Objective To summarize the clinical experience of da Vinci surgical system in treatment for senile patients with severe obstructive jaundice．Methods From January 2009 to May 2011, 209 patients with hepatopancreatobiliary （HPB） diseases underwent robotic surgeries by using da Vinci surgical system. Forty-seven senile patients with severe obstructive jaundice were selected for robotic surgery （robot group） and 44 for open surgery（open group）.The distribution of disease, pro-, intra-, and post-operative data in the two groups were analyzed. Results Baseline of two groups was same. A total of 46 patients had underwent total robotic surgeries （97.87%，46/47） and 1 patient converted to hand-assisted procedure （2.13%，1/47）. Surgeries included all HPB difficult surgical procedures, also including 1 case of hilar cholangiocarcinoma patient who had high level serum bilirubin （375μmol/L）and underwent emergency resection for hilar cholangiocarcinoma and portal-jejunal Roux-en-Y anastomosis． Postoperative complications occurred in 7 cases （14.89%, 7/47） and 1 case died （2.13%, 1/47） . Three-month survival rate was 78.15%. Fifteen-day and 3-month after surgery, physical strength score was 42.87±18.61 and 58.51±23.86, respectively. The total length of abdominal incision was （6.30±1.70） cm. All the patients in the open group completed surgery, including emergency operation in 4 cases. Postoperative complications occurred in 13 cases （29.55%, 13/44） and 2 cases died （4.55%, 2/44）.Three-month survival rate was 72.36%. Fifteen-day and 3-month after surgery, physical strength score was 37.15±13.64 and 45.27±18.96, respectively. The total length of abdominal incision was （26.73±3.07） cm. There were significant differences of postoperative complications, postoperative 15-day and 3-month physical strength score, and incision length between two groups（P＜0.05）. Conclusions da Vinci surgical system is safe and effective in treatment for senile patients with severe obstructive jaundice.
【Abstract】Objective To investigate the anatomic structure and experimental methods of peribiliary vascular plexus(PVP) in rat’s hepatic portal bile duct.Methods To observe the morphological structure of PVP in rat’s hepatic portal bile duct after the hepatic artery was perfused with Chinese ink and transparency management, performed and to make three dimensional reconstruction of PVP’s spacial structure in MoticBuaa3Dvol software.Results The microvascular distribution and plane structure of PVP in rat’s hepatic portal bile duct could be shown clearly through Chinese ink perfusion and transparency management. The three dimensional structure of PVP could be reconstructed effectively by MoticBuaa3Dvol software, its effect was verisimilitude. Conclusion Chinese ink perfusion and vitrification is a simple and easy method in PVP’s morphologic study of rat’s hepatic portal bile duct. MoticBuaa3Dvol software is useful in microvascular study of hepatic portal bile duct.