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Objective To analyze the changes of portal venous velocity (PVV) ratio (PVVR) in different degrees of portal vein stenosis (PVS) following 70％ partial hepatectomy (PH) in rats.Methods According to different surgical methods,102 SD rats were randomly subjected into sham operation rats group (n=6),non PVS group,mild,moderate and severe PVS group (each group n=24).Models of 70％ PH without PV ligation were established in non-PVS group,while in PVS groups were produced with partially ligating PV in different degrees following 70％ PH.PVV was measured 1,3,7 and 14 days after operation,and PVVR was calculated in PVS groups.Combined with mitotic index (MI) 3 days after operation and liver regeneration degree (LRD) 7 days after operation,the changes of PVVR in different groups were analyzed.Results MI of non-PVS and moderate PVS groups were significantly higher than that of mild PVS group (both P＜0.05),while of severe PVS group was significantly lower than that of moderate PVS group (P＜0.05).LRD of severe PVS group was significantly lower than that of non PVS and moderate PVS groups (both P＜0.05).In non-PVS group,PVV decelerated to the lowest 3 days after operation,and recovered 7 and 14 days.In PVS groups,PVVR decelerated to the lowest 7 days after operation,and recovered until 14 days.PVVR of severe PVS group was significantly higher than that of mild and moderate PVS groups 1 and 3 days after operation (all P＜0.05),while there was no statistical differences among PVS groups 7 and 14 days after operation (all P＞0.05).Conclusion Ultrasound can well demonstrate blood flow changes of PVS following 70％ PH in rats.Changes of PVVR may relate to pathological changes in hepatocytes,the nuclear division and the volume of regenerated liver in rats.
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Objective To explore the change of postoperative pancreatic fistula (POPF) in modified pancreaticoenteric anastomosis in pancreaticoduodenectomy.Methods This paper retrospectively analyzed clinical data of 122 patients who suffered pancreaticoduodenectomy or enlarged pancreaticoduodenectomy from Apr.2008 to Sep.2017 in West China Hospital of Sichuan University.All surgeries were operated by a surgeon.30 patients from Apr.2008 to Dec.2010 were divided to control group,and 92 patients from Jan.2011 to Sep.2017 were the experimental group.Pancreatic duct-jejunum mucosa anastomosis was adopted in the two groups,but the method in experimental group was modified.Clinically relevant POPF was compared between the two groups.Results The rate of clinically relevant POPF was 0％ (0/92) in the experimental group,while it was 13.3(4/30) in the control group.Conclusion Modified technique for duct-to-mucosa pamcreaticojejunostomy can reduce the incidence of POPF.
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<p><b>PURPOSE</b>To investigate the changes of cerebral hemodynamics pre- and post-ventricular drainage in patients with posttraumatic acute diffuse brain swelling.</p><p><b>METHODS</b>Twenty-four cases of traumatic diffuse brain swelling were analyzed retrospectively. Patients in nonsurgical group were treated by medicine therapy. Patients in surgical group were treated by external ventricular drainage plus medicine therapy. The first CT perfusion scan was completed within 4-5 h after trauma and scanned again after 7 days. The changes of perfusion parameters in area-of-interest in two groups were analyzed and compared before and after treatment.</p><p><b>RESULTS</b>Compared with the nonsurgical group, the value of cerebral blood volume, cerebral blood flow and mean transit time in bilateral frontal temporoparietal grey matter, basal ganglia, cerebellum, and brain stem at pre- and post-therapy were increased significantly (p < 0.05) in surgical group, and consequently the prognosis of patients undergoing surgery was also better than that of nonsurgical group.</p><p><b>CONCLUSION</b>External ventricular drainage can improve cerebral perfusion and increase survival quality for the patients with posttraumatic acute diffuse brain swelling.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Brain , Brain Edema , Therapeutics , Brain Injuries , Cerebrovascular Circulation , Drainage , Hemodynamics , Retrospective StudiesABSTRACT
Spontaneous rupture of hepatocarcinoma [HCC] is a fatal complication of advanced HCC and is associated with poor prognosis. However, there is no consensus on the best approach to treat hemoperitoneum due to ruptured HCC. In this paper, we evaluate and discuss the outcomes of different treatment methods employed at our center for ruptured HCC. We reviewed the medical records of 132 patients diagnosed with ruptured HCC at our hospital from January 2003 to December 2012 and evaluated and compared the outcomes of five treatment methods for ruptured HCC: conservative treatment, surgical hemostasis, transarterial embolization [TAB], and one-and two-stage resections. There was no significant difference in the median survival time between the conservative treatment and surgical hemostasis groups. Patients in the TAE alone group had a better prognosis than those in the conservative treatment and surgical hemostasis groups. The survival time of the tumor resection group was obviously better than that of the conservative treatment, surgical hemostasis, and TAE alone groups, but no significant difference was observed between the one-stage and two-stage resection groups. One-stage hepatectomy is a better option for patients with preserved liver function, whereas TAE is a better option for those with poorly preserved liver function
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Objective To review the recent advances in the use of marginal liver in liver transplantation. Methods The literatures of recent years on the use of marginal liver for liver transplantation were reviewed and summarized. Results The donors with older age, hemodynamic instability, long stay in the intensive care unit and fatty liver are significantly clinical marginal liver donors. Conclusion Though the use of marginal liver donors negatively influences the results of liver transplantation, marginal liver expands the liver source for liver transplantation with a good result.