Objective To evaluate safety and long-term efficacy of fully covered self-expandable mental stent (FCSEMS) in treatment of biliary stricture after liver transplantation (LT). Methods From January 2010 to June 2018, the data of patients with the biliary stricture after the LT underwent the endoscopic retrograde cholangiagraphy (ERCP) at the First Hospital of Lanzhou University were collected retrospectively. The therapeutic effect of the FCSEMS was evaluated. Results A total of 21 patients with the biliary stricture after the LT were treated. The success rate of the stent placement was 100%. The FCSEMSs were used in 7 cases and the only multiple plastic stents (MPSs) were used in 14 cases. There were no significant differences in the gender, age, time of biliary stricture, frequency of ERCP, recurrence time of biliary stricture, cure time of biliary stricture, curative effect, recurrence of biliary stricture, and incidence of complications between the patients treated with the FCSEMS and the MPS (P>0.050), but the number of plastic stents in the patients treated with the FCSEMS was significantly less than that in the patients treated only with the plastic stents (P<0.050), while the duration of stent retention was longer than that in the patients treated only with the plastic stents (P<0.050). Six patients were cured, 1 was remitted, and 2 were relapsed by the FCSEMS. Eight were cured, 3 were remitted, 3 were ineffective, and 5 were relapsed by the MPS alone. Conclusions FCSEMS might be an safe effective alternative to plastic stent in treatment of biliary stricture after LT, resulting in a longer duration placement, less number of plastic stent use. It is necessary to further accumulate cases to validate cure rate and recurrence rate of biliary stricture.
ObjectiveTo analyze factors affecting post-hepatectomy liver failure (PHLF) of patients with hepatocellular carcinoma (HCC) and explore value of combining albumin-bilirubin (ALBI) score with standardized future liver remnant (sFLR) in prediction of PHLF.MethodsThe clinical data of patients with HCC underwent curative hepatectomy in the Second and the Fifth Departments of General Surgery of the First Hospital of Lanzhou University from January 2016 to June 2018 were retrospectively reviewed. The risk factors of PHLF were identified through the logistic regression, the area under the receiver operating characteristic curve (AUC) was used to analyze the predictive value of the ALBI score, sFLR, or ALBI score×sFLR.ResultsA total of 72 patients with HCC were enrolled, all of them were the Child-Pugh A grade. The incidence of PHLF was 27.78% (20/72) in these 72 patients with HCC, which was 12.96% (7/54) and 72.22% (13/18) in the 54 patients with ALBI- Ⅰ grade and 18 patients with ALBI- Ⅱ grade respectively, the difference was statistically significant (P<0.001). The results of multivariable analysis of PHLF showed that the PLT (OR=0.030, P=0.018), ALBI grade (OR=11.758, P=0.020), and sFLR (OR=0.835, P=0.003) were identified as the independent predictors of PHLF. The AUC for the ALBI score×sFLR in predicting the PHLF was 0.892, it was greater than that of the ALBI score (AUC=0.799) or the sFLR (AUC=0.773).ConclusionCompared with Child-pugh grade, ALBI grade is more accurate in predicting PHLF of HCC patients, and combining ALBI score with sFLR is better than sFLR or ALBI score alone in predicting PHLF of patients with HCC.
Objective To investigate the current situation of salivation in patients with orotracheal cannula, and to systematically analyze its influencing factors. Methods Patients who underwent tracheal intubation treatment in 47 tertiary comprehensive medical institutions were selected between October 10th and 20th, 2023. A cross-sectional survey method was used to conduct an online survey of the patient’s salivation status. The patients were divided into the salivation group and no-salivation group. Results A total of 565 questionnaires were collected and 561 were valid, with an effective recovery rate of 99%. Among 561 patients, 284 were males (50.62%) and 277 were females (49.38%), with an age of (59.80±10.96) years; 159 cases of salivation occurred, with a total static saliva flow rate of (7.21±3.15) mL and the incidence of salivation was 28.34% (159/561). There were statistically significant differences in age, education level, body mass index, primary disease, number of concurrent functional impairments, concurrent oral diseases, smoking, intubation days, intubation depth, intubation process, sedation and/or analgesia days, and enteral nutrition treatment between the two groups (P<0.05). There was no statistically significant difference in other indicators between the two groups (P>0.05). The results of multivariate logistic regression analysis showed that body mass index, neurological diseases, number of concurrent functional impairments, concurrent oral diseases, smoking, intubation days and intubation process were independent risk factors for salivation in patients with oral catheterization. Conclusion The incidence of salivation in patients with orotracheal cannula is 28.34%, which is directly related to body mass index, neurological diseases, number of concurrent functional impairments, concurrent oral diseases, smoking, intubation days and intubation process.