Superselective hepatic artery angiography and embolization for the treatment of massive hemobilia / 中国普通外科杂志

ObjectiveTo evaluate superselective hepatic artery angiography and embolization in the diagnosis and treatment of massive hemobilia. Methods Eight patients with massive hemobilia were admitted from March 1993 to July 2001.All underwent emergent superselective right or left hepatic artery angiography, with the diagnosis being established, and embolization of the hepatic artery branch proximal to the bleeding point. Results Two out of the 8 patients received second embolization for recurrent bleeding, and the bleeding stopped immediately after the embolization in all 8 patients. All patients were alive and without bleeding recurrence at follow up from 2 months to 7 years. Conclusion Superselective hepatic artery angiography and embolization is an effective method in the diagnosis and treatment for massive hemobilia.

Venous External Valvuloplasty in the Treatment of Moderate or Severe Primary Incompetent Deep Venous Valve of Lower Limbs / 中国医师杂志

Objective To evaluate the effectiveness of venous external valvuloplasty in treatmeant of moderate or severe incompetent deep venous valve.Methods 54 patients with moderate and severe primary incompetent deep venous valve underwent anterograde and retrograde venous angiography of lower limbs, the angiography showed that reflux degree were 2～4grade. 54 patients were divided into two groups.The first group patients(n=32) without serious injured free margin of venous valve leaves were treated by venous external valvuloplasty,the other group patients with serious injured free margin of valve leaves(n=22),were other treatment.Results The showed excellent curative effect,were obtained better effect 29(90.6%) of the 32 cases were 3(9.4%) of 32 cases.The symptoms of all patients were disappearance and ulcer were close up. The colour Doppler ultrasonography had shown that blood was not flow backwards in the vein.Conclusions The authors believe that the good results may be expected in the opration of venous external valvuloplasty in patients with moderate and severe primary incompetent deep venous valve whose free margin of valve leaves were not serious injured .

Hepatolithiasis combined with cholangiocarcinoma / 中国普通外科杂志

Objective　To study the diagnosis, treatment and prognosis of hepatolithiasis combined with cholangiocarcinoma. Methods　The clinical, pathological and follow-up data of 17 cases of hepatolithiasis combined with cholangiocarcinoma were retrospectively analysed. Results　The results showed that the incidence of cholangiocarcinoma in hepatolithiasis was 5% in this series. 17.6% of the patients were diagnosed as cholangiocarcinoma preoperatively. Tumor occurring in intrahepatic ducts was 88.2% and in hepatic porta ducts 11.8%. Nine cases were well-differentiated adenocarcinomas. Only 7(41.2%) cases were radically resected and their average survival time was 26.0 months. Eight(47.1%) patients underwent internal drainage with average survival time 12.4 months. 2(11.7%) cases subject to external drainage with survival time 3.6 months. Conclusions　If patients with hepatolithiasis have a long history of recurrent cholangitis, weight-loss in a short period, progressive jaundice or intractable abdominal pain, the possiblility of combined with cholangiocarcinoma should be considered. Resection of the tumor has a better prognosis than that of tumor unresected; and the prognosis of internal drainage is better than that of external drainage.