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Objective To study the safety and feasibility of endobiliary intraductal radiofrequency ablation (RFA) to reopen occluded self-expandable metal stents in patients with malignant biliary obstruction.Methods 11 patients with malignant biliary obstruction and blocked metal stents were prospectively studied.During ERCP, after biliary cannulation, the blocked metal stents underwent RFA using a bipolar radiofrequency probe which was introduced into the stenotic bile duct via a guide wire.This was followed by a balloon to repeatedly remove debris and then endoscopic nasobiliary drainage.The patients were closely observed and followed up.Results RFA was successfully carried out in all the patients and patencies were achieved when compared with pre-RFA.The median post-RFA luminal diameter of the strictures showed significant improvement: 6 (4 ～ 10) mm versus 2 (0 ～ 5) mm, and the mean post-RFA total bilirubin level decreased sharply : (39.4 ± 8.7) μ mol/L versus (130.1 ± 38.2) μmol/L.Following this intervention, 3 patients developed fever, which were controlled with conservative therapy.There was no mortality, haemorrhage, bile duct perforation or bile leak.Of the 11 patients, 3 were dead and 6 were alive at a median follow-up of 187 (75 ～ 304) days.The median stent patency was 135 (75 ～ 203) days and the median survival was 278 (75 ～ 304) days.Four patients had their stents patent at the time of the last follow-up or death.Seven patients had their stents blocked on 113, 124, 154, 203, 96, 135 and 112 days post-procedure.Condusions Endobiliary intraductal RFA is technically feasible and safe to reopen occluded metal stents in malignant biliary obstruction.This efficacy needs to be confirmed by future randomized studies.
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The dialysis for three species of poplar stems apoplast was obtained by microdialysis method, and then the concentration of Na+, K+, Ca2+ in the dialysis sample was directly measured by graphite furnace atomic absorption spectrometry ( GF-AAS) . The flow rate of perfusate was 1μL/min and the cut-off molecular weight of probe was 30 kDa. The real-time and non-destructive test technique established for the detection of ion concentration could be applied in research of poplar biochemical physiology. The recovery of the proposed method was 95. 8%-103. 1%. The contents of sodium ion in Populus wutunensis, Populus simonii and Salix matsudana were 1034-1156 μg/L, 1493-1611 μg/L and 1586-1703 μg/L; potassium ion were 1012-1237 μg/L, 941-964 μg/L and 1095-1201 μg/L; calcium ion were 4976-5237 μg/L, 4786-5042 μg/L and 5893-6142 μg/L. The method could provide reliable data for the study of ion concentration changes of plant response to adapt to all kinds of external environment.
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Objective: To increase the success rate of endoscopic and laparoscopic surgery live broadcast by careful design and well-organized implementation in large medical meetings. Methods: A retrospective analysis of the experience of endoscopic and laparoscopic surgery live broadcast, including digestive, gynecologic, urologic and general surgical operations, from fifteen large-scale national and international conferences in our hospital from January 2006 to December 2012. After communicated with doctors and fully understood patient illness, we analyzed the characteristics, requirements and the forms of the meetings while making emergency measures for the live broadcast, then careful designed procedure for the meeting and next well-organized implementation of our plans. Results: All the endoscopic and laparoscopic surgery live broadcasts were successful. The audio and visual transmission system worked well during the meetings. There was no image interruption occurred in the live broadcast. Conclusion:Careful laparoscopic surgery live broadcast, which is a good method for endoscopic and laparoscopic surgery technique. Our experience of endoscopic and laparoscopic surgery live broadcast it has development application value.
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Objective To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients over 80 years old with biliary-pancreatic diseases. Methods One hundred and twenty patients over 80 years old who underwent ERCP between January 2004 and April 2008 were retrospectively analyzed. The clinical efficacy, safety and complication were observed and followed up. Results One hundred and seventeen patients successfully underwent therapeutic ERCP and the success rate was 97.5%. All diseases of the patients included cholangiocarcinoma in 22 cases, duodenal papilla carcinoma in 3 cases, pancreatic carcinoma in 8 cases, acute pancreatitis in 15 cases, chronic pancreatitis in 5 cases, acute suppurative cholangitis in 9 cases and choledocholithiasis in 58 cases. During the procedure of ERCP, 3 cases failed to insert the duodenoscope, 3 cases were found hemobilia and 2 cases were found acute pancreatitis. Conclusions Therapeutic ERCP is effective and safe in elderly patients over 80 years. Age is not the contraindication of therapeutic ERCP.
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Objective To study on the value and safety of early endoscopic retrograde cholangiopan-creatography (ERCP)and endoscopic sphincterotomy (EST) in acute biliary pancreatitis. Methods Ninety-two patients with acute biliary pancreatitis underwent early ERCP (within 72 hours) and received endoscopic therapy (ERCP group). Another 40 patients with acute biliary pancreatitis were treated conservatively without ERCP (control group). The disappearance of abdominal pain, decrease of serum amylase level, the mean days and costs of hospitalization and complications were observed in all patients. Results In ERCP group, all patients were performed EST, stones in 72 choledocholithiasis patients had been removed with net-basket or air pocket. Ten cases of severe acute biliary pancreatitis received endoscopic pancreatic duct stents drainage. Ninety two cases of acute biliary pancreatitis received endoscopic nasal catheter bile drainage. The days of the disappearance of abdominal pain, the decrease of serum amylase levels, the cost of the hospitalization and the days of the hospitalization were significantly shorter in the early ERCP group than in the control group. The mortalities in ERCP and control group were 8. 3% and 33. 3% respectively. Conclusion Early ERCP endoscopic therapy is a safe procedure has the superiorities in lowering the mortality, hospital days and expense.