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Objective To evaluate the effect of hepatic vein occlusion and stent replacement in treatment for Budd-Chiari syndrome(BCS).Methods Forty three patients with BCS were underwent percutanous puncture,radiography,transjugular angioplasty,balloon dilation and stent placement for hepatic vein under Doppller ultrasounographic guidance from July 2001 to September 2006. Results Technical success was 100%with no complications.The medium vein pressure was reduced from 32.5 tO 20 cm H2O(1 cm H2O-0.098 kPa)after stents replacement(P＜0.01).The hepatic vein angioplasty revealed that all stents were patent and branches were disappeared.The symptoms in 38 patients were disappeared immediately,and improved in 5 patients.All patients were followed up of 32 months(ranged 1-62).Except one patient died of severe gastric bleeding,the 42 patients were survived with symptoms free.Conclusion Hepatic vein occlusion and stent replacement are safe and effective in treatment of BCS.
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Objective To observe the bacterioflora of bile and it' s drugs sensitivity in patients with bile duct diseases to serve as a guidance in medication. Methods Bile of 156 cases of patients with biliary disease was collected and cultured respectively during endoscopic retrograde cholangiopancreatography (ER-CP) by deep cannulation and sucking out bile through the catheter. Forty eight blood samples among them were cultured simultaneously. Ten kinds of drug papers were used to investigate the bacterial sensitivity. The data were analysed statistically- Results Bacteria positive rate of these 156 bile samples was 62. 8% , including Gram - negative bacteria (81.6% ) and Gram - positive bacteria (18. 4% ). These bacteria consist of Pseudomonas aeruginosa (35. 1% ) , Escherichia coli(22. 8% ) , Streptococcus faecalis (16.7%) ,Entero bacilliaerogenes(7. 9% ) ,Klebsiella(7. 0% ) , Citrobacter(6. 1% ) ,Acinetobacler lwqffi(2. 6% ) and Staphylo-coccus aureus( 1. 7% ). The bacteria positive rate was only 4. 2% in the 48 blood samples. Drug sensitive rates of bacteria against 10 kinds of drugs were changed in recent years. The result indicated that the sensitive rates of bacteria were significantly higher in ciprofloxacin, fortum, cefoperazone, sulbactam + cefoperazone and cilastatin than those in ampicillin,azlocillin, cefazolin sodium, eefuroxime(P
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Objective To report 2 cases of acute rejection following small intestin vivotransplantation and to disscuss the diagnostic significance of endoscopy and mucosal biopsy.Methods Endoscopic observation and mucosal biopsies of the graft through the terminal ileum enterostomy were carried out. Results Acute rejection was diagnosed in two patients with human small intestin vivotransplantation in good time.Endoscopic and the pathologic manifestations of the graft during acute rejection were discribed.Conclusion Endoscopy and the pathologic examination of endoscopically guided mucosal biopsy specimens are the most reliable method for diagnosing acute rejection following small intestin transplantation.
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Objective To determine the effect of therapeutic ERCP(endoscopic retrograde cholan-giopancreatography) on endoscopic drainage of pancreatic pseudocysts and patency of main pancreatic duct after dilation or placement of stent. Methods Eight patients with pancreatic pseudocyst were selected after abdominal ultrasonography and computed tomography. All patients have had be operated two times because of acute pancreatitis and /or cholangitis, and were hard to receive further operation. These patients underwent endoscopic transpapillary drainage by main pancreatic duct dilation or placement of stents after ERCP, and were follow up by abdominal ultrasonography and / or computed tomography 6 months after drainage. The stent would be pulled out after the complete disappearance of the cyst. Results Diagnostic ERCP revealed that cysts communicated with main pancreatic duct in 3 cases and obstructive jaundice was present in 1 case. All patients were managed by transpapillary main pancreatic duct dilation (3 cases) and placement of stents (5 cases). Both forms of endoscopic drainage were effective in treating pancreatic pseudocyst and in 7 cases the cysts were completely disappeared within 4 months, while the rest one required surgery as the cyst merely decreased in size. Only 2 cases the levels of amylase in serum and urine were higher than normal but no severe complications occurred. Conclusion Endoscopic transpapillary drainage through main pancreatic duct dilation or placement of stents is quietly an effective, painless and safe mode in treating pancreatic pseudo-cyst. This method may be an ideal choice for the treatment of pancreatic pseudocysts in experts.