Treatment of postoperative bile-duct residual stones with rigid cholangioscopy / 中国医师进修杂志

Objective To evaluate the treatment of postoperative bile-duct residual stones with rigid cholangioscopy. Methods Three hundred and twenty-seven cases of bile duct residual stones were treated with rigid cholangioscopy. As a route for the rigid cholangioscopy, the T-tube tract (315 cases), the U-tube tract (5 cases) and the jejunostomy tube tract of efferent limb (7 cases) were used. Results Four hundred and eighty-six rigid cholangioscopic sessions were carried out, 1.5 sessions on the average for each patient. Treatment was successful in all but one patient in whom rigid cholangioscopic access to bile duct was difficult since the T-tube tract was too long. The rate of complete removal of the stones was 95.4%. There were no serious complications. Conclusions It′s possible to pass the instrument into the common bile duct and the majority of the intrahepatic bile duct. Many of the problems associated with residual stones can be overcome by this method and good results achieved. This technique seems to be a useful new alternative in patients with difficult retained bile duct stones.

Treatment of unresectable large liver cancer by radiofrequency ablation with clustered electrodes / 中国微创外科杂志

Objective To evaluate the clinical significance of radiofrequency ablation (RFA) with clustered electrodes in the treatment of unresectable large primary liver cancer. Methods Under the guidance of ultrasonography, Percutaneous and intraoperative RFA was performed in 38 patients and 5 patients,respectively. Additional ablation could be conducted if residual tumor or recurrence was found after the primary treatment. Results A total of 62 times of RFA, with a mean of 6 foci every treatment, were completed in the 43 patients, in whom the mean diameter of tumor was 7 3 cm. AFP levels had decreased to normal in 18/32 patients (56 3%) whose preoperative AFP levels were above 400 ?g/L. Postoperative CT examinations indicated that the tumor was completely ablated in 33/43 patients (76 7%). Frequent complications included fever, local pain, and liver impairment. No severe complications or treatment-related deaths were seen. The 1-year survival rate was 79 3% (23/29). Conclusions RFA with clustered electrodes in the treatment of unresectable large liver cancer can produce extensive coagulation necrosis of tumor, being a safe and effective therapeutic method. It is breaking fresh ground in the management of unresectable large

The treatment of hepatic carcinoma with B-ultrasonographic located radiofrequency ablation / 中国现代普通外科进展

To study the value of the treatment of hepatocellular carcinoma with B ultrasonographic located radiofrequency ablation(RFA).Methods: The radiofrequency multielectrodes were inserted into the hepatic carcinoma with B ultrasonographic locating.RFA was applied with the power from 50W up to 90W. RFA scope was 1cm out of the margin of the tumor mass in three dimension. After RFA treatment, the AFP level changes and the B ultrasonography, computed tomography (CT), biopsy of the liver and hepato arterioangiography were observed.Results: One month after RFA treatment ,in those with abnormal AFP level AFP falled to normal in 18/20 patients, the volume of the tumor mass were enlarged in 9 patients, not changed in 8 patients and decreased in the others at CT and/or ultrasonography. The alive cancer cells in the margin of the tumor mass were found in 1/6 patients at biopsy. The scattering bloodstream in the carcinoma was showed in 1/8 patients on hepato arteriography. After three months, the volume of the tumor was remarkably decreased in 25 patients.Conclusion: The results suggests that RFA appears to ablate hepatic carcinoma effectively as suitable method mastered.