which was significantly different from preoperative (0.33±0.11),and the difference was statistically significant (t=12.483,P＜0.001).The overall incidence of operation-related complications was 23.9％ (11/46),the incidence of distal arterial puncture-related complications was 4.3％ (2/46).No death occurred in perioperative period.Forty-three patients (93.5％) were followed up for 3-24 months.CTA reexamination performed at 3,6 and 12 months after treatment showed that the primary patency rate of the stent were 91.3％ (4/46),78.3％ (10/46) and 58.7％(19/46) respectively,and the one-year limb salvage rate was 95.7％ (44/46).Conclusion For the treatment of long segment occlusion of femoral-popliteal artery,endovascular management by using retrograde puncture path is technically simple and clinically safe and effective,this technique has certain clinical application value.
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Objective To investigate the application of purse string suture and the end-to-side invagination pancreaticojejunostomy in pancreaticoduodenectomy (PD).Methods Clinical data of 175 cases who were admitted in Cangzhou Central Hospital and underwent pancreaticoduodenectomy because of malignant tumor from December 2012 to December 2016 were retrospectively analyzed.According to the texture of pancreas in the operation,the patients were divided into 2 groups.Purse string suture and the end-to-side invagination pancreaticojejunostomy was performed in study group.Duct-to-mucosa pancreaticojejunostomy was conducted in control group.The operation time,the time of pancreaticojejunostomy,the amount of intraoperative bleeding,the incidence of postoperative pancreatic fistula,postoperative recovery time of gastrointestinal function,the average length of hospital stay and the like were comparative analyzed between the two groups.Results There was no significant difference on gender,age,primary diagnosis,preoperative total serum bilirubin,alanine aminotransferase and serum albumin levels between the two groups.The pancreatic texture of the study group was softer than that of the control group,the pancreatic duct diameter in the study group was significantly smaller than that in the control group [(2.0 ± 0.9) mm vs (3.4 ± 1.3) mm],the time of pancreaticojejunostomy in the study group was significantly shorter than that in the control group [(13 ± 4) min vs (17-± 7) min],the incidence of postoperative pancreatic fistula in the study group was significantly lower than that in the control group(5.88％ vs 15.56％),and the differences were statistically significant (all P ＜0.05).There was no significant difference on mean operative time,mean blood loss,postoperative gastrointestinal recovery time and average hospital stay between the two groups.1 cases with postoperative abdominal bleeding occurred in the study group,and the bleeding was successfully stopped by secondary surgery.Conclusions Purse string suture and the end-to-side invagination pancreaticojejunostomy was simple,safe and effective,which had a advantage of reducing the time of pancreaticojejunostomy and the incidence of postoperative pancreatic fistula.
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Objective To investigate the surgical methods and techniques of total laparoscopic resection of primary extraperitoneal pelvic benign neoplasms.Methods The clinical data of 32 patients undergoing laparoscopic resection for primary extraperitoneal pelvic benign neoplasms in Cangzhou Central Hospital from March 2011 to June 2016 were retrospectively analyzed.Results All cases were successfully operated under total laparoscopic resection.The operation time was 95-240 min,with an average of(152 ± 37) min,the amount of blood loss was 30-100 ml,the average was (56 ± 14) ml.Postoperative pathological examination confirmed mature teratoma in 14 cases,lipoma in 6 cases,epidermoid cyst in 7 cases,dermoid cyst in 5 cases.Patients were discharged from hospital 5 to 8 days after surgery,with an average of (6.5 ± 0.7) days.All patients were followed up for 2 to 36 months with no tumor recurrence.Conclusion Laparoscopic surgery is a safe and effective method for primary extraperitoneal pelvic benign neoplasms.
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Objective To investigate the causes and prevention measures for patients with portal hypertension hypersplenism undergone splenectomy plus pericardial devascularization and post-operative portal vein thrombosis (portal vein thrombogenesis,PVT).Methods 178 cases of splenectomy plus devascularization from July 2013 to May 1994 in Cangzhou Central Hospital of Hebei Province,including 102 cases of early postoperative application of low molecular heparin anticoagulant for the prevention group,76 cases without anticoagulant medicine as control group.33 cases with PVT found by B ultrasound or CT scan,were treated with urokinase body intravenous thrombolysis,hepatic artery catheterization thrombolysis,intestinal resection of + Fogarty catheter embolectomy vein stump treatment respectively.Results The total incidence of thrombosis was 18.5％ (33/178),prevention group was 8.8％ (9/102),including 7 cases in grade Ⅰ,Ⅲ,Ⅳ thrombus,in 1 cases,no intestine necrosis.The control group thrombosis rate was 31.6％ (24/76),including 7 cases in grade Ⅰ,Ⅲ,Ⅳ,thrombosis in 17 cases,5 cases of intestine necrosis,two groups of thrombosis rate were significantly differences (x2 =14.932,P =0.000).Thrombus disappeared completely in 7 cases,the thrombus grading decreased in 2 cases in the preventive group after thrombolysis,and thrombus disappeared completely in 6 cases,11 cases of thrombosis degraded in the control group after treatment of thrombolysis,1 case cured by TIPS with thrombolysis and thrombectomy,1 case died of sudden digestive tract bleeding,Among 5 cases of intestinal necrosis,4 cases died and 1 case undergone abdominal exploration being found with intestine & colon necrosis.Conclusions There are a variety of factors causing PVT after splenectomy and devascularization.Early anticoagulation can significantly reduce the incidence of PVT,early discovery and treatment can prevent severe outcome.
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Objective To explore the effect of early anticoagulation therapy on the blood coagulation in patients undergoing splenectomy plus devascularization.Methods Clinical data of 106 patients in Cangzhou Central Hospital from June 2000 to December 2012 were reviewed.Beginning 24 h after surgery,low molecular dextran 500 ml + ligustrazine 160 mg,once a day for 1 week,and after 48 h low molecular heparin calcium at 4 250 U to 4 500 U was given every 12 h for 7 to 14 d.Blood coagulation was tested on day 3,5,7,10 and 14,ultrasound 1-2 times a week was taken for detection of portal venous thrombosis.Results The incidence of portal thrombosis was 7.5％ (8/106).APTT prolonged during 7-14 d.Prothrombin time (PT),thrombin time (TT) and fibrinogen (FIB) decreased,but all the changes were not statistically significant when compared with the normal values(P ＞0.05).Anticoagulant treatment did not cause bleeding complications in this series.Conclusions Postoperative application of low molecular heparin calcium anticoagulant therapy is effective in the prevention of portal thrombosis and safe in terms of coagulation when started early in patients undergoing splenectomy.
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Objective To investigate the feasibility of establishing a digital model of juxtahepatic vena cava.Methods The clinical data of 120 participants (without liver diseases) who were admitted to the Cangzhou Central Hospital from January 2013 to May 2013 were collected.The results of computed tomography were analyzed.The diameters of juxtahepatic vena cava on different levels (P1 plane:inferior vena cava at the entrance to the right atrium,P2 plane:the upper margin of the roots of hepatic veins,P4 plane:lower boundary of liver,P5 plane:confluence of renal veins and inferior vena cava),and the circumference of the inferior vena cava and the lengths between these levels were recorded.A digital model of juxtahepatic vena cava was established by these data on the premise that the juxtahepatic vena cava was engorged.All data were analyzed using the analysis of variance,paired sample t test and independent samples t test,and correlation and regression were used in analysis of relations between there data.Results Data of the P1 plane and P2 plane were both missed in 3 cases,and the data of the P4 plane was missed in 8 cases.The theoretical diameter of hepatic vena cava at the P1,P2 and P4 planes were (28.1 ± 4.0) mm,(28.7 ± 3.5) mm and (23.5 ± 2.7) mm,respectively.The median diameter of hepatic vena cava at the P5 plane was 24.3 mm.The juxtahepatic vena cava was a 3 dimensional structure of cylinder with a slightly protruding middle part.There were significant differences in P1D-P2D,P2D-P4D,P1D-P4D (F =77.5,P ＜ 0.05).There were significant differences between P2D-P4D and P1D-P4D (t =14.893,11.210,P ＜ 0.05).The median length of hepatic vena cava between P1 and P2 planes was 7.5 mm.The lengths of hepatic vena cava between P1 and P4 planes,P2 and P4 planes were (85.2 ± 11.0)mm and (78.2 ±9.8)mm,respectively.The median length of hepatic vena cava between the P4 and P5 planes was 10.0 mm.P1D-P2D,P2D-P4D,P2D-P5D and P4D-P5D were positively correlated (r =0.862,0.308,0.186,0.788,P ＜ 0.05),while P1D-P4D and P2D-P5D did not correlated (r =0.180,0.118,P ＞0.05).P2D was correlated with the body weight,and P5 D was correlated with the age (r =0.200,0.130,P ＜ 0.05).The P1 D,P2D,P4D and P5 D of the inferior vena cava were (28.5 ± 3.7) mm,(29.0 ± 3.4) mm,(23.9 ± 2.8) mm and (24.3 ± 2.6) mm in males,and (27.8 ±4.2) mm,(28.5 ± 3.6) mm,(23.1 ± 2.5) mm and 24.0 mm in females.There were no significant difference in P1D,P2D,P4D and P5D between males and females (t =0.911,0.809,1.588,1.902,P ＞ 0.05).The length between P1 and P2 planes was negatively correlated with P1D and P2D (r =-0.245,-0.160,P ＜ 0.05),while the length between P4 and P5 planes was positively correlated with P1D (r =0.149,P ＜ 0.05).The length between P2 and P4 planes was positively correlated with P2D (r =0.195,P ＜ 0.05).The length between P1 and P2 planes did not correlated with the age,height and body weight (r =-0.092,-0.047,-0.033,P ＞ 0.05).The lengths between P2 and P4 planes,P1 and P4 planes were negatively correlated with the age (r =-0.343,-0.371,P ＜ 0.05),but positively correlated with the body weight (r =0.271,0.208,P ＜ 0.05).The length between P4 and P5 planes was positively correlated with the height and body weight (r =0.154,0.255,P ＜ 0.05).There were no significant difference in the lengths between P1 and P2 planes,P1 and P4 planes,P2 and P4 planes,P4 and P5 planes between males and females (t =-1.046,-1.274,-0.908,1.375,P ＞ O.05).The length between P2 and P4 planes was similar to the length of retrohepatic vena cava.The length between P2 and P4 planes(mm) =71.23-0.293 × age (years) +0.32 × body weight (kilogram).Conclusion The establishment of digital model of juxtahepatic vena cava based on the computed tomography imaging data is feasible,which provides basis for clinical investigation.
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Objective To discuss the manifestations,diagnosis and management of acute superior mesenteric artery embolism.Methods The clinical data of 22 cases of acute superior mesenteric artery embolism(admitted) in our hospital in recent 10 years were analyzed retrospectively.Results The preoperative diagnostic rate was 77.3%.Among them,2 cases who refused operation died(100%);20 cases were subjected to operation,in whom 5 cases underwent simple resection of necrotic bowel and 3 of them died(60%),while 15 cases were subjected to resection of necrotic bowel after removal of the embolus and 5 of them died((33.3)%).The overall mortality was rate 45.5%.Conclusions Acute superior mesenteric artery embolism should be suspected in every patient with sudden abdominal pain,especially in those who have organic cardiac disease.CTA is an effective method for diagnosis of acute superior mesenteric embolism.Early diagnosis and prompt embolectomy are the key points to improve the therapeutic effects.