One stage percutaneous transhepatic rigid choledochoscope lithotomy (PTCSL) vs ERCP plus EST for choledocholithiasis / 中华普通外科杂志

Objective To investigate the curative effect on patients with choledocholithiasis by percutaneous transhepatic rigid choledochoscope lithotomy (PTCSL) vs endoscopic retrograde cholangiopancreatography (ERCP) plus EST.Methods From Jan 2010 to Dec 2015,92 cases of choledocholithiasis were treated by one-stage PTCSL (n =23) vs ERCP (n =69).The curative effects and postoperative complications in two groups were observed and analyzed.Results In PTCSL group,the complete stone clearance at one-time achieved in all 23 cases (100％).While in ERCP group stone clearance was achieved in 72.46％ cases at first attempt and the final clearance rate was 82.60％,leaving 12 cases with residual stones and among those 12 cases 5 cases were converted to surgical operation.The average intra-operative hemorrhage in two groups was (20.6 ± 4.6) ml vs (3.0 ± 0.3) ml,and the average hospital stay after operation was 6.8 d and 7 d respectively.The post-operative complications (30.43％) and stone recurrence (13.04％) were similar in the two groups.Conclusions PTCSL is safe,effective,and more suitable to patients with large stones and those with a history of biliary surgeries.

Butyl cyanoacrylate for the close of skin incisions / 中华普通外科杂志

Objective To observe the effect and safety of butyl cyanoacrylate used to close type Ⅰ and Ⅱ skin incisions in non-emergency operations of general surgery.Methods We have enrolled 31 cases with written consent.Upon completion of the surgery butyl cyanoacrylate was used to close skin incisions instead of surgical sutures after suturing subcutaneous tissue with 4-0 absorbable thread.Results The length of incisions was 12 - 180 mm (32 ± 32) mm.On the first post-op day,2 cases had redness and 1 had some effusion within the incision subsiding on the second day,there were no fever.Moderate pain was recorded in 3 cases on the first day after operation.The number of cases reporting slight pain on the first day,third day and fifth day were respectively 28,18 and 5.The others had no any pain.The healing time was (6.3 ± 1.1 ) d,there was no delayed healing,no other complications.Conclusions The tissue adhesive method,using butyl cyanoacrylate is of value in closing type Ⅰ and Ⅱskin incisions in general surgery.It has the advantage of reducing scar and inflammation.

Percutaneous hepatocholangiostomy in treatment of recurrence hepatobiliary stones / 中国医师进修杂志

Objective To explore the potential predominance and value of percutaneous hepatocholangiostomy (PCH) in treatment of recurrence hepatobiliary stones (RHS). Methods Seventeen cases with RHS were treated by PCH from February 2001 to October 2005, which was an improved technology of percutaneous transhepatic cholangioscopy (PTCS) and made reference to the methods of percutaneous nephrostomy (PCN). Results Seventeen cases were successfully treated. The average blood loss was 40 ml (ranging from 15 to 100 ml), and stones were removed completely in 88.2% (15/17). The average hospital stay was 14 (ranging from 10 to 59) days. No one required postoperative analgesic. No postoperative bleeding and biliary leakage were found. Conclusions PCH has significant advantages of minimal invasion, little blood loss, less pain, less complications and quick recovery in the treatment of RHS.

Laparoscopic hepatic forceps for laparoscopic hepatectomy: An experimental study in pigs / 中国微创外科杂志

Objective To evaluate the application of a new laparoscopic hepatic forceps for laparoscopic liver resection in pigs.Methods A laparoscopic hepatic forceps was designed by using the CAD software,and was manufactured in coordination with the Hangzhou Kangyou Medical Company for pilot tests.An assessment was made on outcomes of the forceps for blocking hepatic blood flow and controlling cut surface hemorrhage in laparoscopic hepatectomy in 12 pigs.Results The experimental group had a significantly lower intraoperative blood loss than control group(47.8 ?6.9 ml vs 86.3?3.9 ml;t=11.898,P=0.000) and a significantly shorter operation time than control(53.2?7.4 vs 97.5?5.8 min;t=11.541,P=0.000).No significant difference was observed in the weight of resected liver between experimental and control groups(34.7?4.2 g vs 35.3?4.2 g;t=0.245,P=0.812).Conclusions This new laparoscopic hepatic forceps can be used for the occlusion of liver blood flow,offering advantages of less blood loss and shorter operation time and facilitating laparoscopic performance in liver resection.