The Clinical Evaluation of Danning Tablets on Regulating Gut Flora Displacement to Eliminate Biliary Inflammation and Prevent Gallstone Formation / 昆明医科大学学报

Objective To explore the mechanism of Danning Tablet on intestinal flora migration to eliminate biliary inflammation and prevent gallstone formation. Methods 104 cases of cholelithiasis admitted to the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine were treated by choledocholithiasis but the master tube was cut and T tube drainage was performed from January 2014 to December 2016. Within a month did not take gallbladder drugs. Randomly divided into the Danning group and the control group, Danning group in addition to conventional treatment of biliary tract after surgery, in the first 2 days after starting to drink liquid according to the instruction manual dose of oral Danning tablets;the control group was given only biliary surgery After routine care, avoid taking gall bladder drugs. All patients were collected on the 7th day and the 14 th day after operation, about 100mL fasting T-tube was collected. Pay attention to the day before the collection of bile T tube pre-clamp to prevent the drainage of T tube affect the bile enterohepatic circulation. Detection of bile composition in the flora, observed before and after the flora differences, long-term follow-up of cholelithiasis recurrence. Results:The changes of the components before and after treatment:On the seventh day, the two groups of HS and UCB％were higher than the control group, the difference was statistically significant (<0.05) . On the 14th day in the treatment group, the three items of TBS, UCB％and HS were higher than the control group, but CH, LI and Z were lower than the control group, the difference was statistically significant ( <0.05) . The trend of stone formation before and after treatment:Compared with UCB％in control group, there was no significant change in LI and Z, but the HS value decreased, the difference was statistically significant ( <0.05) . There was no significant change of HS and UCB％in the treatment group, but the LI and Z values decreased, the difference was statistically significant (<0.05) . Conclusion Dan Ning Tablets can prevent cholesterol gallstone formation by regulating the intestinal flora, and affect the cholesterol content in bile , that plays a important role in prevention of cholesterol gallstone.

Surgical treatment of hepatocellular carcinoma with tumor thrombus in inferior vena cava / 中华外科杂志

<p><b>OBJECTIVE</b>To review the experience for the management of hepatocellular carcinoma with tumor thrombus in inferior vena cava.</p><p><b>METHODS</b>From July 2003 to May 2005, hepatectomy combined with thrombectomy were performed on 7 cases of hepatocellular carcinoma with tumor thrombus in inferior vena cava. In order to remove the tumor thrombus in inferior vena cava, total hepatic vascular exclusion were adopted on all cases to control the blood flow of IVC. According to the position of extension of tumor thrombus, 5 different procedures were adopted in the cases to control the suprahepatic IVC and extract the tumor thrombus out of IVC and atrium. Procedure 1: Median sternotomy, extracorporeal bypass, cardiac arrest, incision on right atrium and IVC were performed on 1 case for thrombectomy. Procedure 2: Median sternotomy, extracorporeal bypass without cardiac arrest, incision on IVC and (or without) incision on right atrium were performed on 2 cases for thrombectomy. Procedure 3: Abdominal approach to control intrapericardial IVC through an incision on diaphragm was performed on 1 case for thrombectomy. Procedure 4: Abdominal approach to control suprahepatic IVC above diaphragm through a small incision made on vena cava foramen for thrombectomy was performed on 1 case. Procedure 5: Abdominal approaches to control suprahepatic IVC below diaphragm for thrombectomy were performed on 2 cases.</p><p><b>RESULTS</b>All operations were successfully performed. The postoperative complications included pleural effusion in 1 case, subphrenic fluid collection in 1 case and wound infection in 1 case. The average survival time of 7 cases was 9.8 month. The longest survival time was 26 months.</p><p><b>CONCLUSION</b>Hepatectomy and thrombectomy can be safely performed on the case of HCC combined with tumor thrombus in IVC. Surgical treatment can relieve the patient from the risk of sudden death caused by heart failure and pulmonary.</p>

Surgical treatment of hepatocellular carcinoma originating from caudate lobe / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the significance of surgical treatment of HCC originating from caudate lobe.</p><p><b>METHODS</b>From 1995 to 2003, caudate lobectomy, including 19 cases of isolated lobectomy and 20 cases of combined lobectomy, were performed in 39 patients with HCC originating from caudate lobe, and the factors that might influence postoperative liver function were compared between the two groups.</p><p><b>RESULTS</b>All tumors were resected successfully. One patient died of postoperative renal failure. Hydrothorax occurred in 3 patients, ascites in 4 patients, and bile leakage in 1 patient. The survival rates of 1, 3, 5 year were 53%, 50%, 39% respectively.</p><p><b>CONCLUSIONS</b>Caudate lobectomy is a effective method for HCC originating from caudate lobe.</p>

Role and significance of extrahepatic control of hepatic vein and inferior vena cava in difficult hepatectomies for patients with liver tumors / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the role of extrahepatic control on blood flow of hepatic vein and inferior vena cava in hepatectomy, and observe its effect on minimizing hemorrhage.</p><p><b>METHODS</b>From 2001 to April 2003, 33 patients who had liver tumors involving segment IV, VII, VIII or half liver underwent major hepatectomies that required exposure of the inferior vena cava and main trunks of hepatic veins, during which the major hepatic veins and inferior vena cava were isolated and taped to control blood flow when necessary.</p><p><b>RESULTS</b>In 33 attempts, 32 were successful and all tumors were resected successfully. The placement of occlusion tape was unsuccessful in 1 case. 7 cases did not need blood transfusion during operation. The amount of blood transfusion for other cases were form 0 to 1 600 ml. there was no operative mortality.</p><p><b>CONCLUSIONS</b>Appropriate control of main truck of hepatic vein and inferior vena cava is effective in reducing blood loss during hepatectomies. It is also very helpful for performing difficult hepatectomies.</p>