The article reports 300 cases of laparoscopic cholecystectomy performed in Chengdu General Hospital of P.L.A. from October 1992 to August 1993. 16 of 300 were converted to open procedure. The number of postoperative complication cases was 12(4%).
目的 探討胃大部切除術后殘胃功能性排空障礙（FDGE）的發病機理、診斷及治療。方法 對1993~1998年我科256例胃大部切除術患者的臨床資料進行回顧性分析。結果 本組共發生FDGE 12例，發生率為4.7％(12/256)，均發生于術后3~12天。于1周內治愈1例(8.3％)，2周內治愈8例(66.7%)，3周內治愈11例(91.7%)； 所有患者于32天之內經保守治療治愈出院。結論 術后殘胃和遠端空腸正常的運動功能破壞是發生FDGE的主要原因； 消化道造影及胃鏡檢查是診斷本病及與機械性梗阻相鑒別的重要方法； 采取非手術治療一般可治愈，針對胃排空動力學機理采用促胃腸動力藥物能收到較好的療效。
Objective To find the relation between donor liver cold preservation-reperfusion injury and hepatocellular apoptosis during liver transplantation. Methods Four groups of rabbit livers, which had experienced cold storage for 0,3,6,9hr respectively, were observed during their cold preservation-reperfusion by using TdT-mediated dUTP-biotion nickend labeling and electron microscope.Results Apoptopic hepatic parenchymal cells were obviously observed in reperfusing livers subsequent to cold storage. Furthermore, the longer the cold storage duration, the greater the number of apoptotic cells. On the contrary, no or rare apoptotic hepatic parenchymal cells was observed in all the groups at the end of cold preservation. Conclusion It suggests that apoptosis of hepatic parenchymal cells is markedly involved in donor liver cold preservation-reperfusion injury.
The substitution of ρ-shaped jejunum for stomach in 64 patients with gastric carcinoma after total gastrectomy is reported . Survival rate of the first, third anad fifth year afer surgery were 71.8%,42.2% and 34.4% respectively.Postoperative death and complications with fistula of anastomotic stoma , refulx esophagitis and dumping syndrome were not encountered in this all series. These results show that the operative procedure is a simple, safe, and can be accomplished within short time and that the quality of living of the patient is good.
Objective To study the results of in situ microwave thermocoagulation therapy for liver neoplasms. Methods Thirty-one patients (male 28, female 3) with liver neoplasms underwent in situ microwave thermocoagulation therapy in recent 4 years were studied. The time of the therapy arranged from 2 to 6 minutes with the core temperature from 110℃ to 125℃. Twenty six of the thirty one (83.9%) were followed up. Results Ninty point three percent of these patients have a good result. The average survival time after the operation was 19.7 months. One-year and three-year survival rate were 77.4% and 38.7%, respectively. Conclusion The in situ microwave thermocoagulation therapy have the advantages of causing slight trauma, promoting repair, good tolerance and curative effectiveness. It’s a simple, safe and effective method with less adverse effect for treating the liver neoplasms, especially for unresectable neoplasms.
ObjectiveTo study the relationship between hepatocellular apoptosis and glycogen contents during hepatic cold preservationreperfusion and its mechanism.MethodsBased on the model of four groups of rabbit livers with different hepatocellular glycogen contents, hepatocellular apoptosis and bax gene expression were observed during hepatic cold preservationreperfusion.ResultsApoptotic hepatocytes were obviously found in 60 minute reperfusing livers subsequent to 9 hour cold storage, and there was significant difference in the numbers of apoptotic hepatocytes among all the groups. In the same time, there was the close relationship between the levels of bax gene expression and the glycogen contents of hepatocytes.ConclusionIntracellular abundant glycogen may significantly depress the hepatocellular apoptosis during hepatic cold preservationreperfusion by decreasing hepatocellular bax gene expression.
Experienc of nurtitional treatment to 7 patients with acute renal failure (ARF) and nitrogemia after biliarty (tract) surgery is reported in this article. Nittrogen source inn all cases was obtained from "Renal Amine" and "7% Vamin" etc,which are composed of 8 essential amino acids (EAA), and the nergery sources are mainly supplyed by Intralipid (20 or 10%) and suitable amount of glucose. The nutritional admicture of "all in one" were employed as parenteral nutrition (PN). Satisfactary curative effecs in these patients were obtained. The suthors consider that (a) the nutritional treatment of different casuses of ARF should be providing enough energy and more EAA requirments than in normal need to synthesizw non-essential amino acide (NEAA) and protein from excessive blood urea nitrogen (BUN) for redcuing pritein breakdown and nitrogemia, and (b) 20% Intralipid is an effective low-volume, highly calories nutritional agent specially in ARF patients with restiction of waterr.