ObjectiveTo explore the reliability and safety of diagnosis and treatment for cholecystocolonic fistula during laparoscopic cholecystectomy. MethodsData of patients with cholecystocolonic fistula in department of general surgery, Gansu provincial hospital from Jan 2002 to Dec 2015 were analyzed retrospectively. There were 112 cases diagnosed by routine intraoperative cholangiography from 11 472 laparoscopic cholecystectomy patients, including 33 males and 79 females, age from 58 to 84 years〔(67.4±12.6) years〕. ResultsOne hundred and twelve cases of cholecystocolonic fistula were diagnosed by routine intraoperative cholangiography in laparoscopic cholecystectomy. There were 105 cases of cholecystocolonic fistula performed laparoscopic cholecystectomy and colon repair, and 7 cases performed colostomy, no surgical complications occurred. Seventy cases were followed-up for 6-27 months〔(16.4±5.3)months〕after operation, no long-term complications occurred. ConclusionsThere is a lack of specific symptoms and special diagnosis for cholecystocolonic fistula before operation. Intraoperative cholangiography is a only objective method for diagnosis, and treatment of cholecystocolonic fistula by laparoscopic cholecystectomy and colon repair or colostomy is safe and reliable based on experienced laparoscopic skill.
ObjectiveTo systematically review the expression and clinical significance of CD133 in gastric cancer. MethodsSearches in the databases such as PubMed, EMbase, Web of Knowledge, The Cochrane Library (Issue 10, 2013), CBM, VIP, CNKI and WanFang Data were performed to collect case-control studies about the association between the CD133 expression and gastric cancer up to October 2013. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of the included studies, and then RevMan 5.2 software was used for meta-analysis. ResultsNine case-control studies involving 623 patients were included. The results of the meta-analyses showed that, there were significant differences of CD133 expression in the following comparisons:gastric cancer tissues vs. normal esophageal tissues (OR=3.89, 95%CI 1.87 to 8.11, P=0.000 3), lymph node metastasis vs. non-lymph node metastasis (OR=2.75, 95%CI 1.99 to 3.81, P < 0.000 01), clinical stages Ⅲ-Ⅳ vs. clinical stages Ⅰ-Ⅱ (OR=2.83, 95%CI 2.13 to 3.76, P < 0.000 01), as well as distant metastasis vs. non-distant metastasis (OR=2.38, 95%CI 1.47 to 3.85, P=0.000 4). While no significant difference was found between the cell differentiation G1-G2 vs. cell differentiation G3 (OR=1.70, 95%CI 0.90 to 3.21, P=0.10). ConclusionOver-expression of CD133 is associated with lymph node metastasis, distant metastasis and poor TNM stage, which suggests that CD133 may participate in the carcinogenesis of gastric cancer. However, due to the limitations of the included studies, more large-sample high-quality case-control studies are still needed to verify these results.