ObjectiveTo explore the feasibility and safety of the artificial pneumoperitoneum and gastrointestinal contrast CT imaging, and imaging diagnostic value on abdominal wall adhesion to intestine after operation. MethodsThirtynine patients with adhesive intestinal obstruction after operation relieved by conservative therapy were included from January 2008 to November 2009. After the artificial pneumoperitoneum established by injection of gas into abdominal cavity and gastrointestinal comparison by oral administration low concentration of meglucamine diatrizoate, CT scan imaging was performed and the radiographic results were compared with surgical findings. ResultsFour patients refused surgery and discharged, so enterolysis was performed in the remaining patients. The surgical findings were consistent with radiographic results. It was showed by laparoscopic operation that intestinal obstruction caused by the fibrous adhesions and the intestine did not adhere to the abdominal wall in eight patients with fibrous adhesion diagnosed by CT. Of eighteen patients with the abdominal wall septally adhered to the intestinal, the surgical findings showed the intestine and the abdominal wall formed “M”type adhesions and omentum adhesions in sixteen patients underwent open operation, and clear fat space was showed in eight patients and close adhesion was found in another eight patients between the intestine and abdominal wall. Of thirteen patients with the abdominal wall tentiformly adhered to the intestinal, the surgical findings showed the intestine and the abdominal wall formed continuous and tentiform adhesions and omentum adhesions to the intestine in eleven patients. After the followup of 6-18 months (mean 9 months), incomplete intestinal obstruction occurred in one patient and was relieved by conservative treatment. One patient with discontinuous discomfort in abdomen after operation did not receive any treatment. The other patients were cured. ConclusionThe artificial pneumoperitoneum and gastrointestinal contrast CT imaging can accurately show the location, area, and structure composition of the postoperative abdominal wall adhesion to intestine, which is safety, simple, and bly repeatable, and a better imaging method for the diagnosing of abdominal wall adhesion to intestine after operation.
ObjectiveTo compare the clinical effects of two commonly used organ preservation solutions University of Wisconsin (UW) solution and histidine-tryptophan-ketoglutarate (HTK) solution in liver transplantation.MethodsThe PubMed, Embase, Cochrane Library, CNKI, CBM, VIP, and Wanfang Data were searched to collect the comparative studies of the UW solution and HTK solution in the liver transplantation. The data were extracted and evaluated by the RevMan 5.3 software.ResultsFinally, 16 articles with a total of 35 024 patients were included. The meta-analysis results showed that the HTK solution group had a lower incidence of postoperative biliary complications [RR=1.30, 95%CI (1.07 1.58), P=0.008] and lower aspartate aminotransferase peak level within 7 d after operation [MD=112.45, 95%CI (93.34, 131.56), P<0.01] as compared with the UW solution group. No significant differences were found in terms of the incidence of primary non-function [RR=1.07, 95%CI (0.52, 2.18), P=0.86], survival rates of patient and graft in different time points (P>0.05), incidence of retransplantation [RR=0.83, 95%CI (0.48, 1.45), P=0.51], incidence of acute rejection [RR=1.27, 95%CI (0.96, 1.68), P=0.33], alanine aminotransferase peak level within 7 d [MD=31.79, 95%CI (–161.84, 225.42), P=0.75] after operation, total bilirubin [MD=19.42, 95%CI (–10.83, 49.67), P=0.21], and prothrombin time [MD=1.75, 95%CI (0.01, 3.49), P=0.84] between these two groups.ConclusionsHTK solution is safe and effective for liver transplantation, and has similar effects as UW solution. Regarding effect of both on long-term survival rates of patient and graft, large-sample and high-quality RCT is still needed for systematic evaluation.