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Surgical Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus

Progress in Surgical Treatment of Primary Liver Cancer

自1888年Langenbuch为肝脏肿瘤患者施行首例肝切除术后，肝脏外科至今已有一百多年历史。我国的肝脏外科经历了20世纪50年代的大肝癌的规则性切除，60年代的肝移植，70年代的小肝癌的局部切除，80年代的复发肝癌的再切除和肝癌的二期切除，90年代确立的肝癌综合治疗以及21世纪的肝癌转移、复发的防治研究阶段。肿瘤的早期发现和以手术切除为主的综合治疗大大提高了肝癌患者的生存率，手术切除仍是获得长期生存的最重要手段。随着肝脏解剖学的发展、影像学技术的进步、术中超声的应用、肝储备功能评估方法的改进、围手术期处理的完善、手术技术的进步以及手术器械的发展，使肝切除手术的死亡率和术后并发症发生率大大降低。近年来，微创观念和微创外科技术的兴起以及肝移植特别是活体肝移植(LDLT)的蓬勃开展，对传统的肝切除术造成巨大冲击，也因此促使了肝切除术的不断发展、丰富和完善。如何安全、彻底地切除肝脏病灶，同时保留充足的功能性肝组织，成为外科医师面临的新挑战。................

Study of Relationship Between Cholecystectomy and Helicobacter Pylori Infection

ObjectiveTo study the relationship between cholecystectomy and Helicobacter pylori （Hp） infection. MethodsOne hundred and eleven patients with cholecystolithiasis were chosen as the investigation group, while 577 patients with upper digestive tract symptoms without cholecystolithiasis as the control group. All the patients took the 13C breath test to determine whether they were infected by Hp. All the patients with Hp infection continued eradical therapy for Hp infection for one course after cholecystectomy and were followed up on outpatient basis. ResultsThe infection rate in the investigation group was 45.9%, while 27.4% in the control group. During the 3 to 6 months of followup for the patients undergoing eradical therapy for Hp infection, we found no patient complaining of epigastric pain, malaise, belching and nausea. ConclusionThe infection rate of Hp in patients with cholecystolithiasis is high, Hp may be one of the factors causing “postcholecystectomy syndrome”. Eradical therapy for Hp after cholecystectomy will help improve the effects of operation.