ABSTRACT
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 study the prevention and treatment of pneumoperitoneum-related complications after laparoscopic cholecystectomy (LC). Methods A retrospective analysis was made on clinical data of 1 100 cases of LC from October 1993 to January 2003. The cases were divided into two groups: 980 cases admitted before September 2001 received a 14 mmHg carbon dioxide pneumoperitoneum (Group A), and 120 cases after September 2001 received a 10 mmHg pneumoperitoneum (Group B). Results Carbonemia happened in 2 cases in the Group A but in no cases in the Group B. The incidence of postoperative shoulder pain was significantly lower in the Group B (19 2%, 23/120) than in the Group A (43 9%, 430/980) ( ? 2 =26 951, P =0 000). The incidence of postoperative nausea and vomiting (PONV) was significantly lower in the Group B (25 8%, 31/120) than in the Group A (61 2%, 600/980) ( ? 2 =54 750, P =0 000). Conclusions Carbonemia, shoulder pain and PONV can be reduced by regulating the ventilation and decreasing the pneumoperitoneum pressure.
ABSTRACT
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