Research progress of intraoperative cholangiography in laparoscopic cholecystectomy / 国际外科学杂志

With the widespread implementation of laparoscopic cholecystectomy in various levels of medical institutions, surgical complications have also increased. Among them, the incidence of bile duct injury remains high in complex laparoscopic cholecystectomy. The reason for this is that surgeons cannot effectively and accurately identify the relationship between the aberrant bile duct and the cystic duct and the common bile duct, resulting in the accidental injury of the bile duct, resulting in long hospital stays, increased medical costs, and decreased long-term quality of life for patients. Intraoperative cholangiography, as a real-time visual method of biliary presentation, can effectively reduce the incidence of iatrogenic bile duct injury. However, most surgeons do not fully understand the technology of intraoperative cholangiography during cholecystectomy. This article reviews the application of intraoperative cholangiography in laparoscopic cholecystectomy based on the clinical experience of the author′s team and the literature in recent years, with the aim of deepening the understanding of surgeons about intraoperative cholangiography, so as to better apply it to clinical practice and benefit patients.

Application progress of combination of multiple artery-first approaches in pancreaticoduodenectomy / 国际外科学杂志

With the improvement of modern surgical techniques and surgical instruments,combined with mutiple artery-first approaches in pancrcaticoduodenectomy,can shorten the operation time effectively,reduce intraoperative blood loss,regulate lymph node dissection,improve R0 resection rate,and thus improve the prognosis of patients,has become an important surgical treatment of pancreatic cancer and periampullary cancer.The principle of the proposed basis is mainly based on "anatomical basis no-touch concept" and " pancreatic mesorectal excision" and the combination of the main approches:superior approach,posterior approach,interior approach (anterior approach,medial uncinate approach,mesentery approach).Pancreatic surgeons need to judge the position of the tumor and the intraoperative situation,weigh the benefits and disadvantages of each approach,so as to combine theory with practice,flexibility with principle.