ABSTRACT
BACKGROUND: The surgical step-up approach often requires multiple debridements and might not be suitable for infected pancreatic necrosis (IPN) patients with various abscesses or no safe route for percutaneous catheter drainage (PCD). This case-control study aimed to investigate the safety and effectiveness of one-step laparoscopic pancreatic necrosectomy (LPN) in treating IPN. METHODS: This case-control study included IPN patients undergoing one-step LPN or surgical step-up in our center from January 2015 to December 2020. The short-term and long-term complications after surgery, length of hospital stay, and postoperative ICU stays in both groups were analyzed. Univariate and multivariate logistic regression analyses were performed to explore the risk factors of major complications or death. RESULTS: A total of 53 IPN patients underwent one-step LPN and 37 IPN patients underwent surgical step-up approach in this study. There was no significant difference in the incidence of death, major complications, new-onset diabetes, or new-onset pancreatic exocrine insufficiency between the two groups. However, the length of hospital stay in the one-step LPN group was significantly shorter than that in the surgical step-up group. Univariate regression analysis showed that the surgical approach (one-step/step-up) was not the risk factor for major complications or death. Multivariate logistic regression analysis indicated that computed tomography (CT) severity index, American Society of Anesthesiologists (ASA) class IV, and white blood cell (WBC) were the significant risk factors for major complications or death. CONCLUSION: One-step LPN is as safe and effective as the surgical step-up approach for treating IPN patients, and reduces total hospital stay.
ABSTRACT
The molecular composition of organic matter formed during pyrolysis is complex. Fourier transform infrared spectroscopy (FTIR) is a good technique to investigate the coal chemical structural evolution. However, reports on the effects of chemical structure on the n-alkane yields and their relative functional groups are scarce in the literature. In our case, the chemical structural evolution process of bituminous coal obtained by pyrolysis at two different heating rates has been analyzed by pyrolysis-gas chromatography (Py-GC) and FTIR. Furthermore, some of the small molecular compounds (e.g., n-alkanes 24 can generate n-alkanes 20 or low-weight compounds) generated by gold-tube pyrolysis were identified using other GC techniques. Biomarkers were analyzed and compared to generated n-alkanes from the gold-tube pyrolysis experiments. We present the results of the relationship between the FTIR parameters and the molecular compositions that were analyzed. A good linear relationship can be seen between the FTIR parameters (C=O, C=C, and C-factor values), the carbon preference index (CPI), and the ratio of the pristane content and n-C17 alkane content (Pr/n-C17). Furthermore, the n-alkane fraction of the pyrolysates, in particular pristane, phytane, n-C17 alkane, and n-C18 alkane, changed upon maturation. Our conclusions indicate that FTIR is applicable as a structural and chemical change probe to explore the pyrolysis process.
