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Objective To investigate the clinical curative effect and safety of ultrasound-guided lauromacrogol injection and ethanol injection in treating hepatic hemangiomas.Methods A total of 60 patients with hepatic hemangioma were randomly and equally divided into lauromacrogol group (n=30) and ethanol group (n=30).Ultrasound-guided lauromacrogol injection and ultrasound-guided ethanol injection were performed for the patients of lauromacrogol group and the patients of ethanol group,respectively.The clinical curative effect and the incidence of adverse reaction of the two groups were evaluated,and the results were compared between the two groups.Results No statistically significantly difference in clinical curative effect existed between the two groups (P=0.489,P＞0.05).The incidence of adverse effects in the ethanol group was significantly higher than that in the lauromacrogol group,and the difference was statistically significant (x2=5.963,P=0.03,P＜0.05).Conclusion For the treatment of hepatic hemangiomas,ultrasound-guided lauromacrogol injection carries quite the same curative effect as ultrasound-guided ethanol injection does,but lauromacrogol injection has less untoward effects and lower pain rate,besides,injection of lauromacrogol can be well tolerated by the patients.Therefore,the method of ultrasound-guided lauromacrogol injection is worthy of clinical application.
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Objective To explore the efficacy of endoscopic sphincterotomy with small incision combined with balloon dilatation (sEST+EPBD)in the treatment of patients with choledocholithiasis and juxtapapillary duodenal diverticula (JPDD).Methods From January 2011 to January 2015 ,149 patients with choledocholithiasis and JPDD who underwent endoscopic retrograde cholangio-pancreatography (ERCP)were enrolled.Among them,60 patients were in sEST+EPBD group and 89 were in endoscopic sphincterotomy (EST)group.Success rate of ERCP and first-time stone removal,changes of total bilirubin (TBil)and direct bilirubin (DBil)levels,as well as the incidence of postoperative complications between the two groups were compared.Chi-square test or t-test was performed for statistical analysis. Results The ERCP success rate sEST+EPBD group was 100.0% (60/60),and the first-time success rate of stone removal was 91 .7%(55/60);correspondingly,ERCP success rate of EST group was 98.9%(88/89),and the success rate of first-time stone removal was 77.5 %(69/89).There was no statistically significant difference in success rate of ERCP between the two groups (χ2 =0.19,P =0.410).The first-time success rate of stone removal of sEST +EPBD group was higher than that of EST group,and the difference was statistically significant (χ2 =5 .53,P =0.020).After operation,the TBil level of sEST+ EPBD group was (152.62 ±109.04 )μmol/L,which was lower than that before operation ((266.02 ± 143.31)μmol/L),and the difference was statistically significant (t =4.88,P <0.01 ).After operation, the DBil level of sEST +EPBD group was (87.13 ±65 .90)μmol/L,which was lower than that before operation ((175 .70 ± 100.53 )μmol/L),and the difference was statistically significant (t = 5 .71 ,P <0.01).After operation,the TBil level of EST group was (251 .90 ±247.90)μmol/L,which was lower than that before operation ((340.20 ±176.20 )μmol/L),and the difference was statistically significant (t=2.74,P <0.05).After operation,the DBil level of EST group was (168.10±140.60)μmol/L,which was lower than that before operation ((228.40 ±139.60 )μmol/L),and the difference was statistically significant (t = 2.87,P = 0.005).The complication rate of sEST + EPBD group after operation was 8.3%(5/60),which was lower than that of EST group (20.2%,18/89 ),and the difference was statistically significant (χ2 =3.88,P =0.049 ).Conclusion sEST+EPBD could increase the first-time success rate of stone removal in patients with choledocholithiasis and JPDD,and it is a safe and effective treatment.
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Objective To investigate the effect of ultrasound- guided percutaneous injection of lauromacrogol in treating hepatic hemangiomas. Methods During the period from June 2010 to Jan. 2013 at authors’ hospital, a total of 32 patients with hepatic hemangiomas were treated with ultrasound-guided percutaneous injection of lauromacrogol. The largest lesion was 6.0 cm × 5.6 cm in size, and the smallest lesion was 3.0 cm × 2.6 cm in size. Before and after the treatment ultrasonography, hepatic functions and measurement of tumor size were performed, and the results were evaluated. Results A total of 54 times of puncturing were carried out for the 32 patients. Three times of puncturing were made in 2 cases , two times of puncturing in 18 cases, and single time of puncturing in 12 cases. Complete cure was achieved in 25 cases (78.1%) and effective result was obtained in 7 cases, with an effective rate of 100%. After the treatment, all patients complained of different degrees of pain at hepatic region, which were relieved spontaneously. Two patients developed fever (37.5 - 38.5℃), and after physical cooling the body temperature fell to normal within two days. One patient developed mild nausea and vomiting, which disappeared after symptomatic treatment. No severe complications occurred. Conclusion Ultrasound- guided percutaneous injection of lauromacrogol is a simple, safe and effective treatment for hepatic hemangiomas. Besides, this technique has no serious complications.