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find Author "顾元龙" 4 results
  • Relative Anatomic Research Around Pancreatic Interfascial Space and Safe Surgical Plane-Regard Pancreas as Axis

    Objective To study the vascular applied anatomy,the anatomic features of fascial,and interfascial space around the pancreas and duodenum,observe marker and safe surgical plane of pancreaticoduodenal region,and provide clinical anatomy basis for surgery of duodenum, pancreatic head,and distal common bile duct.Methods Anatomical observations were performed in 7 formalin fixed cadavers on duodenum,distal common bile duct,and pancreatic peripheral blood supply.Transverse mesocolon,pancreatic capsule and potential interfascial space,surgical plane and anatomic marker for reorganization around pancreas were observed.Results Gastropancreatic fold and hepatopancreatic fold formed by pancreatic capsule were good markers to locate the root of left gastric artery and common hepatic artery.A vessel-free plane between the behind pancreas and the anterior lamella of Gerota fascia could be used to make lymphadenectomy and pancreatic dissection behind pancreas and duodenum.Gerota fascia should be regarded as a safe posterior border to avoid injuring vessels and adrenal gland by mistake.The descending part and horizontal part of duodenum were mainly supplied by the anterior and posterior pancreaticoduodenal arterial arcade.The anterior and posterior pancreaticoduodenal arterial arcade should be protected in duodenum-preserving resection of pancreatic head.Conclusions Full understanding of pancreatic fascial and interfascial space formed in embryonic development is very important.Operation along the interfascial spaces is safe without bleeding and organ injury,which is essential in oncosurgery.

    Release date:2016-09-08 10:36 Export PDF Favorites Scan
  • Study of therapeutic effect of human heat shock protein 70-peptide complex/dendritic cells on hepatocellular carcinoma

    Objective To investigate immunological therapeutic effect and safety of dendritic cells (DCs) combined with heat shock protein 70 (HSP70)-peptide complex (PC) derived from autogeneic hepatoma tissue. Methods Thirty patients with hepatocellular carcinoma from February 2010 to February 2015 in the Gaochun People’s Hospital of Nanjing and The Third Affiliated Hospital of Nantong University were studied, and subsequently were divided into an immunotherapy group (treated with HSP70-PC/DCs vaccine,n=15) and a chemotherapy group (n=15) according to the prescribed postoperative treatment methods. The levels of T lymphocyte subtypes were assayed by FACS. The toxicity adverse reactions, alpha-fetoprotein (AFP), CA19-9, hepatic tumor recurrence rate, survival rate, and KPS of two groups patients were evaluated and compared between these two groups. Results ① The values of CD3+, CD4+, CD4+/CD8+, and CD3CD56 had no significant differences between the immunotherapy group and the chemotherapy group before treatment (P>0.05), which in the immunotherapy group were significantly higher than those in the chemotherapy group after treatment (P<0.05), and which were significantly higher in the immunotherapy group after treatment as compared with the levels before treatment (P<0.05), and which had no significant differences in the chemotherapy group between after treatment and before treatment (P>0.05). ② Before treatment, the levels of AFP and CA19-9 had no significant differences between the immunotherapy group and the chemotherapy group (P>0.05), which in the immunotherapy group were significantly lower than those in the chemotherapy group after treatment (P<0.05). In the immunotherapy group, the levels of AFP and CA19-9 after treatment were significantly lower than those before treatment (t=2.564,P=0.021;t=2.011,P=0.041), which in the chemotherapy group before treatment were decreased as compared with the levels before treatment (t=2.221,P=0.036;t=2.487,P=0.066). ③ The patients treated with the HSP-PC/DCs vaccines was well tolerated and no obvious toxicity was appeared. ④ All the patients were followed up 5–19 months with median follow-up time of 9 months. The median survival time was 560 d and 436 d in the immunotherapy group and the chemotherapy group, respectively. After treatment, KPS score was significantly higher and recurrence rate was significantly lower in the immunotherapy group as compared with the chemotherapy group (P<0.05). The total survival had no significant difference between the immunotherapy group and the chemotherapy group (P>0.05). Conclusions The preliminary results of limited cases in this study show that HSP70-PC/DC vaccination is safe and effective in treatment of hepatocellular carcinoma, the pulsed DCs are effective in activating specific T-cell responses against hepatocellular carcinoma cells. HSP70-PC/DC vaccine might improve immunity and prevent postoperative recurrence of hepatocellular carcinoma.

    Release date:2017-02-20 06:43 Export PDF Favorites Scan
  • Clinical Study on Transumbilical Single Port Laparoscopic Cholecystectomy Comparing with Conventional Laparoscopic Cholecystectomy

    ObjectiveTo compare the advantages and disadvantages of transumbilical single port (TUSP) and conventional laparoscopic cholecystectomy (LC). MethodsThe clinical data of 45 patients underwent elective LC were analyzed, 20 patients with TUSP LC (TUSP-LC group), 25 patients with conventional LC (conventional LC group). The operation time, Child-Pugh score and painkiller application frequency within three days after operation, the first time of out of bed and hospital stay after operation, intraoperative blood loss, chronic pain within one month after surgery were compared between two groups. ResultsAll cases were operated successfully except one patient in the conventional LC group. The frequency of painkiller application within three days after operation and postoperative hospital stay in the TUSP-LC group were better than those in the conventional LC group (Plt;0.05). There were no significant differences on postoperative chronic pain of surgical area within 1 month and Child-Pugh score between two groups (Pgt;0.05). The operation time and intraoperative blood loss in the conventional LC group were less than those in the TUSP-LC group (Plt;0.05, Plt;0.01). ConclusionTUSP LC has the advantages of small wound, slight pain, and fast recovery.

    Release date:2016-09-08 10:45 Export PDF Favorites Scan
  • 腹腔镜下经胆道镜钬激光碎石治疗难治性胆管结石

    目的探讨腹腔镜下经胆道镜钬激光碎石治疗难治性胆管结石的可行性和疗效。 方法回顾性分析我院2009年6月至2014年12月期间18例腹腔镜下经胆道镜钬激光碎石治疗难治性胆管结石(无法在内镜下乳头括约肌切开取石术取出者)的临床资料。 结果成功手术18例,手术时间60~200 min,平均130 min。一次性取净结石16例,2例女性患者分别有四川、安徽生活居住史,术后造影在左、右肝管内再次发现絮状结石,予熊去氧胆酸口服,随访至今,其中1例结石消失,另外1例仍有结石表现。术后均无胆管出血、胆瘘、胆管狭窄等并发症发生。 结论对于难治性的胆管结石,腹腔镜下经胆道镜钬激光碎石治疗是一种安全、有效的方法。

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