Duodenum-and bile duct-preserving pancreatic head resection / 中华消化外科杂志

Duodenum-and bile duct-preserving pancreatic head resection is rarely carried out in China due to its complexity.From September 2013 to May 2014,5 patients (1 with mass-forming pancreatitis of the head of the pancreas,2 with mucinous cystadenoma of the pancreatic duct combined with focal cancerous,2 with chronic pancreatitis and pancreatic duct stones) received duodenum-and bile duct-preserving pancreatic head resection at the Zhangzhou Zhengxing Hospital.The lesions of the 5 patients were resected by the Takada method and then the pancreatic duct was reconstructed in situ.One patient received T-tube drainage of the bile duct.The operation time was 210-330 minutes,and the mean volume of intraoperative blood loss was 300 mL (range,100-500 mL).The stones of 2 patients were antler-shaped,and the other 3 patients were with tumor.No patients died intraoperatively.One patient was complicated by pancreatic leakage and 1 by bile leakage after the operation,respectively,and they were cured by non-surgical treatment.Patients were followed up for 3-11 months,and no abnormal glucose metabolism,common bile duct stricture,chronic indigestion and tumor recurrence occurred.The Takada method is safe and effective for the treatment of mass-forming pancreatitis of the head of the pancreas,benign lesions of the head of the pancreas and low-grade malignant tumor of the head of the pancreas.

Promoter methylation of RASSF1A gene in hepatocellular carcinoma and its clinical significance / 中华普通外科杂志

Objective To explore the relationship between promoter methylation of RASSF1 A gene and clinico-pathological characteristics in hepatocellular carcinoma.Methods MS-PCR was used for analyzing the status of aberrant promoter methylation of RASSF1A in 100 primary HCC samples and adjacent noncancerous tissues,10 normal liver tissues,and six HCC cell lines.RT-PCR was used to assess reactivation of RASSF1A expression after HCC cell lines treated with demethylating agent 5'-aza-2' deoxycytideing.Results Abnormal promoter methylation of RASSF1A gene was found in 69(69％) cases of HCC,15 (15％) cases of adjacent normal tissues,and no abnormal promoter methylation of RASSF1A gene was found in normal liver tissues,and the difference was statistically significant (x2 =67.75,P ＜0.001).The methylation of RASSF1A gene was correlated to HBsAg (x2 =11.341,P ＜ 0.05) and histological differentiation(x2 =10.575,P ＜ 0.05).Four cell lines with abnormal CpG island methylation of RASSF1A gene were all re-expressed after treated with 5'-Aza-CdR.Conclusions RASSF1A gene promoter methylation was correlated to HBsAg and histological differentiation and this is one of the most important mechanism for low expression of RASSF1A in HCC.