Technical points of total laparoscopic choledochal cyst excision / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Choledochal cyst excision and biliary enteric reconstruction constitute the best therapy for choledochal cyst. And laparoscopy is currently used to cure this disease now.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 34 cases of total laparoscopic choledochal cyst excision between January 2007 and August 2011. All patients underwent in vitro Roux-en-Y hepatoenterostomy.</p><p><b>RESULTS</b>All 34 patients underwent successful total laparoscopic choledochal cyst excision. The operation time was 200 - 360 minutes. The duration of hospital stay was 3 - 7 days. Follow-up observations lasted 1 - 56 months. One patient developed an anastomotic stoma stricture, but no other cases had postoperative complications. No patients died.</p><p><b>CONCLUSION</b>Total laparoscopic choledochal cyst excision is safe and feasible.</p>

Diagnosis and treatment of fungal infection after liver transplantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Liver transplantation is the most effective treatment for end-stage liver diseases; however, infections after transplantation can seriously affect the patient's health. The aim of this research was to investigate the diagnosis and treatment of fungal infection following liver transplantation.</p><p><b>METHODS</b>Clinical data for 232 liver transplant patients at risk of fungal infection were examined for the presence of fungus in the blood, fluid, sputum, urine and stools of patients and by chest or abdominal CT scans. Patients diagnosed with a fungal infection were treated with Fluconazole or, if this was not effective, Voriconazole or Amphotericin B. Immunosuppressive therapy was also reviewed.</p><p><b>RESULTS</b>Thirty-seven of 232 (15.9%) patients were diagnosed with a fungal infection, which occurred 4 to 34 days post-transplantation. Candida infections were diagnosed in 23 cases (62.2%) and Aspergillus infections in 12 cases (32.4%). Twenty-one cases were effectively treated with Fluconazole, 11 cases with Voriconazole, and two cases with Amphotericin B; however, three cases were not effectively treated with any of the antifungal agents. Overall, treatment was effective in 91.9% of patients.</p><p><b>CONCLUSIONS</b>Fungal infection has a significant influence on survival rate after liver transplantation. Imaging studies, and pathogenic and biopsy examinations can diagnose fungal infections, which can be effectively treated with antifungal agents such as Fluconazole, Voriconazole or Amphotericin B.</p>