ABSTRACT
To study the diagnosis, therapy, precaution, and prognosis after surgical treatments of malignant changes that occurred in adult choledochal cysts. We analysed retrospectively the clinicopathologic data, the ways of operative treatment and the survival time of patients with malignancy in 74 cases of adult choledochal cysts in our hospital from 1986 to 2008. Among the 74 patients, 9 cases [3 males and 6 females] had carcinomas arising from choledochal cysts at the mean age of 51.6 +/- 16.4 years [range: 22 to 72 years] with the prevalence of 12.2% [9/74], which was significant difference comparing with no malignant change groups [P=0.0037]. The prevalence of malignancy for different groups were closely related to the age increased [r=0.363, p=0.011]: 3.4% for 16-30 group [1/29], 8.7% for 31-45 group [2/23], 15.4% for 46-60 group [2/13], and 44.4% for 61-75 group [4/9], respectively. Surgical treatments included cysts excision with Roux-en-Y hepaticojejunostomy in three patients, cysts excision with cholangiojejunostomy in two patients, partial cyst excision with left lobectomy and Roux-en-Y hepaticojejunostomy, pancreatoduodenectomy, chemotherapy with implantable drug delivery system via hepatic artery and portal vein, and choledochotomy with T-tube drainage and metastatic lymph node biopsy in one patient, respectively. The survival time was from three months to 66 months with the mean survival of 19.1 +/- 18.6 months. Choledochal cyst is a premalignant lesion and the incidence of malignancy increases remarkably with the increase in age. Patients require close monitoring so that recurrent carcinoma of the remnant bile duct can be identified as early as possible
Subject(s)
Humans , Male , Female , Biliary Tract Neoplasms , Cholangitis/diagnosis , Palliative Care , Retrospective Studies , Neoplasm Recurrence, Local/prevention & control , Jejunostomy , Treatment OutcomeABSTRACT
The elucidation of vapor-liquid equilibrium (VLE) of the halogenated silane was necessary for the production of silicon derivatives, especially for methylvinyldichlorosilane, due to the lack of the relevant reports. Isobaric VLE for the system methyldichlorosilane-dimethyldichlorosilane-benzene and isobaric VLE of the three binary systems were measured with a new pump-ebulliometer at the pressure of 101.325 kPa. These binary compositions of the equilibrium vapor were calculated according to the Q function of molar excess Gibbs energy by the indirect method and the resulted VLE data agreed well with the thermodynamic consistency. Moreover, the experimental data were correlated with the Wilson, NRTL, Margules and van Laar equations by means of the least-squares fit, the acquired optimal interaction parameters were fitted to experimental vapor-liquid equilibrium data for binary systems. The binary parameters of Wilson equation were also used to calculate the bubble point temperature and the vapor phase composition for the ternary mixtures without any additional adjustment. The predicted vapor-liquid equilibrium for the ternary system was in a good agreement with the experimental results. The VLE of binary and multilateral systems provided essential theory for the production of the halogenated silane.