ABSTRACT
Objective To evaluate the effect and safety of stone extraction via endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) in elderly cases over 90 years old with gallstones in common bile duct (CBD). Methods Retrospective clinical data analysis was performed in 37 elderly cases treated by endoscopic stone extraction via ERC and EST.Results The gallstones of 30 cases were successfully extracted with only one trying. The multiple stones of another 4 cases were not totally extracted, they underwent endoscopic naso-biliary drainage (ENBD) for 5 days, and then the stones were successfully extracted. The successful rate of stone extraction was 91.9% (34/37). Giant stones in 2 cases were minimized and extracted 6 months later with help of endoscopic retrograde biliary drainage (ERBD). In one case stone extraction failed,because of huge diverticulum. Bleeding complication during operation was observed in one case (2.7%). Duodenal perforation and acute pancreatitis were not documented in this group.Conclusions EST and ERBD are minor invasive, effective, safe and practical for stones extraction in elderly patients over 90 years old with gallstones in CBD.
ABSTRACT
Objective To evaluate the clinical value of infusing dehydrated alcohol on pancreatic pseudocyst (PPC). Methods Twenty one patients with D'Egidio type I PPC underwent CT or ultrasound (US) guided percutaneous catheter drainage, and CT or US were used to re-evaluate the efficacy of drainage. If no residual cavity was observed, the drainage tube was clamped for 3~7 d, and then the tube would be pulled out. Non-curative cases with catheter drainage for 21 days were given dehydrated alcohol 20 ml infusion. Results The curative rate by using percutaneous catheter drainage was 71.43% (15/21). Among the remaining 6 patients, the treatment was effective in 3 patients and ineffective in other 3 patients. 2 cases of non-infective mutli-antrum pancreatic pseudocyst, 1 case of infective single antrum and 3 cases of infective multi-antrum were included in the 6 non-curative cases, and all of them recovered completely 6~21 d after dehydrated alcohol infusion. No complication and recurrence were found during the 6~12 follow-up. Conclusions Percutaneous puncture and dehydrated alcohol infusion for infective or mufti-antrum pancreatic pseudocyst was effective and safe.
ABSTRACT
Objective To evaluate the role of Lugol’s s taining in detecting early esophageal cancer.Methods 2% Lugol’s solution was adopted to stain esophageal m ucosa in 111 cases with esophageal superficial lesions. And multiple biopsies we re taken for pathological study.Results Among the 111 cases with Lugol’s staining, the results in normal, light, deep and non-stained were 4, 68,11 and 28 cases respectively . Pathology result: no cases of esophageal cancer or cell dysplasia in normal an d deep stained groups, 3 cases of severe dysplasia and 1 case of canceration in light stained group, 17 cases of esophageal squamous cell carcinoma and 5 cases of severe dysplasia in un-stained group.Conclusion The cancerous and precancerous lesions are liable to occur in cases with non- and light Lugol’s staining groups. The rate of detec ting early esophageal cancer increased when Lugol’s staining and biopsy are use d in combination.