Analysis of clinical diagnosis,surgical management and prognosis in primary malignant tumor of the duo-denum / 实用医学杂志

Objective To evaluate the diagnosis,surgical treatment and prognosis of primary malignant tumor of the duodenum. Methods The clinical data of 118 cases with primary malignant tumor of the duodenum were collected and analyzed retrospectively during January 2005 to December 2015. Results Tumors located in the first,second,third and fourth parts in 7 cases,92 cases,12 cases,and 7 cases individually.The correct di-agnosis rate of endoscopy,duodenography,abdominal enhanced CT and ultrasound was 83.02%,79.42%,47.46% and 29.41% separately.Eighty cases underwent pancreaticoduodenectomy,18 cases received segmental duodenectom and 20 cases received bypass operation. Conclusions Tumors located in papillary region account for the majority of primary malignant tumors of the duodenum and are mainly of adenocarcinoma.Duodenography and endoscopy are the major methods for diagnosis of primary malignant tumor of the duodenum.Pancreaticoduodeneetomy is the first choice of therapy for primary malignant tumor in the duodenum.

Clinical diagnosis, surgical management and prognostic factors of patients with primary duodenal carcinoma / 中华肝胆外科杂志

Objective To study the diagnosis,surgical treatment and prognosis of patients with primary duodenal carcinoma.Methods The clinical data of 56 patients with primary duodenal carcinoma treated between 2008 to 2015 were retrospectively analyzed.Results The number of patients with tumors located in the first,second,third and fourth parts of duodenum were 3,44,6,and 3 patients respectively.Tumors which were within the papillary region accounted for 71.4％ (40 patients).Twenty-two patients (22/56,39.3％) had well differentiated adenocarcinoma,16 patients (16/56,28.6％) had moderately differentiated adenocarcinoma and 6 patients (7/56,10.7％) had undifferentiated carcinoma.The clinical manifestations were not specific,which included abdominal pain,abdominal distention,jaundice,bowel obstruction or bleeding.The correct rates of diagnosis made by endoscopy,duodenography,ultrasound and CT were 84.0％,81.3％,30.4％ and 48.2％ respectively.Forty patients underwent pancreaticoduodenectomy,5 segmental duodenectomy,9 bypass operation,and 3 subtotal gastrectomy and duodenal bulb tumor resection.The 1-,3-,and 5-year survival rates of all the patients were 82.6％,56.7％ and 30.1％ respectively.The-1,3-,and 5-year survival rates of the patients who underwent pancreaticoduodenectomy and segmental duodenectomy were 100％,68.8％,42.2％ and 100％,61.8％,0 respectively.All the patients who underwent palliative resection died 6 to 24 months after surgery.Univariate analysis revealed the operation types.,depth of tumor invasion,lymphatic invasion,and tumor differentiation correlated with prognosis.Multivariate analysis showed only the operative types,depth of tumor invasion and lymphatic invasion to be independent prognostic factors.Conclusions Tumors located in the papillary region accounted for the majority of primary malignant tumors of the duodenum and they were mainly adenocarcinomas.Duodenography and endoscopy were the major methods used in the diagnosis of primary duodenal carcinoma.Pancreaticoduodeneetomy was the best therapy for primary duodenal carcinoma.

Clinical study of the interventional therapy in Budd-Chiari syndrome / 中国综合临床

Objective To evaluate the interventional therapy in Budd-Chiari syndrome (BCS). Methods 12 cases with BCS were treated with balloon dilatation angioplasty and placement of stent. The pathologic types were composed of complete occlusion of inferior vena eava(IVC) (9 cases) and IVC stenosis (3 cases). Results Sue-eess was achieved in 12 cases. IVC eavepressure was(4.56±1.51 )kPa before interventional therapy,and (2.51± 0.77 ) kPa after stent implantation. The symptoms disappeared or markedly improved postoperatively. Complications of hepatic venous occlusion occurred in 1 ease after IVC stent 8 months later,and the symptoms relieved after meso-RA shunt. Conclusion The interventional therapy for BCS is very effective and safe to appropriate patient.

Treatment of primary hepatic cancer with portal venous tumor thrombosis / 中国普通外科杂志

Objective To investigate an effective method of treating primary hepatic cancer(PHC) with portal venous tumor thrombosis (PVTT). Methods The clinical data Of 23 patients with PHC and PVTT were retrospectivly analysed. Results Of the 23 patieats after hepatoma resection and PVTT extraction, continuous micro dose infusion chemotherapy or perfusion chemotherapy by DDS was adopted. In 8 patients with main portal vein tumor thrombus, 2 died, 4 recured in 6 months. In 8 patients with the first class branch of portal vein tumor thrombus, 2 recurrd in 6 months and 6 recurred in 12 months. In 4 patients with secondary class branch of portal vein tumor thrombus, l recurred in 12 months (P

Clinical study on hepatic segmentectomy under segmental staining and intraoperative chemoembolization for primary liver cancer / 中国普通外科杂志

Objective To explore the clinical efficacy of hepatic segmentectomy under segmental staining and intraoperative chemoembolization for primary liver cancer(PLC).Methods Twenty cases of liver cancer underwent hepatic segmentectomy under segmental staining and intraoperative chemoembolization(observed group),the results were compared with 22 cases of PLC after treated by routine hepatectomy(control group).AFP,CT and MRI were regularly used after hepatectomy to evaluate the outcome.Results In observed group,the operative blood loss was(295?105)mL,blood transfusion was(280?85)mL,liver function levels were in the normal range accounted for 15%(3/20) one week postoperatively,the incidence of postoperative complications was 40%(8/20),the postoperative 3-year survival rate was 60%,and the postoperative local recurrence rate was 35%;while in the control group,these parameters were(490?140)mL,(370?105)mL,40.9%(9/22),45.5%(10/22),40.91% and 68.18% respectively.In observed group,the operative blood loss,blood transfusion,cases with liver function levels in the normal range,the incidence of postoperative complications,postoperative 3-year survival rate,and postoperative local recurrence rate were significantly lower than those in the control group(P0.05).Conclusions The hepatic segmentectomy under segmental staining and intraoperative chemoembolization for PLC may reduce postoperative complications,lower postoperative relapse rate and improve survival rate.