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The adhesion in the gallbladder triangle is the most important factor influencing the conversion to laparotomy in laparoscopic cholecystectomy (LC).The degree of adhesion in the cholecystic triangle is closely related to the difficulty of LC operation.With the reduction of cholecystic triangle adhesion,the treatment of gallbladder during LC will be easy and the rate of conversion to laparotomy will decrease accordingly.In order to investigate the causes of cholecystic triangle adhesion and its influence on LC,this paper reviews the current research progress.
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Objective Four different methods were examined to identify a safer and more reliable method for tail vein punctures in C57BL/6 mice. Methods In total,320 mice were randomly divided into four groups: a blank group, incandescent lamp baking method group,three-line method group,and combined method group. Blood samples were taken from the left or right peripheral vein of puncture mice. Puncture success rate of each group was recorded. SPSS 13.0 software was used to compare statistical difference among groups. Results Compared with the blank group,success rates of the other three methods were significantly higher(P < 0.001). Further, the three-line method was better than the incandescent lamp baking method(P< 0.001). The success rate of the combined method was significantly higher than the three-line and incandescent lamp baking methods(P< 0.001). Conclusions The combined method greatly improved the success rate of tail vein punctures in C57BL/6 mice. This method is more reliable and should be more widely used in the future.
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Objective To compare the effect of TNF-α preconditioning and ischemic preconditioning on hepatic ischemia-reperfusion injury ( IRI) and investigate the underlying mechanisms of TNF-αpreconditioning. Methods Fourty healthy male Wistar rats were random-ly divided into four groups which were Sham-operated group ( SO) ,ischemia-reperfusion group ( IR group:produced by total inflow occlusion for 30 min) ,ischemic preconditioning group ( IPC group:induce with 10 min hepatic ischemic and open 10 min before IR) and TNF-αpre-conditioning group ( TPC group:intraperitoneal injection with 1 μg/kg TNF-a 30 min prior to IR) . The sample of blood and hepatic tissue of all groups were taken after experiment. The protein levels of NF-κBp65 and Bcl-2 in the hepatic tissue were detected by immunohistochemis-try. Results There was significant difference (P0. 05) between IPC group and TPC group. Conclusion TNF-α preconditioning decreased the intensity of hepatic IRI,just as ischemic preconditioning,by induces an de-crease in the NF-κBp65 expression and an increase in the Bcl-2 expression.
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Objective To study the relationship between Helicobacter pylori (Hp) DNA positive detection in bile of gallbladder and intragastric Hp's colony and its plausible mechanism.Methods Sixty patients of gallbladder innocence diseases were recruited in the case group and 30 health populations were recruited in the control group.13CPDB was used to detect the infection of Hp.The cytotoxin associated gene antigen (cagA) in gall and gall-stone were detected through PCR.The empty function was tested through B ultrasound.Results The infection rate of Hp in all cases is 50.0% (30/60) and 7 of 30 bile (23.3%) ,1 of 30 gallstones (3.3%) were positive for Hp cag-A by PCR analysis in positive Hp infection group,with none of the 30 bile were positive in negative group( x2 = 5.822 ,P ＜ 0.05 ).The contraction rate of gallbladder of Hp positive group ( 56.8 ± 17.1 ) %was lower than negetive group' s ( 69.4 ± 13.1 ) % and the control group' s (63.3 ± 17.1 ) % ( F = 5.633,P ＜0.05).Conclusions Hp DNA is present in bile of gallbladder,and is related with Hp infection in stomach.Impairment of the gallbladder empty function may be related with Hp infection.
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Objective To discuss the effect of abnormal biliary dynamics on the formation of cholelithiasis.Methods A total of 35 cases of gallstone(Gallstone Group),25 cases of gallbladder polypoid lesions(Polypus Group),and 30 normal cases(Control Group) were included in this study.The fasting gallbladder volume was measured with B-ultrasonography,the serum concentration of vasoactive intestinal poly-peptide(VIP) was determined with radioimmunoassay,and the expression of cholecystokinin-A(CCK-A) receptor in the gallbladder mucous membrane was detected with reverse transcriptase polymerase chain reactions(rt-PCR). Results ①The fasting gallbladder volume was significantly greater in the Gallstone Group than in the other two groups(F=3.45,P=0.039).②The gallbladder contraction rate was significantly lower in the Gallstone Group than in the other two groups(F=5.747,P=0.005).③The postprandial increases of VIP of the three groups were not of statistical significance(F=0.768,P=0.47).④Compared with the Polypus Group,the expression of CCK-A receptor in the Gallstone Group was significantly decreased(t?=4.390,P=0.022).Conclusions ① The increase of the fasting gallbladder volume in the Gallstone Group is associated with the formation of gallstones.②In the Gallstone Group,depressed gallbladder contraction results in the formation of gallstones.③The decreased expression of CCK-A receptor leads to depressed gallbladder contraction,which facilitates the formation of gallstones.④Serum VIP is not related to the formation of gallstones.
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Objective To study the relationship between the Helicobacter pylori (Hp) infection and the formation of gallstones. Methods In this controlled study, the Hp infection rate was detected in both 35 cases of simple gallbladder stones (Experimental Group) and 25 cases of polypoid lesions of the gallbladder (Control Group). The Hp cytotoxin associated gene antigen (cag-A) in bile and gallstones of the both groups was amplified by PCR technique. Results The Hp infection rate was 51.4% (18/35) in the Experimental Group and 48.0% (12/25) in the Control Group, without significant differences (?~2=0.069,P=0.793). In the Experimental Group, cag-A positive results were noted in bile samples in 7 cases (20.0%, 7/35) and in gallstone samples in 1 case (2.9%, 1/35), whereas in the Control Group there were no positive results observed. The Hp cag-A positive rate was significantly different between the two groups (?~2=5.822,P=0.016). The presence of Hp cag-A in bile was correlated with the Hp infection of the stomach (x~2=3.886,P=0.049). Conclusions That the DNA of the Hp can be found in bile and gallstones of patients with cholelithiasis indicates a correlation between Hp infection of the gallbladder and the formation of gallstones.
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In the present study,50 patients were treated by mesh & plug hernia repair with Bard R Mesh & FerFix R Plug. Operation time ranged from 24 min to 71 min with mean time being 43.2min.There was no need for analgestic.Hospitalization time ranged from 3d to 7d with mean time being 4.5d.The patients were followed up for 6w to 20 months.No recurrence occurred.
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Objective To determine if the carbon dioxide (CO 2) pressure used in laparoscopic cholecystectomy (LC) has any effect on the occurrence of postoperative shoulder pain. Methods One hundred and twenty consecutive patients undergoing LC were prospectively divided into three groups(40 patients in each group): Patients in group A underwent LC with 10 mm Hg of CO 2, those in group B with 12 mm Hg of CO 2, and in group C with 14 mm Hg of CO 2. PaO 2?PaCO 2?pH before and after LC were recorded. Shoulder pain was recorded on a visual analogue pain scale 1,3,6,12,24,48,72,96 h after operation. Results The intraoperative CO 2 consumption was significantly higher in group C (F=11.38,P