ABSTRACT
Objective: Biliary duct management is of great significance after laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE) in the treatment of cholecystolithiasis accompanied with common bile duct (CBD) stones. This study is to evaluate the safety and effectiveness of primary closure with C-tube drainage through cystic duct after LC + LCBDE. Methods: Through a retrospective study, 290 patients who underwent LC + LCBDE in our hospital from January 2019 to April 2022 were enrolled and divided into 2 groups. 143 patients underwent primary closure with C-tube drainage through cystic duct (C-tube group) and the other 147 patients underwent traditional T-tube drainage (T-tube group). Personal information, perioperative examinations, surgical results, and follow-up results were collected and analyzed. Results: There were no significant differences in the average age, gender, the mean of CBD diameters and the rate of comorbidities (acute cholecystitis, obstructive jaundice, acute pancreatitis and acute cholangitis) between the two groups (P > 0.05). Hospital stay, postoperative hospital stay were significantly shorter in the C-tube group than T-tube group (P < 0.05). In addition, the average time of placing and removal the drainage tubes was significantly less than those of the T-tube group (P < 0.05). This study also showed significant differences in the incidence of postoperative abdominal infection and soft tissue infection in the two groups (P < 0.05). There were no significant differences in the incidence of postoperative complications including cholangitis, bile duct stenosis, mortality in two groups. There were also no significant differences between the two groups of the recurrence of CBD stones, reoperation and readmition in 30 days during the median follow-up of 6 months. Conclusions: Compared with T tube drainage, patients with C-tube drainage after LC + LCBDE with primary closure of cystic duct recovered faster and had fewer complications. C-tube drainage is a safe and feasible treatment option for patients with cholecystolithiasis and choledocholithiasis.
ABSTRACT
In order to study the dynamic mechanical properties of styrene-acrylic latex with a core/shell structure, a variety of latexes were synthesized by semi-continuous seeded emulsion polymerization based on "particle design" with the same material. The latexes were characterized by rotary viscosimeter, dynamic light scattering (DLS), Fourier transform infrared spectroscopy (FTIR), transmission electron microscope (TEM), dynamic mechanical analysis (DMA), and universal testing machine. The effects of difference at the glass transition temperature (Tg) of core and shell and the introduction of the "transition layer" on the damping and mechanical properties of latex film were studied. The results indicate that as the Tg of core and shell gets closer, the better the compatibility of core and shell, from phase separation to phase continuity. Furthermore, the introduction of the "transition layer" can effectively improve the tensile strength and tan δ (max) of the latex film. The tensile strength and maximum loss factor (f = 1 Hz) of latex with the "transition layer" increased by 36.73% and 29.11% respectively compared with the latex without the "transition layer". This work provides a reference for the design of emulsion for damping coating.
