Analysis of hospital cases of cholelithiasis in every four years of the recent 3 decades clearly shows the tendency of changes of cholelithiasis in clinical appearance in Chengdu.Constituent ratio of gallbladder stone was 12.56% in 70’s,47.54% in 80’s and 81.38% in 90’s.Bill duct stones including acute obstructive suppurative cholangitis was 71.01%, 46.08%,and 15.82% respectively. Biliary ascariasis was 11.67%, 2.75% and 0.68% respectively. Age incidence shows right moving, i.e. old patients increased. Urban patients increased.The influencing factors listed are: improvement of diagnostic methods; improvement of livelihood and diet; increased life expectancy; more health follow up examinations; technical improvements in rural areas and etc.
Pancreolith with pancreatic carcinoma is a rare disease. It’s difficult to be diagnosed before operation. In this study we summerized 29 cases of pancreolith (including cases of pancreolith with pancreatic carcinoma) during Jan. 1989 to Oct. 1994 treated in our hospital. The clinical characteristics were the following more male patients encomtered; many had the history of chronic alcoholic pancreatitis and many accompanied with diabetes; the main symptoms were persistent upper abdominal pain, pain in the back anoxia, diarrhea, wasting, but rarely jaundice. Main points in diagnosis: ①When the symptoms of chronic pancreatitis are getting worse and the patients become wasting, the carcinoma should be considered. ②Mutiple investigations such as B-US, CT, and MRI, CA19-9, CEA should be taken. ③Exploretory laparotomy and freezy biopsy is performed If nesscessery. Two patients were diagnosed before operation in this study. 3 cases had pancreatoduodenectomy. One had biopsy and other had pancreatojejunostomy.
【Abstract】Objective To analysis the clinical characteristics, pathogenesis, diagnosis and treatment of acute acalculous cholecystitis.Methods Seventy-nine cases of acute acalculous cholecystitis from January 1996 to January 2003 were retrospectively reviewed.Results Of those 79 cases, 13 cases were treated nonoperatively and 66 cases were treated operatively. Twentythree cases were suppurative, 43 cases were gangrenous with perforation in 18 cases，which were proved by postoperative pathology. Seventysix cases were cured and 3 cases were dead. Conclusion Keeping vigilant alert, observing dynamically as well as appropriate operative intervention are effective to improve the prognosis of acute acalculous cholecystitis.
目的 探討膽源性肝膿腫的診治方法。方法 對我院2000~2004年期間收治并確診為膽源性肝膿腫的12例患者進行分析，在應用抗生素和全身支持的前提下，再依據其病變發生、發展的不同階段采用不同手段治療。結果 4例急性期患者中2例行急診膽道引流手術后治愈，另2例轉為亞急性期（膿腫融合期）； 6例亞急性期患者均經B超導向下行膿腫穿刺抽膿后注入抗生素治療后治愈； 4例慢性期患者行膿腫切開引流后治愈。結論 本病在應用廣譜抗生素（二聯抗生素）和全身支持治療的前提下，再根據病變不同時期采用不同方法治療，可獲得良好效果。
ObjectiveTo observe the effect of 5Fluorouracil(5FU) on the exocrine pancreas. MethodsThe effects of 5FU were investigated in 8 patients who had undergone pancreatoduodenectomy. The pancreatic juice was temporarily diverted to the exterior via a pancreatic duct catheter.Ten days after operation,the patients were injected intravenously with 5FU 500 mg/d for three days. The samples of pancreatic juice were taken for measurement of amylase,pH, HCO3-, Na+, K+, Cl-, Ca2+ and Mg2+.ResultsThe amylase, pH, HCO3-, Na+, K+, Cl-, Ca2+ and Mg2+ did not alteredsignificantly before and after 5FU injection.Conclusion5FU has no shortterm effect on exocrine pancreas. Therefore, improvement of acute pancreatitis cannot be achieved through inhibiting pancreatic enzymes synthesis.
The authors analysed the medical records of 30 patients with congenital cystic disease of the liver treated in this hospital and with a review of the article some problems of diagnosis and treatment are discussed. B-altrasonic scaner (B-US), computerized tomographic scanning and magnetic resonance imaging appeared to be most helpful in diagnosing and treating this disease. After comparing different treatments, such as aspiration .alcohol sclerotherapy, fenetration, cyst resection and partial hepatectomy, the arthors state the best results could be achieved by alcohol sclerotherapy under B-US guidence (6 cases) or fenestration (15 cases) with no postoperative complication. Malignant change was found in one patient of this group.
Objective To study the clinical diagnosis and treatment of juxtapapillary duodenal diverticula with biliary deseases.Methods Eighteen duodenal diverticulum treated in our department in recent 5 years were retrospectivly analyzed, especially investigated the postcholecystectomy cases whose symptoms were continuing existence after operatoins. Articles about the surgical treatment were reviewed. Results The total of 18 duodenal diverticulum with 17 cases of juxtapapillary duodenal diverticulum were included in this study. The ages of 12 cases were over 50 years old. Sixteen cases(88.89%) presented biliary stones. Seven cases once had performed cholecystectomy or cholecystectomy plus choledochotomy,but symptoms persisted after operations. The duodenal diverticulum were found by endoscopic retrograde cholangiopancreatography (ERCP) and hypotonic duodenography. Sixteen patients underwent surgical treatment with good effect. Conclusion The juxtapapillary duodenal diveticula has the close relationship with biliary stones. ERCP and hypotonic duodenogrphy are the most reliable methods to get the correct diagnosis. In case of recurrent common bile duct stones after operations or persisting billiary symptoms after cholecystectomy, the coexistence of juxtapapillary duodenal diverticulum should be ruled out. The surgical treatment is only considered for the duodenal diverticulum with complication.