Objective To investigate the choleenterostomy type and the longterm results in treatment of benign diseases of biliary tract. MethodsA total of 614 cases of choleenterostomy from January 1981 to December 2000 were followed up and analysed. The original diseases: 321 were original hepatolithiasis and/or bileduct stricture (52.3%)， 106 congenital cyst of common bile duct (17.3%), 151 iatrogenic bile duct injury (24.6%) and others 36 cases (5.9%). Choledochoduodenostomy was performed in 89 cases and choledochojejunostomy in 525 cases. Five hundred and twentyfour cases have been followed up for 1 to 20 years. The rate of followup was 87.9%. ResultsIn 84.5% of the cases, excellent or good longterm results were achieved. Reoperation rate were 49.4% in cases of choledochoduodenostomy or cystoduodenostomy, 14.2% in sideside (cyst) cholangiojejunostomy and 4.4% in endside cholangiojejunostomy, respectively. Conclusion The choledochoduodenostomy should be abolished. The endside cholangiojejunostomy shoud be the best choice when it is needed to perform choledochojejunostomy in benign bile duct diseases and can promise a satisfactory longterm result.
The antireflux spur-valvewas originally designed for the Roux-Y cholenterostomy. It is made by plication of the two upper limbs of the "Y" after the removal of the seromusculature from the biliary limb, so that the conjoined wall-in-between will he compassed deviating to the biliary, side to form a spur value. It could successfully stop the reflux due to normal peristalsis or intestinal distension. This value was primarily used in choledochal cyst and biliary atresia for more than 100 cases, and also applielied to many other operations for perventing reflux, including: gastroesophageal refluk-Nissen fundoplication, colon replacement of esophagus, side to side shert-circuit of intestinal obstruction, and Kock scontinent ileoslomny. The detailed procedures were described.
Objective To investigate the historical evolution and the research progress of pancreaticoenterostomy method in the pancreaticoduodenectomy. Methods The related literatures of PubMed， EMBASE， Wanfang， CNKI， and VIP databases were retrieved and reviewed. The advantages and disadvantages of various pancreaticojejunostomy type in pancreaticoduodenectomy were summarized. Results The type of pancreaticoenterostomy is the major influence factors for the pancreaticoduodenectomy success or failure and the patients’s recovery. Conclusion According to the specific cases， the type of pancreaticojejunostomy in skilled operation is the key to success.
Objective To investigate the new method of pancreaticoenterostomy and decrease the probability of complications like pancreatic fistula etc. Methods By using the absorbable bandage and ear-brain glue, modified sutureless pancreaticoenteromy was made in 10 swines. Experimental data includes： routine analysis of blood, levels of amylase in blood and abdominal drainage and lipase in blood and abdominal drainage. The tissues in anastomosis were taken for pathology examination in 1 month after operation. Results The average operative time was （35±10） min.Nine of ten animals had no pancreatic fistula and survived. The levels of amylase and lipase in abdominal drainage were both normal. One swine had a evident abdominal distensile on 2 days after operation, the level of amylase was 10 000u/L,then died on 10 days after operation. Pancreatic fistula and infection were found because of the loss of stent in pancreatic duct. Conclusions Comparison with traditional operation, the modified sutureless pancreaticoenteromy can also control the probability of pancreatic fistula. And this method can be hoped to be one of the routine operations of pancreaticoenterostomy because of its simplicity and practicality.
ObjectiveTo analyze the characteristics of colorectal cancer surgery in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was the updated version on April 16th, 2020. The data items included timing of operation, types of operative procedure, radical resection level of operation, patient’s wish of anus-reserving, types of stomy, date of stoma closure, surgical approaches, extended resection, and type of intersphincteric resection (ISR). The data item interval of stoma closure was added, and the selected data items were statistically analyzed.ResultsThe total number of medical records (data rows) that met the criteria was 11 757, including 2 729 valid data on the timing of operation (23.2%), 11 389 valid data on the types of operative procedure (96.9%), 4 255 valid data on the radical resection level of operation (36.2%), 3 803 valid data on patient’s wish of anus-reserving (32.3%), 4 377 valid data on types of stomy (37.2%), 989 valid data on date of stoma closure (8.4%), 4 418 valid data on surgical approaches (37.6%), 3 941 valid data on extended resection (33.5%), and 1 156 valid data on type of ISR (9.8%). In the timing of operation, the most cases were performed immediately after discovery or neoadjuvant completion (915, 33.5%). In types of operative procedure, ultra low anterior resection (ULAR), right hemicolectomy (RHC), and low anterior resection (LAR) were the most, including 1 986 (17.4%), 1 412 (12.4%), and 1 041 (9.1%) lines. Respectively in the colon and rectal cancer surgery, the proportion of RHC (50.0%) and ULAR (26.0%) was the highest, with 172 (26.1%) and 815 (27.9%) extended resection. In ISR surgery the majority was ISR-2 (741, 64.1%). In radical resection level of operation, the number of R0 was the largest with 2 575 (60.5%) lines. In patient’s wish of anus-reserving, positive and rational were the most with 1 811 (47.6%) and 1 440 (37.9%) lines, respectively. And in types of stomy, there were 2 628 lines (60.0%) without stoma and 1 749 cases (40.0%) with stoma, among which the most lines were right lower ileum stoma (612, 35.0%). The minimum value, maximum value, and median value of interval of stoma closure were 0 d, 2 678 d and 112 d. The linear regression prediction of date of stoma closure by year was \begin{document}${\hat {y}} $\end{document}=9.234 3x+22.394 (R2=0.2928, P=0.07). In the surgical approaches, the majority was standard with 3 182 (72.0%) lines.ConclusionsIn the DACCA, rectal cancer surgery is still the majority, and ULAR is the most type. The application of extended resection in both colon and rectal cancer has important significance. The data related to stoma are diversified and need to be further studied.