ObjectiveTo evaluate the feasibility of clipless laparoscopic cholecystectomy (LC) to patients with calculous cholecystitis in acute inflammation stage. Methods The clinical data of 169 patients with calculous cholecystitis in acute inflammation stage who underwent clipless LC from December 2008 to July 2010 were analyzed. ResultsAll patients were successfully operated by LC except one case who suffered from gallbladder perforation and a conversion to open surgery was performed. The operation time ranged from 25-70 min (mean 38 min). The blood loss ranged from 10-200 ml (mean 22 ml). Peritoneal drainage was done in 38 patients, and the drainage time ranged from 1-6 d (mean 1.8 d). The time to out-of-bed activity was at 2 h after operation and the hospitalization time was 3-7 d (mean 3.5 d). There was no complication such as bile duct injury, hemorrhage, billiary leakage, and intra-abdominal infection. ConclusionWith improvement of operator’s experiences and skills, the clipless LC becomes feasible and safe for patients with calculous cholecystitis in acute inflammation stage.
ObjectiveTo explore how to select the suitable indications of ERCP for clinical diagnosis and treatment. MethodsThe data of patients treated by ERCP between January 2005 and December 2009 in our hospital were analyzed retrospectively. ResultsTotal 221 patients received ERCP, among whom 99 (45%) cases of common bile duct stones, 44 (20%) cases of malignant tumor, 9 (4%) cases of papilla narrow, 45 (20%) cases were negative, and 24 (11%) cases were failed. It had the trend that the number of the patients received ERCP reduced year by year. The postoperative complication rate was 11% (25 cases), including 15 cases of postoperative pancreatitis, 3 cases of bleeding, 5 cases of biliary duct infection, and 2 cases of basket stranded. ConclusionIn the modern medical condition, with the advancement of image and laparoscopy technology, we should select the diagnosis and treatment methods with the principles of no damage or less damage for patients, without unlimitedly broadening the clinical indications of ERCP.
【Abstract】ObjectiveTo eliminate the interference of CEA-related substances in CEA measurement and increase the specificity of CEA in the detection of malignant digestive diseases. MethodsCEA level of peripheral blood and digestive juice (bile, gastric juice) from patients with benign or malignant digestive diseases was measured by ELISA, and semi-dry electrophoretic transfer method of Western blot technique to distinguish CEA and CEA-related substances. ResultsIn malignant diseases, the CEA level of digestive juice was significantly higher than that in the blood, and there was no difference of CEA level in digestive juice and blood in benign diseases. Meanwhile, the CEA level of digestive juice and blood in malignant diseases were significantly higher than that in benign diseases. A specific band (molecular weight about 210×103) was detected in all malignant diseases except four cases whose CEA level was too low (less than 5 μg/L), whereas no one of benign diseases had this specific band no matter how high or low the CEA level was. ConclusionThe specificity of CEA detection in malignant digestive diseases can be improved by using digestive juice as sample and combining with Western blot technique.