【Abstract】Objective To evaluate the application of duct endoscopy in the diagnosis of breast diseases characterized by nipple discharge. Methods One hundred and sixtynine consecutive cases from October 2003 to September 2004 who had duct endoscopy for nipple discharge were reviewed and followed up. Results Of 169 cases, 79 ductitis, 62 intraductal papilloma, 9 intraductal carcinoma in situ, 19 without breast diseases were diagnosed under duct endoscopy. During following up, the diagnostic accuracy of intraductal papilloma and intraductal carcinoma in situ with duct endoscopy was 89.8%(44/49) and 55.6%(5/9),respectively. There was only one patient who had breast pain and mild skin redness which was cured with oral antibiotics for 3 days. Conclusion Duct endoscopy is an only technique to explore the etiology for duct discharge under vision. It is direct, safe and effective, with a high accuracy.
Objective To summarize the preoperative CT three-dimensional reconstruction, and administration and visualization of indocyanine green (ICG) during ICG-assisted laparoscopic duodenum-preserving pancreatic head resection (LDPPHR). Methods A 56-year-old female patient admitted to the Department of Biliary Surgery in West China Hospital in April 2022 was retrospectively analyzed. The patient was considered the possibility of benign tumor of pancreatic head, and underwent LDPPHR. Three-dimensional CT reconstruction was performed before operation, and ICG (5 mg) was injected intravenously preoperative and intraoperative to complete LDPPHR. Results Preoperative three-dimensional CT reconstruction can assist in judging the course and relationship of anterior and posterior pancreaticoduodenal arterial arch and surrounding main blood vessels. After intravenous injection of 5 mg ICG 24 hours before operation, the common bile duct at the upper edge of pancreas was clearly visualized, and the cystic mass was judged not to communicate with bile duct and pancreatic duct. But it was difficult to identify the pancreatic segment of the common bile duct in fluorescence mode, ICG 5 mg was injected intravenously during the resection stage, and then the common bile duct was obviously visualized. After the resection stage, injected ICG (5 mg) intravenously again. Within 1 min, the fluorescence of the duodenum was enhanced, which suggested that the blood perfusion of duodenum was well. The operative time was 280 min, the blood loss was about 200 mL. On the 10th day after operation, the patient developed transient gastrointestinal bleeding with bile leakage, which improved after symptomatic treatment and was discharged on the 19th day. Postoperative pathological examination diagnosed pancreatic serous cystadenoma. Conclusions Three-dimensional reconstruction and ICG assisted LPDDHR can successfully visualize and identify the blood vessels and bile ducts, and check the duodenal blood perfusion. Which can making the operation more accurate and visual is a powerful guarantee for LDPPHR to be carried out safely and effectively.
【摘要】目的探讨超声导向下Mammotome活检及旋切系统切除乳腺肿块的并发症及其处理。方法在超声导向下，利用Mammotome系统对乳腺肿块进行活检和切除，对出现的并发症进行及时的处理。结果46例患者的75个乳腺肿块被切除，病理证实68个为纤维腺瘤，7个为纤维腺病。术中并发症包括出血、血肿和胸大肌损伤，经及时处理后恢复，术后并发症为瘢痕形成。结论Mammotome乳腺肿块切除术具有创伤小、并发症少的优点，是一种有效的、不影响乳房外观的微创手术，超声监控能够减少和发现并发症并进行正确的处理。
ObjectiveTo investigate the effectiveness of hydrocolloid dressing in preventing peripheral phlebitis due to intravenous infusions. MethodsFrom April 1st to October 30th, 2014, 320 patients admitted in the Biliary Department of West China Hospital for parenteral nutrition were collected along with their clinical data and were randomly divided into control group and intervention group. A total of 160 patients who were allocated in the control group accepted simple dressing with 3M adhesive tape (6 cm×7 cm) at the intravenous catheter site. In contrast, hydrocolloid dressing (5 cm×7 cm) was applied at the intravenous catheter site and then covered with 3M adhesive tape (6 cm×7 cm) for the patients in the intervention group. ResultsPhlebitis rate was significantly higher in the control group (115 patients) than that in the interventions group (64 patients) (χ2=32.978, P<0.001). In addition, the severity of phlebitis was higher in the control group than that in the intervention group (Z=-4.466, P<0.001). Statistically significant difference was noted. ConclusionHydrocolloid dressing is effective in preventing and delaying the occurrence of peripheral phlebitis due to intravenous infusions.
ObjectiveTo investigate the effectiveness of epidermal growth factor receptor antagonist (AG-1478) on chronic proliferative cholangitis (CPC), so as to investigate new treatment approach for hepatolithiasis associated with CPC. MethodsForty-six SD rats were divided into 5 groups: CPC model group (n=10), only made models. AG-1478 treatment group (divided into 3 mg/kg， 6 mg/kg， and 12 mg/kg groups, n=10 per group), the common bile ducts in CPC animal model received an intralumenal administration of AG-1478 at the meantime of modeling, followed by intraperitoneal AG-1478 injection of 1.5 mg/(kg·d) for 7 days. Sham operation group (SO group, n=6). Subsequently, histopathological observation, immunohistochemistry, real time PCR， and Western blot were used to evaluate the mRNA expression and influence of AG-1478 on the hyperplasia （EGFR， ki-67， BrdU， collagen Ⅰ protein） and lithogenic potential (Mucin 5AC) of CPC. ResultsCompared with CPC model group, the expressions of EGFR, ki-67， and BrdU were obviously decreased in the AG-1478 treatment group. Also, the inhibition of hyperplasia of biliary epithelium and collagen fibers were confirmed by histopathological observation. Additionally, the expressions of Mucin 5AC mRNA and collagen Ⅰ protein remarkable decreased in the AG-1478 treatment group (Plt;0.05). Conclusions EGFR inhibitor (AG-1478) could shows inhibitory effectivenss on the CPC-mediated hyperplasia and lithogenic potential, and therefore holds promise as the new treatment approach for CPC.