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| 1 | Combined invagination and duct-to-mucosa techniques with modifications:anew method of pancreaticojejunal anastomosis显示文摘BACKGROUND:Soft pancreatic texture and a small main pancreatic duct are thought to be the most significant risk factors for the occurrence of pancreatic fistula (PF),a common and serious complication after pancreaticoduodenectomy (PD).This is in part due to the technical difficulties of pancreaticojejunostomy (PJ) posed by a soft gland with a normal-sized duct.To deal with this problem,we developed a new anastomotic technique which combines the two most widely used techniques,namely,the invagination technique and the duct-to-mucosa technique,with a modification of the suture route and insertion of a temporary stent tube.METHODS:Between January 2003 and December 2009,ninetytwo consecutive patients underwent PD in which the new PJ technique was used.Charts and follow-up data of these patients were reviewed for operative details,early postoperative events,and outcomes at 6 months after the operation.PF was defined by the International Study Group on Pancreatic Fistula (ISGPF) guidelines and graded (A,B or C) according to the clinical procedures and outcome.RESULTS:In this group of 92 patients,there was only 1 early death from acute renal failure.PF was observed in 11 patients (12.0%),8 in grade A,1 in grade B,and 2 in grade C.For the 2 patients in grade C,PF was surgically managed.There were no early or late deaths attributable to PF.Six months after the operation,all of the patients were free of PJ-related symptoms except for 2,who were found to have steatorrhea.CONCLUSIONS:Our modified technique is simple and safe in PD.Present data suggest that this technique produces excellent early and medium-term results. | Bin Zhu,Li Geng,You-Gang Ma,Yong-Jie Zhang and Meng-Chao Wu Second Department of Biliary Surgery and Department of Special Treatment,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University,Shanghai 200438,China | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，4： | 18 |
| 2 | Surgical procedure and prognosis of hilar cholangiocarcinoma显示文摘BACKGROUND: Hilar cholangiocarcinoma has a low radi-cal resection rate and a poor long-term survival rate. In re-cent years, its prognosis has been improved with advance-ment of preoperative diagnostic techniques and surgicaltechniques. The aim of this study was to evaluate the prog-nostic factors of hilar cholangiocarcinoma and the relationsof surgical procedure to the prognosis of the carcinoma.METHODS: A retrospective cohort study was done in 198patients with hilar cholangiocarcinoma (117 men and 81women, aged from 27 to 81 years) , who had been admit-ted to this hospital from December 1997 to December 2002.Their symptoms were jaundice (94.5%), pruritus (56.6%)and abdominal pain (33.8%). Bismuth-Corlette classifica-tion showed type in 14 patients, type in 19, type in12, type in 15, type in 112, and unclassifiable typein 26. 144 patients underwent laparotomy and others re-ceived bile drainage endoscopically (including endoscopicretrograde biliary drainage (ERBD) or endoscopic metalbiliary endoprosthesis (EMBE) in 21 patients, endoscopicnose-biliary drainage (ENBD) in 31 or percutaneous trans-hepatic cholangiodrainage in 2. 120 patients (83.3%) re-ceived tumor resection including radical resection in 59 pa-tients (41.0%). Twenty-three patients underwent paunchedbiliary exploration and drainage.RESULTS: Cox’ s regression model analysis showed thatoccupation, preoperative total serum bilirubin level, opera-tive procedure and postoperative adjuvant radiation weresignificantly related to postoperative survival rate in con-trast to gender, age, choledocholithiasis, hepatitis, preope-rative serum CA19-9 level, Bismuth-Corlette type, his-topathologic grading and postoperative chemotherapy. Thesurvival of patients in groups of biliary drainage, palliativeresection and radical resection differed statistically and pro-longed in a descending order. No statistical difference wasfound between ERBD or EMBE group and palliative resec-tion group. So was between ERBD or EMBE group andbiliary drainage group, or between ENBD group and biliarydrainage group. The survival differed statistically betweenERBD or EMBE group and ENBD group.CONCLUSIONS: Operative procedure is the most impor-tant prognostic factor affecting the operative results of hilarcholangiocarcinoma. Radical resection is still the primarymeasure for a cure and long-term survival of the patients.For patients with irresectable hilar cholangiocarcinoma, noevidence has shown that the prognosis after treatment ofERBD or EMBE is poorer than that after laparotomy. | Bin Yi, Bai-He Zhang, Yong-Jie Zhang, Xiao-Qing Jiang, Bao-Hua Zhang,Wen-Long Yu, Qing-Bao Chen and Meng-Chao Wu Department of Biliary Surgery, Eastern HepatobiliarySurgery Hospital, Shanghai 200438 , China | 2004 | Hepatobiliary & Pancreatic Diseases International2004，3，3： | 12 |
| 3 | Modified Sugiura procedure for the management of 160 cirrhotic patients with portal hypertension显示文摘BACKGROUND: Portal hypertension is a common diseasewith a high mortality and serious effect on the life quality ofpatients. Presently, shunt and disconnection are commonlyused for surgical treatment of portal hypertension. The aimof this study was conducted to analyze the results of a modi-fied Sugiura procedure for the management of 160 cirrhoticpatients with portal hypertension.METHODS: The results of a modified Sugiura procedurefor the treatment of 160 cirrhotic patients with portal hyper-tension from January 1991 to July 2002 were retrospectivelyanalyzed.RESULTS: The operative mortality for the procedure waszero. Postoperative intra-abdominal bleeding was noted in2 patients, drowned lung in 1, pneumonia in 1, and splenicvenous thrombosis in 4. Of the 160 patients, 157 (98%)were followed up from 6 months to 11.5 years. Of the 157patients, only one died of hepatic coma 6 years after opera-tion, and 3 of rebleeding. The absolute and relative survivalrates were 97.5% (156/160) and 99% (159/160), respective-ly. The absolute and relative occurrence rates of hepatic co-ma were 2.5% (4/160) and 0.6% (1/157), respectively. Theabsolute and relative occurrence rates of rebleeding were3.8% (6/160) and 1.9% (3/157) , respectively. In 96 of 116Child B patients (82.8%), liver function improved frompreoperative class B to A 3 months after operation. Sixty-five patients were subjected to gastroscopy and 22 patients,esophageal barium photography 6 months after operation.Gastro-esophageal varices disappeared in 56 patients(64.4%, 56/87), obviously improved in 30 (34.5%, 30/87),and unchanged in 1 (1.2%, 1/87). The occurrence rate ofportal hypertensive gastropathy (PHG) was 13.9% (9/65).CONCLUSION: Our results showed that the modifiedSugiura procedure is effective in the treatment of portal hy-pertension, with a low rate of operative complication,bleeding recurrence, and hepatic coma. | You-Gang Ma, Xiao-Song Li, Jun Zhao, Han Chen and Meng-Chao Wu Department of Second Biliary Surgery, Eastern Hepa-tobiliary Hospital, Shanghai 200438, China | 2004 | Hepatobiliary & Pancreatic Diseases International2004，3，3： | 6 |
| 4 | Surgical therapy for hiliar cholangiocarcinonia:analysis of 198 cases显示文摘BACKGROUND: Carcinoma of the hepatic duct confluence is the most common site of bile duct malignancies. Although hilar cholangiocarcinoma has been characterized as a slow-growing and late metastasizing tumor, post-therapeutic prognosis has remained poor. The study was undertaken to analyze factors influencing the surgical curative effect of hilar cholangiocarcinoma. METHODS: A retrospective clinical analysis was made of 198 patients with hilar cholangiocarcinoma who had been surgically treated at our hospital from 1997 to 2002. Jaundice (94.5%, 187 patients), pruritus (56.6%, 112) and abdominal pain (33.8%, 67) were the main symptoms. According to the Bismuth-Corlette classification, there were 14 type Ⅰ patients, 19 type Ⅱ patients, 12 type Ⅲa patients, 15 type Ⅲb patients, 112 type Ⅳ patients, and 26 unclassified patients. 144 patiens received laparotomy, and 120 tumor resection including radical resection (59 patients) and palliative resection (61). Fifty-four patients were treated by endoscopic surgery and 16 patients by postoperative adjuvant radiation. RESULTS: Occupation, preoperative level of total serum bilirubin, operative procedure and postoperative adjuvant radiation affected postoperative survival of the patients. The postoperative suvivals of endoscopic nose-biliary drainage (ENBD) group, endoscopic retrograde biliary drainage (ERBD) or endoscopic metal biliary endoprosthesis (EMBE) group, biliary exploration and drainage group, palliative resection group and radical resection group differed (x2 =87.0489, P<0.01). CONCLUSION: Early diagnosis and radical resection are important to improve the prognosis of hilar cholangiocarcinoma. | Bai-He Zhang, Qing-Bao Cheng, Xiang-Ji Luo, Yong-Jie Zhang, Xiao-Qing Jiang, Bao-Hua Zhang, Bin Yi, Wen-Long Yu and Meng-Chao Wu Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China | 2006 | Hepatobiliary & Pancreatic Diseases International2006，5，2： | 5 |
| 5 | Relationship between pancreaticobiliary maljunction and gallbladder carcinoma: a meta-analysis显示文摘BACKGROUND: Reports on the relationship between pancreaticobiliary maljunction (PBM) and gallbladder carcinoma (GBC) are conflicting. The frequency of PBM in GBC patients and the clinical features of GBC patients with PBM vary in different studies. DATA SOURCES: English-language articles describing the association between PBM and GBC were searched in the PubMed and Web of Science databases. Nine case-control studies fulfilled the inclusion criteria and addressed the relevant clinical questions of this analysis. Data were extracted independently by two reviewers using a predefined spreadsheet. RESULTS: The incidence of PBM was higher in GBC patients than in controls (10.60% vs 1.76%, OR: 7.41, 95% CI: 5.03 to 10.87, P<0.00001). The proportion of female patients with PBM was 1.96-fold higher than in GBC patients without PBM (80.5% vs 62.9%, OR: 1.96, 95% CI: 1.09 to 3.52, P=0.12). GBC patients with PBM were 10 years younger than those without PBM (SMD: -9.90, 95% CI: -11.70 to -8.10, P<0.00001). And a difference in the incidence of associated gallstone was found between GBC patients with and without PBM (10.8% vs 54.3% OR: 0.09, 95% CI: 0.05 to 0.17, P<0.00001). Among the GBC patients with PBM, associated congenital dilatation of the common bile duct was present with a higher incidence ranging from 52.2% to 85.7%, and 70.0%-85.7% of them belonged to the P-C type of PBM (the main pancreatic duct enters the common bile duct). No substantial heterogeneity was found and no evidence of publication bias was observed.CONCLUSIONS: PBM is a high-risk factor for developing GBC, especially the P-C type of PBM without congenital dilatation of the common bile duct. To prevent GBC, laparoscopic cholecystectomy is highly recommended for PBM patients without congenital dilatation of the common bile duct, especially relatively young female patients without gallstones. | Yi-Lei Deng, Nan-Sheng Cheng, Yi-Xin Lin, Rong-Xing Zhou, Chen Yang, Yan-Wen Jin and Xian-Ze Xiong Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，6： | 5 |
| 6 | Chronic viral hepatitis显示文摘 | S D Ryder I J Beckingham:ABC of diseases of liver pancreas and biliary system | 2001 | BMJ2001，322，27： | 1 |
| 7 | Glass-fiber reinforcement of in situ compatibilized polypropylene/polyethylene blends 显示文摘 | TSELIO C BILIARIS D SAVIDIS P PANAYIOTOU C | 1999 | Journal of Materials Science1999，34，： | 1 |
| 8 | Multieenter randomized trial of postoperative eorticosteroid therapy for biliary atresia 显示文摘 | Japanese Biliary Atresia Soeiety Nio M Muraji T | 2013 | Pediatr Surg Int2013，29，11： | 1 |
| 9 | Guidelines for the management of primary biliary cirrhosis:the intractable hepatobiliary disease study group supported by the Ministry of Health,Labour and Welfare of Japan显示文摘 | Working Subgroup(English version)for Clinical Practice Guidelines for Primary Biliary Cirrhosis | 2014 | Hepatol Res2014，44，1： | 1 |
| 10 | The Brisbane 2000 terminology of liver anatomy and resections 显示文摘 | Terminology Committee of the International Hepato-Pancreato- Biliary Association | 2000 | HPB2000，2，： | 1 |
| 11 | A re view of the multisystemic consequences of obstruc tire jaundice and their impact on perioprative mot bidity and mobility显示文摘 | O'Connor M J Mechanical biliary obstruction | 1985 | Am Surg1985，51，24： | 1 |
| 12 | Complications after liver Transplantation显示文摘 | O' Cnnor TP Iewis WD Jnkins RL Biliary tract | 1995 | Arch Surg1995，130，： | 1 |
| 13 | 显示文摘 | Alimoglu O Ozkan OV Sahin M Timing of cholecystectomy for acute biliary pancreatitis outcomes of cholecystectomy on frist admission and after recurrent biliary pancreatitis | 2003 | World J Surg2003，27，3： | 1 |
| 14 | leakage following T - tube removal 显示文摘 | Gharaibeh KI HA Biliary | 2000 | Int surg2000，85，1： | 1 |
| 15 | Multicenter randomized trial of postoperative eorticosteroid therapy for biliary atresia显示文摘 | Japanese Biliary Atresia Society Nio M Muraji T | 2013 | Pediatr Surg Int2013，29，11： | 1 |
| 16 | Multicenter rando- mized trial of postoperative corticosteroid therapy for biliary atresia 显示文摘 | Japanese Biliary Atresia Society Nio M Muraji T | 2013 | Pediatr Surg Int2013，29，11： | 1 |
| 17 | Biliary complications after living-donor liver transplantation : causes and treatment 显示文摘 | Hirotaka T Toshiyuki I Tamito S et Duct-to-duct biliary al | 2007 | Wodd J Surg2007，31，： | 1 |
| 18 | Gastrointest显示文摘 | ASGE guideline:the role of ERCP in diseases of biliary tract and the pancreas | 2005 | Endosc2005，62，： | 1 |
| 19 | Real-time imaging during the Kasai proce- dure:a pilot study 显示文摘 | Hirayama Y Iinuma Y okoyama N et aL Near-infrared fluorescence cholangiography with indocyanine green for biliary atresia | 2015 | Pediatr Surg Int2015，31，12： | 1 |
| 20 | A morphometric study显示文摘 | dos Santos JL da Silveira TR da Silva VD et ak Medial thickening of hepatic artery branches in biliary atresio | 2005 | J Pediatr Surg2005，40，4： | 1 |
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