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Objective To summarize the management experiences of pancreatic injuries during laparoscopic urologic surgery.Methods From June 2003 to August 2008,395 laparoscopic operations for upper urinary or adrenal diseases were performed.4 cases of pancreatic injuries which all occurred in left side introperiotoneal procedures were identified with the incidence of 1%.2 men and 2women were involved with the mean age of 45.3(range 32~76y).2 injuries occurred during left radical nephrectomy and 2 during left adrenalectomy.All the injuries located at tail of pancreas with transaction injuries in 2 cases,and mild laceration in 2 cases.Only 1 case had received open surgery for pancreatic debridement,another 3 cases had received clamp and endo-GIA occlusion laparoscopically with local styptic powder aspersing and drainage.Absolute diet,gastrointestinal decompression,,transvenous-use of Somatostatin and hyperalimentation were given routinely.Results The mean blood,urine and drainage fluid diastase that were(648?136)U、(1278.6?368.4)U and(1368.5?428.2)U respectively elevated in all 4 cases postoperatively.Only 1 case had high fever and blood WBC after operation.The mean drainage and hospital stay was 14.2 and 24.6 days.No sequelae was found.Conclusion The tail of pancreas is the most predilecting location of pancreatic injury in laparoscopic urological surgery.The key of ensuring a good prognosis is early detection and suitable management.A severe laceration of the main excretory pancreatic duct need a open surgical management,conservative managements are suitable for a small tear and mild contusion of pancreas.
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Objective To evaluate the video urodynamic abnormalities of women with lower urinary tract symptoms.Methods 38 females with lower urinary tract symptoms underwent video urodynamic test.Filling cystometry was done with 15% urographin saline fluid.A diagnosis was made in each case based on cystometrography finding,voiding pressure flow study,EMG and fluoroscopic appearance.Results Video urodynamic showed abnormalities in 23 cases(60.5%),including sensory urgency in 6,detrusor instability(DI) in 5,pseudodyssynergia(PDS) in 4,PDS+DI in 2,urethral orifice stricture in 2,DI+urgency incontinence in 1,impaired compliance in 1,bladder neck stricture in 1 and urethral diverticulum in 1.Conclusion Video urodynamic is useful not only for understanding the abnormalities of functions and morphology of women with lower urinary tract symptoms,but also for properly diagnosing and treating such cases.