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Objective To investigate the efficacy of laparoscopic cholecystectomy(LC)for patients with acute cholecystitis.Methods From May 2003 to November 2007,238 patients with acute cholecystitis underwent LC in our hospital.Four trocars were used in the operation.During the procedure,intraperitoneal pressure was controlled at 11 to 13 mm Hg(10 mm Hg for elderly patients).Retrograde cholecystectomy was performed on the patients with difficult anatomy caused by edema of the cystic triangle.For cases with calculi incarcerated in the cystic duct,the LC was performed after the stones were removed into the cyst(cholangiography was performed to exclude bile duct calculi).Results Of the 238 cases,LC was completed successfully in 220 patients,the other 18 cases were converted into open surgery because of massive hemorrhage and difficult anatomy(12 cases)or bile duct calculi(6 cases).After the LC,two patients received a second surgery because of postoperative hemorrhage;six patients developed bile leakage(occurred at 2-4 days after the LC with 50-80 ml of drainage)and were cured by conservative therapy including fasting,intravenous nutrition and anti-biotic therapy.This series were followed up for 1 to 12 months(mean,6 months).No post-operative complications were noticed during the period.Conclusions LC is a safe and effective for patients with acute cholecystitis or acute episode of chronic cholecystitis.Controlling the operation opportunity properly and dissecting the Calot's triangle area carefully to expose the cystic duct are the key steps during the operation.Convertion to open surgery is necessary in some difficult situations.
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Objective To evaluate the approaches of percutaneous trans-hepatic stent for relieving malignant biliary obstruction and its clinical effect. Methods 20 stents were set up in bile duct to treat malignant biliary obstruction in 18 cases using two steps under x-ray fluoroscopy. After the stents set up successfully, the contrast agent was injected through the long sheath in order to find out the expansion and expedition of the stent. The stents were provided by Micro-Tech co.1td.(Nanjing). The patient’s jaundice, liver function and amylase (AMY)levels were observed after the procedure and all the patients were followed up for three to eleven months. Results Twenty stents were placed in 18 patients successfully in one time.STB , ALT, AST, r-GT and ALP decreased 66.27%, 57.83%, 62.21%, 44.74% and 47.57% respectively one week after the procedure. Early complications included hyperamylasemia , acute pancreatitis,hernobilia, bile leakage,ect.Late complications were displacement and restenosis of the stent . A patient died due to failure of heart and lung. Conclusion The percutaneous transhepatic insertion of biliary stent is an effective method in relieving malignant obstructive jaundice.
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Objective To know the pollution of microcystin(MC) in Yanghe reservoir during the period of water blooms in the summer of 2007 and to find the variation characteristics about the pollution.Methods The microcystin concentration was determined by ELISA Kit.A 49 consecutive days monitoring was conducted during Jul.-Aug.,2007.Results The concentration of MC in Yanghe reservoir ranged from 0.13 ?g/L to 0.93 ?g/L,and its average level was(0.26 ?0.13)?g/L.As well as,the concentration of MC in Yanghe reservoir descended fluctuant.Conclusion Water in Yanghe reservoir was polluted by MC.All monitoring results of MC concentration during seven weeks(49 days) did not exceed the limit value of microcystin toxin,1 ?g/L for MC-LR,the grade two water ruled in China Environmental Quality Standard for Surface Water.The basic data for changing regularity of MC studied in the present paper will be useful for the warning of alga pollution.