Percutaneous transhepatic gallbladder drainage and elective laparoscopic cholecystectomy vs emergency LC for elderly patients with acute cholecystitis / 中华普通外科杂志

Objective To compare the effects between percutaneous transhepatic gallbladder drainage (PTGD) plus delayed laparoscopic cholecystectomy (LC) in comparison with emergency LC for elderly patients with acute cholecystitis.Methods From June 2011 to December 2014,the clinical data of elderly patients with acute cholecystitis receiving PTGD plus LC and emergency LC were retrospectively studied.Results In this study 38 patients received PTGD plus LC,59 patients received emergency LC.Patients in PTGD + LC group had longer operative time (67 ± 14) min and higher conversion rate (5 cases)than those in LC group (51 ± 13) min,1 case (t =5.741,x2 =5.057,P ＜ 0.05),but had quicker bowel function recovery time (24.5 ±6.4) h,shorter hospital stay (4.2 ± 1.8) d,less complications (3 cases)than those inLC group (27±5.2) h,(6.2±1.9) d,17 cases (t =2.11,t=5.165,x2 =6.18,P＜0.05).Conclusions Percutaneous transhepatic gallbladder drainage plus delayed cholecystectomy is safe for elderly patients with acute cholecystitis.

The comparative study of life quality in patients after laparoscopic appendectomy and open appendectomy / 中国基层医药

Objective To evaluate the life quality in patients who underwent laparoscopic appendectomy resection and open appendectomy resection for choledocholithiasis.Methods A survey was made on 30 patients who underwent laparoscopic appendectomy resection and 30 patients who underwent open appendectomy resection.The quality of life was measured with the Gastrointestinal quality of life index (GIQLI) preoperation and 2,5,10,16 weeks after the operation.Results There were no significant difference in the GIQLI scores.The GIQLI scores were 121,115,126,131,and 133 respectively in preoperation and 2,5,10,and 16 weeks after laparoscopic appendectomy resection.The scores of GIQLI were 122,109,120,127,and 129 respectively in preoperation and 2,5,10,and 16 weeks after open appendectomy resection.Conclusion The GIQLI scores from laparoscopic appendectomy resection group is better than that from the open appendectomy resection group.

Management strategy of hepatic trauma / 中国医师进修杂志

Objective To explore the management strategy of hepatic trauma. Methods From January 1997 to January 2008, a retrospective study was performed on 112 cases of hepatic trauma. Base on the classification of AAST,non-operative treatment was used in 40 hemodynamic steady patients (grade Ⅰto Ⅱ), hepatic repair was therapeutic method to grade Ⅱ to Ⅳ (48 cases), while hepatectomy or plus selective ligation of hepatic artery were chosen for grade Ⅳ to Ⅴ (13 cases). Peripheral hepatic tamping or plus selective ligation of hepatic artery were effective therapeutic approaches to grade Ⅳ to Ⅴ (11 cases) according to damage control surgery. Results In the operative case.s, 60 cases were cured, 12 died. All non-operative cases were cured. Conclusions Non-operative management is widely becoming one of the most important strategies in the treatment of hepatic trauma with stable hemodynamics. Surgical intervention is still the principal measure of treatment for severe hepatic trauma. According to specific condition, appropriate operative procedures, damage control surgery and prompt management of associated injury will earn a higher success rate.