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Objective To determine the value of ERCP and EST after Billroth gastroenterostomy. Methods ERCP was used in 31 patients after Billroth- Ⅰ gastroenterostomy, 12 of whom received EST. It was in 137 patients after Billroth-Ⅱ gastroenterostomy, of the 34 received EST and 4 EPBD.Results Billroth- Ⅰ gastroenterostomy ERCP was successfully performed in 28 out of the 31 patients and EST in 11 out of the 12 patients. Billroth- Ⅱ gastroenterostomy ERCP was successfully performed in 109 out of the 137 patients and EST in 31 out of the 38 patients. There were no serious complications in patients receiving endoscopic treatments. Concluasion The success rates of ERCP and EST are high in patients with bile duct lithiasis after Billroth-gastroenterostomy. Endoscopic treatment or cholangioduodenostomy has good therapeutic effects.
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Objective To explore early endoscopic diagnosis and treatment of the clinical value of biliarypancreatitis. Methods From January 2007 to December 2009 completed 93 cases acute pancreatitis of endoscopic treatment,routining for endoscopic incision nipple,observed remission of symptoms and recurrence after treatment. Results In these cases acute biliarypancreatitis was 62.4% (58/93),occult biliarypancreatitis diagnosed by endoscopy was 27.6% (16/58),remission rate was 93.8% (15/16),no surgical operation and recurrence. Conclusion Occult biliarypancreatitis occupies a certain proportion of acute pancreatitis,also easily missed diagnosis and recurred,endoscopy is currently the most effective method.
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Objective To evaluate the effect of mini-abdominal incision for choledochoscopy via cystic duct in exploration of the common bile duct(CBD).Methods The right subcostal incision was 4-6 cm in length.Choledochoscopy via cystic duct stump for exploration and extraction of CBD stones was done in 135 cases.Results The CBD stone was removed in 109 of 135 patients(80.7%).The CBD exploration was negative in 26 cases(19.3%)and retained CBD stones occurred in 4 cases(3.0%).One case(0.7%)had intraoperative injury of common bile duct,2 cases(1.5%)had tear of cystic duct stump,and 2 cases(1.5%)had biliary leakage,all the 5 cases were recovered after treatment.Conclusions The mini-abdominal incision with choledochoscopy via cystic duct for exploration of the CBD is safe and feasible.
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Objective To investigate the causes of and prophylactic measure for complications of minilaparotomy cholecystectomy (MC).Methods The clinical data of 10 200 patients receiving MC from Apri1 1991 to March 2006 were analyzed.Results MC was successful in 9 835 cases(96.4%), and in 365 cases(3.6%) the incision was lengthened. Serious complications were 12 cases(0.12%)of bi1e duct injury, 4 cases(0.04%)of colon injury, 8 cases(0.08%)of massive haemorrhage, and 25 cases (0.25%)of bile leakage. Four 4 cases(0.04%) died. Conclusions The key to prevention of complications is a strict selection of MC indications,careful identification of the anatomical structures of Calot's triangle,use of suture ligation of the mesentery of gallbladder triangle and the technique of deep knot-tying and the timely use of extension of the incision.
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AIM:To observe the effects of Tianma Gouteng Decoction on mRNA expression of L-Type Calcium Channel ?1 C subunit (CaL-?1C) and plasma membrane calcium-ATPase (PMCA1) in vascular smooth muscle cells of spontaneously hypertensive rat (SHR). METHODS:Twelve-week-old SHRs were assigned randomly to 5 groups:group A (treated with Tianma Gouteng Decoction),group B (treated with Tianma Gouteng Decoction excluded concha haliotidis),group C (treated with Nifedipine),group D (treated with concha haliotidis),group E (treated with normal sodium,NS),each group consisted of 9 rats was adminstrated,once a day for 4 weeks and mRNA expression of CaL-?1C and PMCA1 was measured with RT-PCR half-fix-quantify method. RESULTS:After 4-week-treatment,both Tianma Gouteng Decoction,Tianma Gouteng Decoction excluded concha haliotidis and Nifedipine could regulate downward mRNA expression of CaL-?1C in vascular smooth muscle cells and regulate upward mRNA expression of PMCA1 in vascular smooth muscle cells,concha haliotidis has no effect on mRNA expression of CaL-?1C and PMCA1. CONCLUSION:Tianma Gouteng Decoction can regulate downward expression of CaL-?1C,and regulate upward expression of PMCA1 at the same time,and meliorate the Ca 2+ overload in vascular smooth muscle cells with hypertension.