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Objective To explore the surgical alternatives to severe liver injuries. Methods The data of 86 cases with severe liver injury treated surgically from January 1989 to December 2001 were summarized. There were 43 cases with grade Ⅲ injury, 32 with grade Ⅳ and 11 with grade Ⅴ. Eleven cases complicated by injuries on cardinal vein and posthepatic vein were all treated surgically. Results Of all, 66 cases (76.7%) were cured and 20 (23.3%) died. The post operative complication occurred in 23 cases (26.7%). Conclusions Correct surgical procedure for severe liver injury is crucial for a better curative effect. It is safe and effective to ligate one or two hepatic veins when the liver trauma is complicated by hepatic vein injuries.
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Objective To study the characteristics and treatments of occlusive abdominal injuries during pregnancy. Methods The clinical data of 37 cases with occlusive abdominal injuries admitted in hospital from June 1993 to June 2003 were collected for study. Results All 37 cases received operative treatment, of which two cases complicated by enterorrhexis in the early pregnancy and one by retroperitoneal hematoma were managed using laparoscope. Laparotomy was performed in other 34 cases, of which eight received caesaren section because of placental abruption and enlarged uterus that impeded the management for intraabdominal organs. Of all, 33 cases (33/37,89%) were cured and four (4/37, 11%) died. The postoperative incidence of complications was 16% (6/37). The complications included abdominal cavity infection in two cases (5%), pulmonary infection in three (8%) and multiple organ failure in one (3%). Conclusion Besides obstetrics' diseases, we must keep alert about the injury of abdominal organs during the management of trauma. Accurate diagnosis and timely treatment will win time to save the lives of mother and infant.
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Objective To evaluate the clinical efficacy of transcatheter arterial chemoembolization (TOCE) and percutaneous absolute ethanol injection (APEI) in moderate or advanced liver cancer.Method During May,1993～Aug,1999, 137 patients with unresectable advanced liver cancer were retrospectively studied. 85 cases only received TOCE, 52 cases were treated by TOCE+APEI by B-US guidance.Results The effect in TOCE+APEI group was significant better than that in only TOCE group,the half year, 1-year,2-year and 3-year survival rates of the TOCE+APEI group were 86 54%,67 31%,43 55% and 21 77%,while those of the TOCE group were 65 89%,47 92%,22 12% and 1 48% respectively. There was significant difference between the two groups in survival rate(P
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Objective To explore the effect of hepatectomy or cholangiolithotomy on patients with hepatocholangic stones. Methods The clinical data of surgical treatment of 316 patients with hepatocholangic stones combined with bile duct stricture was retrospectively analyzed. The patients were divided into two groups:172 patients chiefly underwent hepatectomy,and the other 144 patients chiefly underwent cholangiolithotomy. Results The ratio of residual stones and reoperation in the hepatectomy group was significantly lower than those in the cholangiolithotomy group (P
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0.05),but the mortality of the patients undergoing anatomical resection was higher than that of the patients undergoing resection debridement(? 2=4.85,P
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Objective To explore the management methods for liver injury combined with posthepatic vein injuries in order to make an improvement in corresponding treatment. Methods Twenty-three cases with liver injury combined with posthepatic vein injuries were treated with the following 5 ways: repairing the hepatic vascular blockage step-by-step, pressing directly to exhibit the injured vessels for repair, ligating the injured hepatic veins, suturing the hepatic tissues and packing with gauze. Results Of all, 18 cases (78.3%) were cured and 5 (21.7%) died. Conclusions Rational preoperative emergent resuscitation and correct complex intraoperative management are key to the liver injury combined with posthepatic vein injuries.