• Volume 17,Issue 8,2008 Table of Contents
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    • >胆石症专题研究
    • Laparoscopic combined with duodenoscopic procedures in the treatment of gallbladder stones with common bile duct stones: a clinical analysis of 164 cases

      2008, 17(8):1-741. DOI: 10.7659/j.issn.1005-6947.2008.08.001

      Abstract (985) HTML (0) PDF 911.97 K (642) Comment (0) Favorites

      Abstract:Abstract:Objective:To investigate the value of combined use of laparoscopic cholecystectomy (LC) and duodenoscopic procedures in the treatment of gallbladder stones with common bile duct stones.
      Methods :We retrospectively analyzed clinical data of 164 cases of gallbladder stones with common bile duct stones treated with laparoscopic cholecystectomy + endoscopic sphincterotomy (EST)from January 2003 to December 2007.
      Results:All the cases underwent ERCP and endoscopic sphincterotomy (EST) followed by LC.In the 164 cases, 196 bile duct stones were extracted from 155cases with a success rate of 94.5%. The procedures were unsuccessful in 9 cases, and among them, 4 cases had stricture of bile duct more than 2 cm in length, and 5 cases had impacted stones that precluded passage of the guide wire. After EST,6 of the 155 cases had the complication of mild acute pancreatitis and LC was performed after its treatment. The success rate of LC was 96.5% and the average hospital stay was (11±4)d.
      Conclusions:The combined use of EST and ERCP before LC is effective in treatment of gallbladder stones with common bile duct stones,and has broadened the utilization of minimally invasive treatment for bile duct diseases.

    • Comparison between laparoscopic common bile duct exploration and endoscopic sphincterotomy for common bile duct stone

      2008, 17(8):2-745. DOI: 10.7659/j.issn.1005-6947.2008.08.002

      Abstract (921) HTML (0) PDF 841.52 K (657) Comment (0) Favorites

      Abstract:Abstract:Objective:To investigate the rationality and advantage of laparoscopic common bile duct exploration for common bile duct stone.
      Methods :The clinical data of 238 cases of common bile duct stone were analysed retrospectively. Among them, 125 cases underwent endoscopic sphincterotomy (EST group), while 113 cases had laparoscopic common bile duct exploration(LCBDE group).The therapeutic effect and complications were compared between the two groups.
      Results:There was no significant difference in operation time, postoperative hospital stay, surgical achievement ratio, bile duct retained stones, or shortterm complications between the two groups (P>0.05). Longterm complications were significantly different between the two groups (P<0.05), in EST group, bile duct recurrent stones were seen in 14 cases (11.20%), duodenal papilla stenosis in 9 cases (7.20%)and cholangitis in 13 cases(10.4%); in LCBDE group, bile duct recurrent stones were seen in 4 cases (3.53%), cholangitis in 2 cases(1.8%)and no case of duodenal papilla stenosis.
      Conclusions:The longterm outcome of LCBDE treatment for common bile duct stone is superior to that of EST and is a rational operative method.

    • Minilaparotomy incision combined with choledochofiberoscopy for common bile duct exploration: a report of 296 cases

      2008, 17(8):3-748. DOI: 10.7659/j.issn.1005-6947.2008.08.003

      Abstract (656) HTML (0) PDF 827.66 K (649) Comment (0) Favorites

      Abstract:Abstract:Objective:To investigate the effects and methods of minilaparotomy incision operation combined with choledochofiberoscopy in common bile duct (CBD) exploration.
      Methods :The clinical data of 296 patients who underwent laparotomy operation combined with choledochofiberoscopy in common bile duct exploration were analyzed retrospectively.Among these 296 patients,there were 253 patients with cholecystolithiasis and common bile duct stone, 4 patients with bile duct ascariasis, 6 patients with MirizziI syndrome, 23 patients with acute suppurative cholangitis, 21 patients with acute pancreatitis and 17 patients with benign papillary stenosis. There were 23 patients treated with choledochotomy, calculus removal, and primary closure by choledochoscope, 18 patients with CBD exploation and removal of calculi through cystic duct with reticular basket under choledochofiberoscope,and no case with T tube drainage; the others underwent choledochotomy, calculi remove and T tube drainage.
      Results:All the cases were operated on successfully,and the average time of operation was 55 (40-165)minutes, including 18(10-40) minutes for removing calculi. Two hundred and tweentthree patients were ambulatory and began liquid diet on the next day after operation, and 62 patients used one dose of analgesic. The length of hospital stay was 8-20 days.
      Conclusions:The method of the minilaparotomy incision combined with choledochofiberoscopy in common bile duct exploration has the advantages of less trauma, less pain,low complication rate and rapid recovery,and it is also safe and effective. It is worthy of widespread use.

    • Use of miniabdominal incision for choledochoscopy via cystic duct in exploration of the common bile duct: report of 135 cases

      2008, 17(8):4-751. DOI: 10.7659/j.issn.1005-6947.2008.08.004

      Abstract (924) HTML (0) PDF 831.01 K (800) Comment (0) Favorites

      Abstract:Abstract:Objective:To evaluate the effect of miniabdominal incision for choledochoscopy via cystic duct in exploration of the common bile duct (CBD).
      Methods :The right subcostal incision was 4-6 cm in length. Choledochoscopy via cystic duct stump for exploration and extraction of CBD stones was done in 135 cases.
      Results:The CBD stone was removed in 109 of 135 patients (80.7%). The CBD exploration was negative in 26 cases (19.3%) and retained CBD stones occurred in 4 cases (3.0%). One case (0.7%)had intraoperative injury of common bile duct, 2 cases (1.5%) had tear of cystic duct stump, and 2 cases (1.5%) had biliary leakage, all the 5 cases were recovered after treatment.
      Conclusions:The miniabdominal incision with choledochoscopy via cystic duct for exploration of the CBD is safe and feasible.

    • Prevention and treatment of complications in choledochoscopic removal of gallstones

      2008, 17(8):5-754. DOI: 10.7659/j.issn.1005-6947.2008.08.005

      Abstract (1151) HTML (0) PDF 827.18 K (702) Comment (0) Favorites

      Abstract:Abstract:Objective:To explore the causes, prevention and treatment of common complications in stone extraction by choledochoscopy after bile duct operation.
      Methods :The clinical data of 165 cases with complications after stone extraction by choledochoscopy in 1379 treated cases during 7 years were analyzed.
      Results:The common unfavorable reactions of nausea, vomiting, abdominal pain and diarrhea occurred in 107 cases, and were alleviated by controlling the amount and rapidity of the infused sterilized water during choledochoscopy. Chills and fever occurred in 25 cases and were controlled by adequate T tube drainage and antibiotics. Bile duct hemorrhage occurred in 11 cases, including automatic hemostasis in 5 cases, hemostasis after infusing thrombin by T tube in 5 cases and hemostasis after infusing thrombin by vein in 1 case. Biliary fistula from sinus tract perforation occurred in 3 cases, and in these, T tube was successtully reinserted in 1 case and T tube was inserted by reoperation in 2 cases. Ttube tract could not admit the choledochoscope in 19 cases, and were treated by recholedochoscopy after gradual Ttube dilataton in 12 cases, but the sinus tract close to common bile duct was completely obstructed in 7 cases.
      Conclusions:Choledochoscopic removal of retained stones is a safe procedure but unfavorable reactions and complications are not uncommon. The severe complications, such as bile duct hemorrhage and biliary fistula, should be prevented and appropriately treated.

    • >基础研究
    • The effects of hydralazine and valproic acid on the methylation ofASC/TMS1 of human cholangiocarcinoma cell line

      2008, 17(8):6-759. DOI: 10.7659/j.issn.1005-6947.2008.08.006

      Abstract (882) HTML (0) PDF 1.10 M (817) Comment (0) Favorites

      Abstract:Abstract:Objective:To investigate changes of methylation status of ASC/TMS1 in QBC939 cell line of cholangiocarcinoma before and after combined DNA methylation and histone deacetylase inhibitors treatment, and the correlation of the apoptosis which is induced by caspase1, and methylation status of ASC/TMS1.
      Methods :Apoptosis was detected by mixed dye including both AnnexinFITC and Propidium with flow cytometry technique, and changes of methylation and transcription of mRNA were explored by RTPCR and MSP techniques after the intervention of hydralazine and valproic acid either alone or combined for 24 hours and 48hours.
      Results:The transcription of mRNA of TMS1/ASC gene and caspase1 reexpressed again after the combined intervention of hydralazine and valproic acid, which was higher than that of the cells treated with either hydralazine or valproate alone (P<0.05). The demethylation effect of 48 h by combind intervention treatment was better than that of 24h (P<0.05). The growth of the QBC939 cell line was inhibited, flow cytometry showed marked increase of apoptosis(49.88±0.044)%.
      Conclusions:TMS1/ASCgene and caspase1 may reexpress after the synergistical intervention of hydralazine and valproic acid, and the effect is more obvious as the treatment time is extended. The apoptosis of QBC939 cell line is increased, which may be indued by caspase1 passway.

    • Efect of glucagon-like peptide-2 on modulation of intestinal epithelium tight junction in rats with obstructive jaundice

      2008, 17(8):7-763. DOI: 10.7659/j.issn.1005-6947.2008.08.007

      Abstract (1063) HTML (0) PDF 872.65 K (756) Comment (0) Favorites

      Abstract:Abstract:Objective:To study the effects of GLP-2 on modulation of intestinal mucosa epithelium tight junction in obstructive jaundice rats.
      Methods :The obstructive jaundice model of rats was set up. At 10 days after operation, the rats were randomly divided into 4 groups: normal group, jaundice group,experiment group A and B. Each group consisted of 10 animals.The animals of jaundice group had subcutaneous injection of 0.5ml 0.01mmol/LPBS,experiment group A had intraperitoneal injecton of 0.5 mL 250 g/(kg.d) GLP-2; experiment group B intraperitoneal injectied 0.5ml 125g/ (kg.d)GLP-2, b.i.d×7. Immunohistochemistry and Western-blot were used to examine the distribution and expression of tight junction proteins ZO-1, occludin and Claudin-1,-4 in the terminal ileum mucosa. Image analytical system and statistics software were used to analyze the results quantitately.
      Results:In normal group, the strong positive expression ratios of ZO-1,occludin and claudin-1 were 70.0%,80.0% and 70.0% respectively. In jaundice group, ZO-1 and Occludin staining appeared discontinuous and vague. ZO-1, occludin and claudin-1 staining recovered somewhat after exogenously supplied GLP-2 in experiment group A. The strong positive expression ratios were obviously higher in experiment group A than those in the jaundice group (20.0% vs 80.0%,30.0% vs90.0%,20.0% vs 80.0%,all P<0.05). The distribution and expression of Claudin-4 altered insignificantly. There were no noticeable changes in the expression and quantity of tight junction proteins in experiment group B. The same outcomes were obtained by quantitative analysing Western blot images.
      Conclusions:Exogenous supplemented GLP-2 in obstructive jaundice can influence the expression and distribution of the tight junction proteins ZO-1, occludin,Claudin-1 of intestinal mucosa. This suggests that GLP-2 could recover and maintain the integrity of intestinal mucosa epithelium barrier.

    • Establishment of a novel canine model of severe acute cholangitis

      2008, 17(8):8-767. DOI: 10.7659/j.issn.1005-6947.2008.08.008

      Abstract (913) HTML (0) PDF 1019.61 K (649) Comment (0) Favorites

      Abstract:Abstract:Objective:To establish a novel canine model of severe acute cholangitis (ACST).
      Methods :Ten dogs were randomly divided into two groups: model group and control group. ACST models were established by placing T-tube in common bile duct and ligating the distal bile duct, then injecting E.coli trough T-tube and closing the T-tube. The changes of peripheral WBC, total bilirubin, ALT, AKP, IL-1β, TNF-α and endotoxin were observed pre-operatively and at 24 h, 48 h, 72 h, and 7 d post-operatively. The pathological changes of bile duct were observed when the dogs were sacrificed.
      Results:There were no significant differences in all indices between two groups pre-operatively. Serum IL-1β,TNF-α, endotoxin and total bilirubin, ALT, AKP level in model group increased gradually and were higher than control group (P<0.05) post-operatively. Marked acute inflammation of bile duct was observed in model group.
      Conclusions:This method of establishing canine ACST model can be used in related studies of ACST.

    • Hepatitis B virus X protein induces AFP expression by activation of NF-κB signaling pathway

      2008, 17(8):9-772. DOI: 10.7659/j.issn.1005-6947.2008.08.009

      Abstract (928) HTML (0) PDF 1.28 M (805) Comment (0) Favorites

      Abstract:Abstract:Objective:To study the effect of NF-κB signaling pathway for HBx on up-regulation of alpha-fetoprotein (AFP).
      Methods :On the basis of the establishment of LO2-HBx cell line with stable transfected HBx gene, NF-κB signaling pathway blocker PDTC was introduced to cut off its signal transduction, double fluorescent staining and laser scanning confocal microscopy were applied to study the activation and deactivation of NF-κB signaling pathway, and real-time PCR and Western Blot were facilitated to observe the expression of AFP gene before and after the HBx transfection as well as treating with PDTC.
      Results:The NF-κB signaling pathway of Lo2-HBx cells was activated after transfection with HBx gene. When compared with control Lo2 cells without treatment, the mRNA and protein levels of AFP in Lo2-HBx cells increased (2.78±0.43) and (4.72±0.53) times respectively, this difference was of statistical significance(P<0.05). But the mRNA levels of AFP decreased to (1.40±0.16), and at the same time the expression of AFP also reduced to (3.12±0.44)(P<0.05) when the NF-κB signaling pathway was blocked after treated by 50μmol/L PDTC for 24h respectively.
      Conclusions:NF-κB signaling pathway is one of the routes for HBx to up-regulate the expression of AFP.

    • The impact of cold preservation and warm ischemia on hepatocytes apoptosis in rats

      2008, 17(8):10-776. DOI: 10.7659/j.issn.1005-6947.2008.08.010

      Abstract (1212) HTML (0) PDF 1.16 M (707) Comment (0) Favorites

      Abstract:Abstract:Objective:To observe the effect of cold preservation and warm ischemia on apoptosis of hepatocytes in rats.
      Methods :The hepatocyte apoptosis rate and regenerative rate of cold preservation group and warm ischemia group were detected and compared through flow cytometry.
      Results:There was no difference in the hepatocyte apoptosis rate and regenerative rate(P<0.05) at different time points during cold preservation. The hepatocyte apoptosis rate increased as the warm ischemia with time incresed (P<0.05); whereas there was no difference in regenerative rate(P>0.05).
      Conclusions:The hepatocyte apoptosis of rats is more severe after aerobic reperfusion during cold preservation /reperfusion. It is more severe after ischemia and reperfusion during warm ischemia/reperfusion periods.

    • Effects of TAE and TACE on HIF-1α,MVD and PCNA in rabbit liver carcinoma

      2008, 17(8):11-780. DOI: 10.7659/j.issn.1005-6947.2008.08.011

      Abstract (903) HTML (0) PDF 1.22 M (735) Comment (0) Favorites

      Abstract:Abstract:Objective:To investigate expression and clinical significance of HIF-1α、MVD and PCNA after TAE or TACE for rabbit liver carcinoma,and to identify the mechanism of hepatic carcinoma cell proliferation after the operation.
      Methods :Thirty rabbits were implanted with liver VX2 tumors for 1 week.Then they were randomly divided into 3 groups.Control group had hepatic arterial infusion of 0.5 to 0.8 mL saline.TAE group was embolized with 0.5 to 0.8 ml UFLP. TACE group was embolized with 0.5 to 0.8 ml UFLP mixed with 2 mg THP. Two weeks after treatment, HIF-1α、MVD and PCNA expression was detected.
      Results:Growth of the liver tumor was found in the 3 groups, and there were 15,11 and 3 new tumors found in the control group, TAE group and TACE group respectively. The expressions of HIF-1αand PCNA in control group were higher than those in TACE group,but significantly lower than those in TAE group(P<0.05). The MVD in TAE group(115.3±20.74/ mm) was higher than that in control group (72.11±18.95/ mm)and TACE group(47.33±15.53/ mm) (P<0.05).
      Conclusions:The expressions of HIF-1αand PCNA were higher after TAE and can promote tumor growth. The expressions of HIF-1α and PCNA were lower after the TACE and can suppress tumor growth.

    • The role of TNF-α in the establishment and development of model of pancreatic cancer

      2008, 17(8):12-784. DOI: 10.7659/j.issn.1005-6947.2008.08.012

      Abstract (756) HTML (0) PDF 1.05 M (723) Comment (0) Favorites

      Abstract:Abstract:Objective:To establish a model of pancreatic cancer (PC) in SD rats,and to study the changs of serum levels of AMS and TNF-α and the significances.
      Methods :Dimethylbenzanthracene (DMBA) was directly implanted into pancreatic parenchyma of SD rats (experimental group,group A), and in the process of establishing PC, weekly TSA by 1P was done in intervention group(group B). The tumor development of rats executed within 3~5 months in Group A and Group B were observed by HE staining and gross examination. Meanwhile, the rats in the sham operation group (Group C) were executed at 5 months. The levels of serum AMS were detected by autobiochemical assay apparatus, and the levels of serurn TNF-α were determined by ELISA.
      Results:(1)The incidence of pancreatic cancer in Group A within 3~5 months was 48.7%(18/37),including 17 cases of pancreatic ductal adenocarcinoma and 1 case of fibrosarcoma.The incidence of pancreatic cancer in Group B was 33.3%(12/36), including 11 pancreatic ductal adenocarcinoma and 1 case of fibrosarcoma.The maximal diameter of tumor mass in Group A was higher than that in Group B((P<0.05).No pathological changes were found in pancreas of Group C and in other main organs of Group A and Group B.(2) The serum levels of AMS and TNF-α were singnificantly higher in Group A and Group B than those in Group C(P<0.05 or P<0.01).The serum levels of AMS and TNF-α were significantly higher in pancreatic cancer rats and non-cancerous rats of Group A and Group B than those in Group C (P<0.05).
      Conclusions:A large dose of DMBA directly implanted into the parenchyma of pancreas can induce an ideal pancreatic cancer model with high incidence of occurrence in a short time.TSA may have an inhibitive effect on the carcinogenesis and growth of pancreatic cancer in rats. The serum levels of AMS and TNF-α are significantly increased in the process of carcinogenesis, and TNF-α might have an effect on carcinogenesis of pancreatic cancer in rats.

    • Expression and significance of RANTES and its receptor in gastric cancer metastasis

      2008, 17(8):13-788. DOI: 10.7659/j.issn.1005-6947.2008.08.013

      Abstract (1013) HTML (0) PDF 1.28 M (658) Comment (0) Favorites

      Abstract:Abstract:Objective:To study the relation of RANTES and its receptor (CCR5) expression in gastric cancer and in lymph nodes with cancer metastasis.
      Methods :The expression of CCR5 in gastric cancer and the expression of RANTES in lymph nodes were detected by the CCR5/DNA bivariate and RANTES/DNA bivariate by flow cytometry.
      Results:The expression of CCR5 in gastric cancer and normal gastric tissue was (21.53±3.10)% and (10.10±1.30)% respectively(P<0.05); the positive rate of RANTES in lymph nodes with or without cancer metastasis was (63.50±5.25)% and (44.40±4.76)% respectively(P<0.05).
      Conclusions:RANTES and its receptor might take part in modulation of gastric cancer metastasis.

    • Experimental study of endothelial progenitor cells transfected with VEGF165 gene

      2008, 17(8):14-792. DOI: 10.7659/j.issn.1005-6947.2008.08.014

      Abstract (838) HTML (0) PDF 871.18 K (1012) Comment (0) Favorites

      Abstract:Abstract:Objective:To investigate the method and effect of endothelial progenitor cells (EPCs) transfected with VEGF165 gene.
      Methods :The cultivated EPCs were transfected with recombined adenovirus in which VEGF165 gene (Adv-GFP-VEGF165 group) or only Adv-GFP (Adv group) was incorporated,then the transfection effect was observed by immunofluorescence. And a blank control group was set up. Observation of the proliferation potential of cells was done by MTT method. The VEGF gene expression was observed by detecting the concentration of VEGF protein in supernatant with ABC-ELISA method.
      Results:Green fluorescence was observed in almost all of the cells after transfection with Adv-GFP-VEGF165, which indicated the success of the transfection. The EPCs proliferation was not affected after the transfection, which was confirmed by MTT method. The VEGF protein concentration in the supernatant of transfected group was higher than that of Adv group and control group.
      Conclusions: It is feasible for EPCs to be transfected with VEGF165 gene which was incorporated into adenovirus, and the suitable ratio was 1〖JP20〗∶〖JP〗50.The VEGF protein concentration in the supernatant liquid of endothelial progenitor cells transfected with VEGF increased significantly.

    • The construction of recombinant lentiviral-vector with human interleukin-10 gene

      2008, 17(8):15-797. DOI: 10.7659/j.issn.1005-6947.2008.08.015

      Abstract (822) HTML (0) PDF 1.21 M (918) Comment (0) Favorites

      Abstract:Abstract:Objective:To construct contains human interleukin-10 gene recombinant lentiviral-vector (LV-IL-10) and to form a basis to further explore the therapy of chronic pain.
      Methods :hIL-10 gene fragment was isolated and amplified from pCYIL-10 plasmid by PCR, and was cloned into pWPXL-GFP. The inserted hIL-10 fragment was verified by Pme I digestion and DNA sequencing. The recombinant plasmid pWPXL-IL-10-GFP, envelope plasmid pMD2.G and packaging plasmid psPAX2 were cotransfected into 293T cells, to pack out lentivirus particle that has the ability of duplicated-deficiency, then virus titer determination was undertaken.
      Results:The 530bp IL-10 gene fragment was amplified from pCYIL-10 plasmid by PCR, and was recombinated into pWPXL-GFP plasmid. DNA sequencing confirmed that the cloned gene segment was 100% homologous to the published hIL-10 sequence in genebank. High titer(2×1010)and highly purified lentiviral particles was obtained.
      Conclusions:The lentivirus vector LV-hIL-10 was constructed successfully, which form a basis of research of chronic pain therapy.

    • >临床研究
    • Diagnosis and Treatment of hilar cholangiocarcinoma: a report of 96 cases

      2008, 17(8):16-800. DOI: 10.7659/j.issn.1005-6947.2008.08.016

      Abstract (808) HTML (0) PDF 841.03 K (684) Comment (0) Favorites

      Abstract:Abstract:Objective:To summarize the experience of treatment of hilar cholangiocarcinoma.
      Methods :The clinical data and long-term outcome of 96 cases of hilar cholangiocarcinoma were analyzed retrospectively.
      Results:Out of 96 cases, 65 patients underwent surgical procedures (28 cases of radical resection,6 cases of palliative resection,31 cases of surgical drainage); 31 cases underwent inteventional drainage therapy, of them 18 cases had combined radiotherapy, and 15 cases and combined interventional chemotherapy. (1) The average survival time of the radical resection group, the palliative resection group and the surgical drainage group was 25 months, 15.5 months, and 11.5 months, respectively. There was a significant difference between the three groups (P<0.01). (2) For the surgical drainage group, the average survival time was 11.5 months, which was not significantly greater than that of the interventional therapy group (11 months) (P>0.05). (3) For the group of radical resection plus radiotherapy or chemotherapy, the average survival time was 27 months and 1-,3-,5-year survival rate was 75%,45%, and 15%, respectively, which was significantly greater than the group of radical resection without adding radio-therapy or chemotherapy (24 months, and 50%,12.5%,0, respectively) (P<0.05).
      Conclusions:The best prognosis can be achieved by radical excision for patient with hepatic hilar cholangiocarcinoma. There is similar effect between the surgical drainage and interventional therapy, but the method of interventional therapy is safer with less injury and is convenient with few complications. Postoperative chemotherapy and radiotherapy may help to extend patient’s survival time.

    • Surgical treatment of distal bile duct carcinoma

      2008, 17(8):17-802. DOI: 10.7659/j.issn.1005-6947.2008.08.017

      Abstract (800) HTML (0) PDF 758.15 K (796) Comment (0) Favorites

      Abstract:Abstract:Objective:To study the methods and outcome of surgical treatment of distal bile duct carcinoma.
      Methods :The clinical data of 51 cases of distal bile duct carcinoma who underwent surgery were analyzed retrospectively. Of them, 28 cases received radical pancreaticoduodenectomy, and 23 cases had internal bile duct drainage procedures.
      Results:The total average survival time was 20 months. The mean survival time of radical and drainage operation was 32 months and 8 months respectively. Postoperative 5-year survival rate in radical pancreaticoduodenectomy group was 17.8%, and in drainage group was 0. The outcome of radical pancreaticoduodenectomy group was significantly better than that of internal bile duct drainage procedures group (P<0.01).
      Conclusions:The results showed that radical pancreaticoduodenectomy for distal bile duct carcinoma can prolong survival and is effective in improving quality of life.

    • Diagnosis and treatment of splenic occupied disease: a report of 68 Cases

      2008, 17(8):18-805. DOI: 10.7659/j.issn.1005-6947.2008.08.018

      Abstract (742) HTML (0) PDF 833.14 K (850) Comment (0) Favorites

      Abstract:Abstract:Objective:To summarize the clinical characteristics and the experiences of diagnosis and treatment of splenic tumors.
      Methods :A retrospective analysis was performed on the clinical data of 68 cases of splenic tumors confirmed by surgery and pathology.
      Results:Benign masses were found in 31 patients(45.59%), including splenic cyst in 15 patients, hemangioma in 12, lymphangioma in 3 and splenic abscess in 1; 37(54.41%) patients with malignant tumors included metastatic tumors of spleen in 24, primary splenic lymphoma in 11, malignant fibrous histiocytoma in 1, and angiosarcoma in 1. The preoperative confirmed diagnostic rate by B-US was 83.82% (57/68) and by CT was 91.18% (62/68). Of the 68 patients, 59 cases underwent splenectomy, 6 cases underwent partial splenectomy, 2 cases of splenic cyst underwent percutaneous drainage and 1 case underwent puncture biopsy. Tweety-two patients with benign tumor were followed up for 7 to 114 months and all are well; 23 of 37 patients with malignant tumor were followed up for 12 to 79 months, of them, 8 lymphoma patients survived 14 to 79 months, and in the other 15 cases, only 3 patients survived more than 2 years and 12 patients died at 3 to 12 months.
      Conclusions:B-US and CT are the main methods of diagnosis for splenic tumors, and surgery is the main method of treatment. Benign splenic tumor does not require any other therapy after splenectomy or partial splenectomy. Splenectomy is the treatment of choice for primary malignant splenic tumor. Adjuvant chemotherapy can prolong survival of patients with lymphoma after splenectomy. Metastatic tumors in the spleen require adjuvant treatment after operation.

Governing authority:

Ministry of Education People's Republic of China

Sponsor:

Central South University Xiangya Hospital

Editor in chief:

WANG Zhiming

Inauguration:

1992-03

International standard number:

ISSN 1005-6947(Print) 2096-9252(Online)

Unified domestic issue:

CN 43-1213R

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