Clinical application of fast-track surgery with Chinese medicine treatment in the devascularization operation for cirrhotic portal hypertension / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the clinical effect of fast-track surgery combined with Chinese medicine treatment in devascularization operation for cirrhotic esophageal varices.</p><p><b>METHODS</b>Seventy-two patients with cirrhotic esophageal varices were selected from January 2009 to June 2013, and randomly assigned to a conventional group and a fast-track group (fast-track surgery combined with Chinese medicine treatment) using a randomized digital table, 36 cases in each group. Operation and anesthesia recovery time, postoperative hospitalization and quality of life were recorded and compared between groups during the perioperative period.</p><p><b>RESULTS</b>Compared with the conventional group, the fast-track group had longer operation time (253.6±46.4 min vs. 220.6±51.0 min) and anesthesia recovery time (50.5±15.9 min vs. 23.5±9.6 min; P<0.01); less bleeding (311.3±46.8 mL vs. 356.2±57.5 mL; P<0.01) and less transfusion (1932.3±106.9 mL vs. 2045.6±115.4 mL; P<0.01); as well as faster recovery of gastrointestinal function, shorter postoperative hospitalization and higher quality of life. There were no serious postoperative complications and no further bleeding occurred.</p><p><b>CONCLUSION</b>Fast-track surgery combined with Chinese medicine treatment is a safe and feasible approach to accelerate the recovery of patients with cirrhotic portal hypertension in perioperative period of devascularization operation.</p>

Analysis of the effect of laparoscopic hepatectomy on 61 cases of primary liver cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility and the effect of laparoscopic hepatectomy for primary liver cancer(PLC).</p><p><b>METHODS</b>A retrospective study on 61 cases of laparoscopic hepatectomy for PLC was made between November 2002 and June 2007, among which there were 49 male and 12 female, aged from 14 to 71 years. All patients were diagnosed as PLC by type-B ultrasonic, CT or MRI, and APF.</p><p><b>RESULTS</b>Fifty-six patients were completed laparoscopically successfully. Five cases underwent conversion to open operation because of hemorrhage. The mean operative time was 60 min (30-150 min). The mean blood loss was 450 ml (100-2000 ml). The mean hepatic portal block time was 20 min (15-30 min). All the patients had excellent recovery without any postoperative surgical complications. The patients were mobilized out of the bed in 24 hours. Oral intake of food started in 1 to 3 days. The average postoperative hospital stay was 6.6 d (5-10 d).</p><p><b>CONCLUSION</b>Laparoscopic hepatectomy for PLC is safe and feasible by using hepatic portal block instrument.</p>

The application of laparoscopy in biliary reconstruction and rehabilitation after transection injury of biliary duct / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the feasibility of biliary reconstruction and rehabilitation after transection injury of biliary duct by laparoscopy.</p><p><b>METHODS</b>The clinical data of 24 cases receiving biliary reconstruction after transection injury of biliary duct by laparoscopy were analyzed retrospectively from August 2002 to April 2008, including operation indications, contraindications, related operation skills and so on. In these 24 cases, the reasons of transection of biliary duct as followed: 15 cases were pancreaticoduodenectomy, 6 cases were resection of the choledochal cyst, 1 case was resection of high cholangiocarcinoma, 1 case was cholecystectomy and 1 case was resection of gastric cancer.</p><p><b>RESULTS</b>Biliary reconstruction and rehabilitation was successfully completed in 24 cases by laparoscopy. There was 1 case of bile leakage and no duct stenosis complications.</p><p><b>CONCLUSIONS</b>Biliary reconstruction and rehabilitation by laparoscopy was feasible and safe procedure, has a high successful rate, and deserves further clinical trials in hospitals.</p>

Laparoscope hepatectomy for hepatic hemangioma: a report of 18 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility and practicality of laparoscopic hepatectomy for hepatic hemangioma.</p><p><b>METHODS</b>Candidate for laparoscopic liver resection were 18 cases of hepatic hemangioma from January 2002 to October 2006. The portal bloods stream was blocked by the laparoscope portal blood blocker. The Electric-cautery and ultracision were used for liver transection. Operative procedures included anatomical left hepatectomy in 2 cases, non-anatomical left hepatectomy 1 case, left lobectomy 5 cases, local liver resection 10 cases. Two cases of hepatic hemangioma associated with gallbladder stone were performed cholecystectomy synchronously, 1 case associated with chronic appendicitis were performed appendectomy synchronously.</p><p><b>RESULTS</b>Laparoscopic left liver resection was successfully performed in all 18 cases. The operative duration was (185.4 +/- 55.7) min. The quantity of blood lost during the operation was (416.2 +/- 128.8) ml. The postoperative recovery was smooth and good. No critical complications occurred. The duration for hospitalization was (6.2 +/- 1.0) d.</p><p><b>CONCLUSION</b>Laparoscope hepatectomy for hepatic hemangioma is safe and feasible.</p>