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Bile duct injury repair — earlier is not better

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《医学前沿（英文）》 2015年 第9卷 第4期   页码 508-511 doi: 10.1007/s11684-015-0418-7

摘要：

Bile duct injury is a common complication of cholecystectomy. The timing of bile duct injury repair remains controversial. A recent review conducted in France reported 39% complications and 64% failure after immediate repair in 194 patients compared with 14% complications and 8% failure after late repair in 133 patients. A national review of 139 consecutive early repairs conducted at five hepatopancreaticobiliary centers in Denmark reported 4% mortality, 36% morbidity, and 42 restrictures (30%) at a median follow-up of 102 months, and only 64 patients (46%) demonstrated uneventful short-term and long-term outcomes. Most patients with bile duct injury present with bile leak and sepsis; thus, early repair is not recommended. Percutaneous drainage of bile and endoscopic stenting are the mainstays of treatment of bile leak because they convert acute bile duct injury into a controlled external biliary fistula. The ensuing benign biliary stricture should be repaired by a biliary surgeon after a delay of 4–6 weeks once the external biliary fistula has closed.

关键词： bile duct injury     cholecystectomy     laparoscopic cholecystectomy    

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Single incision laparoscopic cholecystectomy using the one-incision three-trocar technique with all straight

Hongyi Cui

《医学前沿（英文）》 2011年 第5卷 第3期   页码 283-287 doi: 10.1007/s11684-011-0151-9

摘要： Single incision laparoscopic surgery (SILS) is a novel minimally invasive surgical technique that is gaining popularity around the world. One of the most commonly performed procedures is single incision laparoscopic cholecystectomy (SILC). Most reported techniques utilize special purpose-made access port and articulating instruments, rendering the procedure costly and difficult to learn. This article provides a stepwise description of SILC technique using all straight instruments without the need for a special port. It aims to shorten the learning curve for surgeons wishing to adopt a safe and cost-effective SILC technique to their practice.

关键词： laparoscopic cholecystectomy     single incision laparoscopic surgery    

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Beneficial effects of preventive cholecystectomy in patients with hepatic cancer

LIU Anzhong, LI Jun, HUA Huwei

《医学前沿（英文）》 2008年 第2卷 第2期   页码 139-142 doi: 10.1007/s11684-008-0026-x

摘要： There is no conclusive answer to the question whether excising gall bladder is helpful to the patient with hepatic cancer. The survival rate of patients with hepatic cancer for more than two years has been increased, and the incidence of complications of cholecystitis and gall stone are relatively higher among these patients, which may seriously complicate treatment of advanced hepatic cancer and decrease quality of life. The researchers conducted a prospective clinical investigation from 2002 to 2006 to assess the clinical significance of preventive cholecystectomy in patients with hepatic cancer. One hundred and eighteen cases of postoperative patients with hepatic cancer, who survived for more than two years, were followed up. Based on whether cholecystectomy was performed, the patients were divided into two groups including 48 cases with cholecystectomy and 70 cases with cholecyst reserved. The two-year morbidity of gall stone and morbidity of pain in the right upper abdomen of cholecyst reservation group were 54.29% and 68.57%, respectively, obviously higher than 0.00% and 20.83% of cholecystectomy group. Mainly for those treated with transcatheter arterial chemo-embolization, the morbidity of gall stone was 86.67% ( < 0.01). Therefore, preventive cholecystectomy is strongly recommended during hepatectomy to decrease the incidence of chronic cholecystitis and gall stone, especially for those whose chemotherapy and embolization will be carried out through hepatic artery and portal vein.
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标题 作者 时间 类型 操作

Bile duct injury repair — earlier is not better

null

期刊论文

Single incision laparoscopic cholecystectomy using the one-incision three-trocar technique with all straight

Hongyi Cui

期刊论文

Beneficial effects of preventive cholecystectomy in patients with hepatic cancer

LIU Anzhong, LI Jun, HUA Huwei

期刊论文