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Objective To explore the diagnostic and treatment method of inflammatory bowel obstruction after surgery.Methods The clinical data of 35 patinets with inflammatory bowel obstruction after surgery were retrospectively analyzed.Results Through the conservative treatment,28 cases were cured,accounting for 80.0％,and 4cases were markedly effective,accounting for 11.4％,and 3 cases were effective,accounting for 8.6％,and total effective rate was 100.0％ ;The anal exhaust time was(3.1 ± 0.8)d,and the average defecation time was(3.3 ±0.8)d,and the bowel sounds return time was(2.4 ± 0.5 ) d,and the average completion time of disappearance of symptomswas ( 5.6 ± 0.8 ) d,and the time body temperature returned to normal was (3.0 ± 0.5 ) d,and the mean treatment time was (9.4 ± 1.2)d.Conclusion The treatment of postoperative intestinal obstruction should be used with caution in surgical treatment,and non-surgical conservative treatment was safe and feasible and effective.
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BACKGROUND: Because of the specificity and complexity of hepatic portal, carcinoma of bile duct of the hepatic portal is a difficulty in the surgical treatment. OBJECTIVE: To evaluate the safety and feasibility of simultaneous pancreaticoduodenectomy and liver transplantation for the end-stage hilar cholangiocarcinoma. RESULTS AND CONCLUSION: Pathology demonstrated a middle or low differentiation of hilar cholangiocarcinoma, and left, right hepatic duct, together with lobus quadratus were invaded. The tumor metastasized to hilar and posterior pancreatic lymphonodes, without involving the head of pancreas, duodenum and stomach. The function of transplanted liver recovered smoothly, and the endocrine and exocrine functions of pancreas were kept well. CA19-9 dropped to the normal levels. The patient recovered and discharged at 1 month after surgery, and still survived after one year follow up. These suggest that simultaneous pancreaticoduodenectomy and liver transplantation as a treatment of hilar cholangiocarcinoma are safe and feasible.
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Objective To explore the value of Artis zeego robot imaging system endoscopic retrograde cholangiopancreatography (ERCP) for biliary calculi. Methods ERCP was performed on 12 patients with biliary tract dilation, diagnosed by B ultrasonography. Artis zeego robot was used simultaneously to acquire 3D images and biliary system reconstruction. The diagnostic consistency was assessed based on endoscopy and surgery if necessary. Results 3D rotating acquisition and biliary reconstruction were performed in the 12 patients. All diagnosis coincided with those of surgery and ERCP findings, achieving a consistency rate of 100%. Patients with extrahepatic bile duct stones of uncertain number (n = 2), with suspected biliary duct calculi ( n = 1 ) and with suspected intrahepatic bile duct stones ( n = 2) under ERCP were all diagnosed by the robot imaging system. Conclusion During ERCP, 3D rotating image acquisition and biliary reconstruction with Artis zeego robot is helpful for precise diagnosis of biliary tract stones.
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Objective To investigate the relationship between inducible nitric oxide synthase(iNOS)mRNA expression of pancreatic tissues and intestinal permeability,and the effect of salviae miltiorrhizae on the change in gut permeability in rats with severe acute pancreatitis(SAP).Methods All rats were randomly divided into three groups:Sham operation(group C,n=15),SAP group(group SAP,n=15),and salviae miltiorrhizae therapeutic group(group T,n=15).At 24h After operation,the iNOSmRNA expressions of pancreas were determined by in situ hybridization(ISH),and blood amylase(AMY),nitric oxide(NO) and lipopolysaccharide(LPS) were examined.The histopathologic changes of pancreas and ileum were observed.Intestinal permeability was measured by means of albumin clearance(AC)of 125I-labeled rat serum albumin.Results The iNOSmRNA expressions of pancreas in group SAP were markedly increased in comparison with group T(P