RESUMO
Focal intrahepatic strictures (FIHS) refers to local strictures or stenosis of the intrahepatic bile duct induced by various factors. FIHS is easily leading to misdiagnosis and miss diagnosis. At present, most of the techniques or examinations for making position as well as qualitative diagnosis of FIHS have poor sensitivity. Paying more attention to the medical history and combined applications of various inspection methods might help to improve the diagnostic level of FIHS. In terms of treatment, we suggested for patients with suspected malignant strictures or those who were failure of medical treatment, dilation, drainage and pathological diagnosis of FIHS could be conducted by endoscopy before determining the indications and procedures of surgery based on a new anatomy classification system of FIHS.
RESUMO
Comprehensive therapy is the leading method to improve the overall survival for patients with advanced gallbladder cancer, especially the study of new chemotherapy regimen are on demand.From 2010 to 2011, a phase Ⅲ study of new chemotherapy regimen in the treatment of advanced gallbladder carcinoma would be undertaken nationwide to assess the clinical outcome and safety, in 31 clinical centers led by the department of General Surgery of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, and a total of 260 patients would be accrued for this study.Chemotherapy consists of 2 regimes, conventional regime(cisplatin, epirubicin, and 5-fluorouracil, leucovorin)and new regime(conventional regime plus somatostatin).At present, the study has been approved by Clinical Trial Registration Platform of National Institutes of Health in U.S.A., and more than 30 patients are rolling in the study.The clinical trial could provide the high-quality evidence of EBM(evdence based medicine)for the chemotherapy of advanced gallbladder caner, and it will be one of the important components in the large-scale clinical study of chemotherapy for the advanced gallbladder cancer in China and worldwide.