The mumber of Polymorphonuclear leukocyte (PMN) in hepatic tissue increased in the rats with cholangitis, PMN infiltration was mainly in the hepatic sinus in the early stage; and PMN infiltration presented around the hepatocytes 12 hours after infection. Degeneration and necrosis of the hepatic cells was also observed in the rats with acute cholangitis. Only 40 percent of the rats survived 24 hours after infection. Depletion of circulating PMN decreased the damage and necrosis of hepatocytes and improving the survival rate of the infected rats. The results suggest that PMN infiltration plays an important role in hepatic damage in acute cholangitis.
To evaluate the effect of intercellular adhesiveness molecule-1 (ICAM-1), E-selectin on hepatic microcirculation in acute cholangitis. The Changes of hepatic tissue, content of blood flow and Evan′s blue (EB) in hepatic tissue in acute cholangitis were determinated. Results: The number of PMN in hepatic tissue and sinusin increased, degenaration and necrosis of the hepatic cells and hepatic sinusoidal endothelial cells and content of blood flow in liver were reduced, and content of EB in hepatic tissue increased remarkbly in the rats with acute cholangitis. Pretreatment of anti ICAM-1 and E-selectin mAb reduced the damage of hepatic microcirculation. Conclusion: ICAM-1 and E-selectin may play an important role in damage to hepatic microcirculation in acute cholangitis.
We evaluated the surgical results in 32 patients with liver metastasis from colorectal carcinoma. Twenty four patients had 1-3 metastatic hepatic nodules and 20 patients had synchronous hepatic metastasis. Liver resection was carried out simultaneously with radical resection of the primary tumour in 15 patients, 5 patients experienced resection 2 to 4 weeks later. Liver and primary tumour were resected as a whole in 5 patients with infiltrating metastasis from colonic carcinoma.Other operative types included atypical resections, left lateral lobectom and right posterior lobectomy, and right hemihepatactomy, right trilobectomy.Hepatic metastasis were all documented by pathology. The 3year and 5year survival rate were 37.5% and 25.0%, with no operative death. The authors believed that the number of metastasis is the most important factor influencing the surgical result, and liver resection is an effective form of treatment for patients with resectable liver metastasis from colorectal carcinoma, but the type of surgery shall be choosed reasonably.
One hundred and twenty eight patients with intestinal obstruction due to cancer of left lemicolon are presented. In this series 71 patients suffered from partial intestinal obstruction and 57 patients from complete obstruction, the latter were in later Dukes stages, with lesser resectability of the tumor and higher mortality. The transition from partial obstruction to complete obstruction takes a slow course. Purgatives and coarse fibered food should not be given to the patients with partial obstruction, or else will induce acute obstruction. Several types of operation for partial and complete obstruction are discussed. Methods and results of intraoperative colonic irrigation are presented. The authors believe that intraoperative colonic irrigation is a good emergency management for cancer obstruction of the left colon. Complication of this disease are also discussed.