ObjectiveTo investigate the feasibility and security of laparoscopic Whipple pancreaticoduodenectomy(LPD)or laparoscopic pylorus preserving pancreaticoduodenectomy(LPPPD)for the patients with periampullary diseases, estimate the ratio of postoperative complications between LPD and LPPPD. MethodsFourty-five patients who underwent the LPD or LPPPD from January 2010 to March 2014 were reviewed retrospectively. These patients were divided into LPD group and LPPPD group basing on the Whipple or polyrus preservation. ResultsAmong these 45 patients, 25 patients were performed the LPD, the other 20 patients were performed the LPPPD. There were 25(55.56%)complications after operation, including 10 cases of pancreatic fistula, 1 case of bile leakage, 6 cases of delayed gastric emptying, 3 cases of infection, 2 cases of stomach intestine stomatorrhagia, 1 case of mesenteric venous thrombosis, 1 case of ascites, 1 case of chylous fistula. The complication rate had no significant difference between two groups. One patient died after operation in the LPPPD group. ConclusionLaparoscopic pancreaticoduodenectomy is safe and feasible in the treatment of periampullary diseases, the LPPPD could partly prevent the occurrence of reflux of the digestive juice following the resection of pylorus and improve the quality of life.
ObjectiveTo analyze the retrieval status of master and doctoral dissertations entitled systematic review/meta-analysis (SR/MA) in China. MethodsThe China Dissertation Database was searched for master and doctoral dissertations entitled SR/MA from 1980 to March 2015. Two reviewers independently extracted the basic characteristics of included dissertations, the name of retrieval databases, retrieval strategies and the method of screening literature. Then related data were analysed by Stata 12.0 software. ResultsA total of 1 639 master and doctoral dissertations entitled SR/MA were included for data analysis. Among them, 1 259 (79.5%) retrieved both Chinese databases and English databases, 107 (6.5%) retrieved Chinese databases alone, and the other 237 (14.5%) retrieved English databases alone. 1 137 (69.4%) retrieved two or more Chinese databases, while 1 316 (80.3%) retrieved two or more English databases. The most commonly retrieved Chinese databases were CNKI, VIP, CBM, and WanFang Data; while the most frequently retrieved English databases were PubMed, The Cochrane Library, EMbase and Ovid. 89.9% reported the duration of search time, 73.4% reported manual retrieval, 68.6% reported reference retrieval, 23.3% reported conference retrieval, 23.3% reported using search engine and 26.8% reported contact with experts and authors. 45.8% reported their steps of screening papers, 37.5% provided a flow screening chart, and only 14.9% reported the number of papers from each database. ConclusionThe current study suggests that the retrieved databases of master and doctoral dissertations entitled SR/MA in China are still not enough. We suggest the authors of dissertations on SR/MA retrieve at least 3 common databases, reference, engines, conference paper at the same time, and improve information on search strategy and paper screening methods.
ObjectiveTo evaluate the feasibility and safety of laparoscopic radical antegrade modular pancreatosplenectomy through the ligament of Treitz approach for pancreatic body and tail cancer. MethodsOn 13th November 2017, we selected a patient with a suspicious malignant tumor in the body of pancreas but no evidence of metastasis or local invasion of the retroperitoneum for laparoscopic antegrade modular pancreatosplenectomy through the ligament of Treitz approach. The time of operation, the estimated blood loss, and post-operative complications were observed. ResultsThe procedure was completed successfully in 255 min, and the estimated blood loss was 200 mL, there was no need of transfusion and no significant post-operational complications had been observed. No tumor recurrence or distal metastasis was found after a 12 month’s follow-up. ConclusionLaparoscopic radical antegrade modular pancreatosplenectomy through the ligament of Treitz approach is a feasible and safe procedure for pancreatic body and tail malignant tumor in strictly selected patients.
Objective To explore the feasibility and safety of Frey operation under laparoscopy in the treatment of chronic pancreatitis. Methods The clinical data of chronic pancreatitis patients who underwent laparoscopic Frey procedure in Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University from 2021-2023 were retrospectively analyzed. Results Eleven patients with chronic pancreatitis complicated with pancreatic duct stones were included in the study, 7 of whom had a history of diabetes and (or ) impaired glucose tolerance, suggesting that pancreatic endocrine function was impaired. The median diameter of the main pancreatic duct measured by imaging method was 8 mm (4–20mm). The median operative time was 188 min (120–368 minutes), and the total intraoperative bleeding volume was 50 mL (20–100 mL). Postoperative pancreatic fistula did not occur, one case of postoperative abdominal fluid accumulation and hypoproteinemia improved after symptomatic supportive treatment such as anti infection, acid and enzyme inhibition, and nutritional rehydration. Postoperative bleeding occurred in 3 cases, including 1 case of intestinal anastomotic bleeding, which was sutured again under emergency laparoscopic intestinal anastomosis to stop bleeding. The other two cases improved after conservative management such as blood transfusion, plasma, vitamin K, acid inhibition, enzyme inhibition and hemostatic drugs. The median postoperative hospitalization time was 7 days (4–18 days), and no patient mortality happened within 90 days after surgery. Conclusion Laparoscopic Frey operation is feasible and a relatively safe and effective method for the treatment of chronic pancreatitis.
ObjectivesTo assess the effectiveness of BOPPPS method in teaching of evidence-based medicine for undergraduates.MethodsTwo classes from the first and second clinical medical college of Lanzhou University were randomly selected as BOPPPS group and traditional teaching group, respectively. The examination scores and questionnaire were used in combination to evaluate the teaching effectiveness. EpiData 3.1 software was used for data entry. SPSS 23.0 software was used for statistical analysis.ResultsA total of 25 students were in BOPPPS group and 26 in traditional teaching group. Baseline characteristics such as gender, age, participation in scientific researches, publication of articles were balanced between two groups. The score of the BOPPPS group was higher than that of the traditional teaching group, and there was a significant difference between two groups in evidence searching, evidence evaluation and total score (P<0.05). Compared with traditional teaching group, more students from BOPPPS group deem that study interest, learning initiative, problem analysis and solving capability, self-study capability, communication between teachers and students, information acquisition capability, information analysis and utilization capability, speech capability and so on are improved, and there was a significant difference between the two groups (P<0.05).ConclusionsThe BOPPPS teaching mode is beneficial for undergraduates to improve innovative and practical capability, and improve quality and effectiveness of evidence-based medicine teaching.
ObjectivesTo systematically review the methodological and reporting quality of the current global breast cancer screening guidelines so as to provide useful information for domestic study in the future.MethodsWe searched databases including PubMed, The Cochrane Library, Web of Science, EMbase, CNKI, CBM, WanFang Data and some cancer official websites to collect breast cancer screening guidelines from inception to February, 2018. Two reviewers independently screened literature, extracted data and assessed the quality of the guidelines by using AGREE II tool and RIGHT statement.ResultsA total of 11 guidelines were included, in which 5 guidelines (45%) were issued by the USA. The results of the quality assessment showed that: the average scores in the " scale and objective”, " participants”, " rigorism”, " clarity”, " application”, and " independence” of all guidelines were 83, 48, 60, 77, 53 and 79, respectively. 6 guidelines were evaluated as level A and 5 as level B. For the reporting quality, 3 guidelines were of high quality, including 2 in the USA and 1 in Canada.ConclusionsThe methodological and reporting quality of breast cancer screening guidelines are at present very satisfactory. The quantity of clinical guidelines shows an increasing trend. Multi-country contribution to one guideline is another trend. The evidence-based methodology has been accepted globally in the guideline development.