ABSTRACT
Objective To summarize the clinical experience of three different treatments for gallbladder and common bile duct stones.Methods The clinical data of 180 cases of gallbladder stones combined with bile duct stones undergoing surgery from May 2010 to May 2013 were retrospectively analyzed.They were divided into three groups,A group of 60 patients underwent a period of endoscopic sphincterotomy (EST),under the second phase of laparoscopic cholecystectomy (LC);Group B 60 patients underwent laparoscopic cholecystectomy (LC) + laparoscopic common bile duct exploration surgery (LCBDE) + T tube drainage;Group C 60 patients underwent conventional open cholecystectomy (OC) + bile duct exploration (OCBDE) + T tube drainage.Results A group of 53 cases completed surgery successfully,5 cases of remaining 7 patients failured in the first phase surgery,2 cases of the 5 patients did LC + LCBDE,3 of the 5 patients underwent conventional surgery.Two patients underwent the conventional surgery in the second phase surgery.B group of 57 cases completed surgery successfully,three cases convert to open surgery.All of the group C completed the surgery successfully.Group A complication was the most in the three groups (P＜0.05);group B had the shortest time of hospitalization (P＜0.05),the complication rate was lower than that in group A (P＜0.05),the complication had no significant difference between A and B.(P and group B ＞ 0.05),group B had shortest operation time (P＜0.05);no statistically significant differences were found among three groups in fasting time.Conclusion Three treatment methods have advantages as well as disadvantages,a reasonable treatment should be selected according to the specific circumstances.
ABSTRACT
Objective To summaize the experience of application of direct digital radiography and electrohydraulic shockwave lithotripsy in treatment of residual bile duct stones.Methods A retrospective analysis of clinical records of 60 patients with residual bile duct stones treated in our hospital from 2003 to 2006 was made.Results In 59(95.9%) of 60 cases the stones were removed completely,including successful removal in one time of application of this method in 57 Patients(95.0 %),and 2 applications in 2 Patients ﹙3.3 %).One case with bile duct stone complicated with dile duct cancer was unsuccessful.The biggest stone was 3.5 cm?2.5 cm?2.0 cm.No serious complications occurred and changed to operation.The 59 cases were followed up for 6 mo to l yr,and all had a successful outcome.Conclusions The method of combination of direct digital radiography and electrohydraulic shockwave lithotripsy in treatment of postoperative residual bile duct stones after operation can facilitate removal of residual bile duct stones.The procedure is a safe way of treating residual stones.
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Objective To evaluate the therapeutic effects of gemcitabine regional artery perfusion combined with systemic chemotherapy for late-stage cancer of pancreas.Methods Thirteen cases of late-stage cancer of pancreas proven by operation and pathology were treated with 5-FU+MMC as a combined system chemotherapy, and use of gemcitabine for regional artery perfusion chemotherapy.Results Among the 13 patients who could be evaluated for therapeutic effect, four cases had partial response (PR), six cases had (SD), three cases were PD, and the effective rate of the clinical benifical-reflected evaluation was 76.9%, pain releive rate 75.0% the median survival time was 6.3 months. None of the patients have had serious toxious side-effects.Conclusions The gemcitabine regional artery perfusion combined with systemic chemotherapy can relieve the cancer pain of patients with late-stage cancer of pancreas, improve their general condition, increase the survival quality of life, prolong the survival time. The drug tolerance of the patients is good.