ObjectiveTo explore clinical manifestation, diagnosis and treatment of IgG4 sclerosing cholangitis developed postoperative gastroduodenal hemorrhage, so as to improve awareness and treatment of this disease. MethodThe clinical data of a case of IgG4 sclerosing cholangitis misdiagnosed as the hilar cholangiocarcinoma which developed postoperative gastrointestinal hemorrhage in this hospital were analyzed retrospectively. ResultsThis patient was misdiagnosed as the hilar cholangiocarcinoma and accepted the radical resection, while the postoperative pathology proved to be the IgG4 sclerosing cholangitis. One month later, the patient developed the acute gastrointestinal hemorrhage and it was resolved by using the endovascular embolization. ConclusionsPreoperative distinguishing IgG4 sclerosing cholangitis from hilar cholangiocarcinoma can avoid an unnecessary surgery. Endovascular intervention is both a useful measure of diagnosis and treatment for gastroduodenal pseudoaneurysm. Attention should be paid to arterial protection during process of arterial osteogenesis in hepatobiliary operation.
ObjectiveThe aim of this study was to evaluate the safety and feasibility of robot-assisted surgery in pancreatic cancer.MethodRecent literatures related to robot-assisted surgery in treatment of pancreatic cancer compared with traditional open surgery or traditional laparoscopic surgery were collected to make an review.ResultsCompared with the traditional laparoscopic surgery, the robot-assisted surgery was expensive, with the obvious advantages in terms of anastomosis and reconstruction. Compared with the open operation, both robot-assisted pancreaticoduodenectomy and robot-assisted distal pancreatectomy had longer operation time, but the length of hospital stay and intraoperative blood loss were obviously shortened, robot-assisted distal pancreatectomy also had higher spleen preservation rate. Compared with the traditional laparoscopic distal pancreatectomy, the number of lymph node retrieved, R0 resection rate, and splenic preservation rate were also higher in the robot-assisted group. Simultaneously, robot-assisted total pancreatectomy and midsection pancreatectomy were deemed as safe in some high-volume centers.ConclusionsRobot-assisted pancreatic cancer surgery is safe and feasible, but many surgeries are restricted to a small number of high-volume medical centers, and most cases selected to undergo robot-assisted surgery are often early stage patients with small tumor size. A lot of efforts should be made and problems should be solved.