Right hepatic arterial pseudoaneurysm with hemobilia following minilaparotomy cholecystectomy: a rare complication

Hepatic arterial pseudoaneurysm with hemobilia occurs less frequently as a complication of minilaparotomy cholecystectomy than laparoscopic cholecystectomy; however, given its severe nature, it needs to be managed promptly. This report presents a case of right hepatic artery pseudoaneurysm with hemobilia in a 36-year-old woman who underwent minilaparotomy cholecystectomy 5 weeks earlier. Angiography with embolization was carried out as definitive treatment

Expression of CK20 mRNA in the peripheral blood around postoperative chemotherapy in patients with gastric cancer and its clinical significance / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate whether CK20 mRNA expression level could be considered as an effective molecular indicator for evaluation of chemotherapy sensitivity.</p><p><b>METHODS</b>All samples of peripheral blood were taken from 31 gastric cancer patients undergone radical operation a week before postoperative chemotherapy, at the first day of chemotherapy point, and after the first cycle of chemotherapy respectively, and subjected to FQ RT-PCR assay for CK20 mRNA. The chemotherapy scheme was FOLFOX 4. The control group was 15 healthy volunteers.</p><p><b>RESULTS</b>Aomng the 31 gastric cancer patients, the value of CK20 mRNA before postoperative chemotherapy was increased (2.96+/-2.27 vs 2.22+/-2.12, t=2.10, P<0.05) in 25 positive cases, and then declined after chemotherapy(2.05+/-1.86 vs 2.96+/-2.27, t=2.50, P<0.05) in 24 positive cases. The expression level of CK20 mRNA in patients before chemotherapy was increased in 16 cases(51.6%), declined in 9 cases(29.0%) and stabilized as negative in 6 cases(19.4%). After chemotherapy the level of CK20 mRNA was increased in 7 cases(22.6%), declined in 17 cases (54.8%) and stabilized as negative in 7 cases(22.6%), there was significant difference between the two groups(chi(2)=6.06, P<0.05).</p><p><b>CONCLUSIONS</b>The expression level of CK20 mRNA in the peripheral blood detected by FQ RT-PCR in patients with gastric cancer declines after postoperative adjuvant chemotherapy. Different individuals have different sensitivity to chemotherapeutics. Dynamic monitoring CK20 mRNA should be considered as an effective index to evaluate the efficacy of postoperative adjuvant chemotherapy.</p>

Wound healing after pancreaticojejunostomy in piglets: a comparison between two anastomotic methods / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate wound healing after types of pancreaticojejunostomy.</p><p><b>METHODS</b>After resection of the pancreatic head, 38 domestic piglets were divided into two groups according to the types of anastomoses: group I: binding pancreaticojejunostomy, a new technique designed and advocated by professor Peng Shuyou; group II: end-to-end pancreaticojejunal invagination. Anastomotic strength in vivo and histopathological findings were assessed on operative day and postoperative day 5 and 10.</p><p><b>RESULTS</b>Bursting pressure was 139.7 +/- 8.0, 178.7 +/- 9.7 and 268.8 +/- 12.8 mm Hg in group I on day 0, 5 and 10, whereas 67.3 +/- 7.9, 96.2 +/- 10.4 and 130.6 +/- 9.3 mm Hg in group II. The gain on day 0 to 5 and 5 to 10 was 27.9% and 50.5% in group I and 42.9% and 35.7% in group II, respectively. A significant difference was observed between group I and group II, and between 5 and 10 day after anastomoses (P < 0.01). Breaking strength was 4.5 +/- 0.4, 6.6 +/- 0.4 and 10.0 +/- 0.6 N in group I on day 0, 5 and 10 and 4.6 +/- 0.6, 5.8 +/- 0.5 and 7.1 +/- 0.6 N in group II. Although a similar value was shown in both types of anastomoses on day 0, a rapider gain was demonstrated on day 0 to 5 and 5 to 10 in group I (44.8% and 52.9%) than in group II (25.4% and 22.0%). A significant difference was found on day 5 and 10 between the two types of anastomoses (P < 0.05 and P < 0.01). Anastomotic site was well repaired by connective tissue and the cut surface of pancreatic stump was covered by mucosal epithelium in group I on day 10, but the cut surface was incompletely repaired by granulation tissue and no, regeneration of the epithelium was found in group II.</p><p><b>CONCLUSION</b>Anastomotic strength of binding pancreaticojejunostomy was stronger than end-to-end pancreaticojejunal invagination and the healing was better and rapid.</p>