Development of bile duct cancer as a long-term complication of biliary-enteric anastomosis for benign diseases: a report of five patients / 中华肝胆外科杂志

Objective To study the association, clinical presentation, and diagnosis and treatment of bile duct cancer as a late complication of biliary-enteric anastomoses for benign diseases. Methods A retrospective study was carried out on 5 patients and the medical literature was reviewed. Results They were 3 males and 2 females. The average age was ( 66. 0 ± 0. 7 ) years. The average time period was ( 14. 0 ± 6. 1 ) years after biliary-enteric anastomosis. The clinical presentations included right upper quadrant pain, fever, chills and jaundice. CA19-9, CT and MRI were valuable in diagnosis. There were two patients with distal and three patients with perihilar cholangiocarcinomas (type IIIa, n=2, and type IV, n=1). Local resection with lymphadenectomy was carried out in one patient. Another patient underwent pancreaticoduodenectomy. The remaining three patients only underwent percutaneous transhepatic cholangial drainage ( PTCD). The 2 patients who underwent surgery died of progressive tumor disease at 8 and 13 months postoperatively. The other three patients who underwent palliative biliary drainage died within 6 months of PTCD. There was no significant difference between the two types of treatment ( P ＞0. 05). Conclusions Chronic cholangitis caused by reflux and bacterial infection was properly a predisposing factor leading to late development of bile duct cancer after biliary-enteric anastomosis for benign diseases. Patients treated with biliary-enteric anastomosis should be closely monitored for late development of cholangiocarcinoma. Some procedures such as choledochoduodenostomy and jejunum interposition choledochoduodenostomy should be abandoned because of their poor outcomes and severe complications. Proper indications of biliary-enteric anastomosis should strictly be followed and the Oddi's sphincter should be protected if possible to prevent late development of bile duct cancer.

Application of ERP in Management of Medical Consumable Material / 医疗卫生装备

ERP system is introduced. Combined with the deficiencies of management of medical consumable materials in supply chain and high-value materials, the application of ERP to workflow, fundamental material, operation and high-value material management are explored. It indicates that although with some deficiencies, this ERP system optimizes business process and then improves work efficiency of management of medical consumable materials greatly.

Discussion about brachytherapy with tumour interventional radiology technology / 医疗卫生装备

This paper discusses the brachytherapy with tumour interventional radiology technology.The structure and security of the intravascular iridium-192 sources afterloader are reviewed in comparison with general afterloader.