Feasibility of laparoscopic common bile duct exploration without T-tube drainage / 局解手术学杂志

Objective To explore the feasibility of laparoscopic common bile duct exploration without T-tube drainage.Methods A to-tal of 37 patients who were addmitted into our hospital from May 2014 to August 2015 with common bile duct stones were analyzed.Among these patients,22 cases were given T-tube drainage while the other 15 cases were not.The operation time,hospitalization expenses,anal ex-haust time,postoperative hospitalization time,bile leakage rate and the satisfaction of patients after surgery in the two groups were observed. Results In the non-T-tube group,the anal exhaust time was (1.41 ±0.82)d and the hospitalization time was(4.82 ±1.61)d,which were lower than(3.81 ±1.09 )d and (11.17 ±1.19 )d respectively in the T-tube group,and the differences were statistically significant (P <0.05).The number of bile leakage (0%)in the non-T-tube group was also significantly lower than 31.82% in the T-tube group (P <0.05).The satisfaction rate of patients in the non-T-tube group(100%)was significantly higher than that in T-tube group (50%),and the difference was statistically significant(P <0.05).Conclusion The laparoscopic common bile duct exploration without T-tube drainage is feasible and it can be popularized in clinic.

X-ray Diagnosis of Cystic and Expansive Bone Metastasis(A Report of 35 Cases) / 实用放射学杂志

Objective To investigate the clinical and X-ray characteristic findings of the cystic and expansive bone metastasis.Methods The clinical and X-ray findings of the cystic and expansive bone metastasis in 35 cases were analysed with the literaturereviewed.There were 21 males and 14 females,the age ranged from 35 to 70 years with average of 52 years.Results The bone metastasis was found 1~10 years after primary tumor diagnosed in 29 cases befor primary tumor diagnosed in 5 cases and the primary tumor did not know in one case.The primary neoplasmes included nasopharyngeal carcinoma in 10,lung carcinoma in 9,renal carcinoma in 5,breastcarcinoma in 4,thyroid carcinoma in 3,hepatic carcinoma,prostatic carcinoma,esophageal carcinoma and primary focus unknown in onerespectively.The metastatic lesions localized in the long bone in 20 cases,ribs in 4,pelvis in 4,vertebrae body in 2,scopula in 2,clavicle,metacarpal and skull in one respectively.There were 16 cystic destruction,9 expansive destruction,10 both cystic and expansive.The marginated lesions were in 27 and 8 unclear in outline of lesion was in 8.There were distruction in the bony cortex with soft tissue in 7,and sclerosis in outline of lesion in 11 and bone crest and spot clacification inside the lesions in 6.Conclusion The time of metastases occured of cystic and expansive bone metastases is depended on the differentiating degree of primary tumor cell its developmental speed.