检索结果-南通市图书馆

Effects of epidermal growth factor receptor inhibitor on proliferative cholangitis in hepatolithiasis

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2015年第5期14卷 509-515页

作者： Qin Yang Yong Zhou Fu-Yu Li Hui Mao anuj shrestha Wen-Jie Ma Nan-Sheng Cheng Wei Zhang Department of Hepatobiliary Surgery West China Hospital of Sichuan University Department of Medicine The George Washington University

BACKGROUND： There is currently no effective medication to prevent stone recurrence after choledochoscopic lithotomy or to treat proliferative cholangitis（PC）, which is the pathologic basis of hepatolithiasis. This study aimed to investigate whether gefitinib, an epidermal growth factor receptor（EGFR） inhibitor, inhibited cholangio hyperplasia and lithogenesis in ***： After cholangioscopic lithotomy, indwelling catheters were placed in the diseased bile duct lumens in 94 patients with hepatolithiasis. Subsequently, 49 of the 94 patients were treated with 250 mg gefitinib solution via a catheter twice a week, and they were subjected to choledochoscopic biopsy at 6 and 12 weeks. The rest 45 hepatolithiasis patients without gefitinib treatment served as ***： The expressions of EGFR, PCNA and procollagen I were significantly reduced in the patients treated with gefitinib in 12 weeks compared with those in the control group. Patients in the gefitinib group had a much lower degree of hyperplasia of the biliary epithelium, submucosal glands and collagen fibers compared with those in the control group. Gefitinib treatment significantly decreased mucin 3 expression and β-glucuronidase ***： Postoperative gefitinib treatment could significantly inhibit PC-mediated hyperplasia and lithogenesis, which might provide a novel strategy for the prevention of biliary restenosis and stone recurrence in patients with hepatolithiasis.

关键词： hepatolithiasis proliferative cholangitis epidermal growth factor receptor blockade recurrence restenosis prevention

Histological examination of frozen sections for patients with acute cholecystitis during cholecystectomy

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2015年第3期14卷 300-304页

作者： Zhen You Wen-Jie Ma Yi-Lei Deng Xian-Ze Xiong anuj shrestha Fu-Yu Li Nan-Sheng Cheng Department of Biliary Surgery West China HospitalSichuan University

BACKGROUND： Unexpected gallbladder cancer may present with acute cholecystitis-like manifestat/ons. Some authors rec- ommended that frozen section analysis should be performed during laparoscopic cholecystectomy for all cases of acute cholecystitis. Others advocate selective use of frozen section analysis based on gross examination of the specimen by the surgeon. The aim of the present study was to evaluate whether surgeons could effectively identify suspected gallbladder with macroscopic examination alone. If not, is routine frozen sec- tion analysis worth advocating？

关键词： unexpected gallbladder cancer acute cholecystitis cholecystectomy frozen section analysis

Hepatic epithelioid hemangioendothelioma: Dilemma and challenges in the preoperative diagnosis

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2016年第41期22卷 9247-9250页

作者： Hai-Jie Hu Yan-Wen Jin Qiu-Yang Jing anuj shrestha Nan-Sheng Cheng Fu-Yu Li Department of Biliary Surgery West China Hospital of Sichuan University Department of Pathology West China Hospital of Sichuan University Department of General Surgery Gandaki Medical College

Hepatic epithelioid hemangioendothelioma(HEHE) is a rare category of vascular tumor with uncertain malignant potential. It commonly presents nonspecific and variable clinical manifestations, ranging from asymptomatic to hepatic failure. In addition, laboratory measurements and imaging features also lack specificity in the diagnosis of HEHE. The aim of the present study is to highlight the dilemma and challenges in the preoperative diagnosis of HEHE, and to enhance awareness of the range of hepatobiliary surgery available in patients with multiple hepatic nodular lesions on imaging. In these patients, HEHE should at least be considered in the differential diagnosis.

关键词：肝的上皮状的 hemangioendothelioma 脉管的肿瘤诊断窘境挑战

Sequential embolization of the branches of the bile duct and portal vein to the targeted hepatic lobe in rats

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2014年第1期13卷 55-59页

作者： anuj shrestha Yong Zhou Hui Mao Fu-Yu Li Wen-Jie Ma Nan-Sheng Cheng Ri-Hua Xu Yong-Qiong Zhang Ting Jiang Huan Feng Wen Li Qiang Han Department of Hepatobiliary Surgery West China Hospital of Sichuan University Department of Medicine West China Hospital of Sichuan University

BACKGROUND: The high recurrence rate of hepatolithiasis and the high operative risk of right posterior, caudate or multiple lobe hepatectomy are the unsettled problems in hepatobiliary surgery. The present study was to investigate the efficacy of chemical hepatectomy performed via applying sequential embolization of the branches of the bile duct and portal vein to the targeted hepatic lobe. METHODS: The bile duct and portal vein branches of the median hepatic lobe of rats were treated with: 1) bile duct embolization followed by portal vein ligation(BDE+PVL) and 2) portal vein ligation followed by bile duct embolization(PVL+BDE). The efficacy of chemical hepatectomy in BDE+PVL and PVL+BDE groups was compared with that of sole BDE by histology and Western blotting analysis of collagen I expression. RESULTS: After six weeks of the chemical hepatectomy, rats in the BDE group showed hepatocyte damages, fibrosis and 'selfcut' only in the periphery of the embolized lobe. In contrast, rats in the PVL+BDE and BDE+PVL groups exhibited complete necrosis of hepatocytes and replacement with proliferative ductules and collagen fibers, leading to complete fibrosis and 'self-cut' phenomenon in the whole targeted lobe. Collagen I expression in the PVL+BDE group was slightly higher than that in the BDE+PVL group; however, no statistically significant difference was noted. CONCLUSION: The sequential embolization of the bile duct and portal vein branches to the targeted hepatic lobe may bea feasible and effective approach to acheive the ideal effect of chemical hepatectomy in a short period of time.

关键词： hepatolithiasis bile duct portal vein sequential embolization chemical hepatectomy

腹腔镜胆囊切除术后常规病理检查的必要性探讨

在线全文

学校读者我要写书评

暂无评论

中国普通外科杂志 2015年第8期24卷 1140-1144页

作者：曹贵章邓毅磊 shrestha anuj 吴昊钧青海省交通医院普通外科青海西宁810000 四川大学华西医院胆道外科四川成都610041

目的:探讨腹腔镜胆囊切除术(LC)后胆囊常规病理检查的必要性。方法:搜集华西医院病理科5年间的全部胆囊病理报告,找出其中LC术后意外胆囊癌患者,并分析其临床资料。结果:LC术后意外胆囊癌的发生率约为0.28%(36/12 969),88.9%(32/36)为腺... 详细信息

目的:探讨腹腔镜胆囊切除术(LC)后胆囊常规病理检查的必要性。方法:搜集华西医院病理科5年间的全部胆囊病理报告,找出其中LC术后意外胆囊癌患者,并分析其临床资料。结果:LC术后意外胆囊癌的发生率约为0.28%(36/12 969),88.9%(32/36)为腺癌,58.3%(21/36)为原位癌和早期胆囊癌(T1a和T1b)。结合术前影像学检查,术中通过观察及胆囊标本触摸,成功辨认出34例(94.4%)意外胆囊癌患者存在的可疑病变,遗漏1例原位癌和1例T1a期患者。结论:绝大多数意外胆囊癌患者均可在术中发现可疑病变,极少数肿瘤处于极早期无法发现者,单纯的胆囊切除已达有效治疗。因此,LC术后常规的行胆囊病理检查的必要性有待商榷。

关键词：胆囊切除术,腹腔镜胆囊肿瘤病理学

Effectiveness of additional resection of the invasive cancer-positive proximal bile duct margin in cases of hilar cholangiocarcinoma

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary Surgery and Nutrition 2018年第4期7卷 251-269页

作者： Wen-Jie Ma Zhen-Ru Wu anuj shrestha Qin Yang Hai-Jie Hu Jun-Ke Wang Fei Liu Rong-Xing Zhou Quan-Sheng Li Fu-Yu Li Department of Biliary Surgery West China HospitalSichuan UniversityChengdu 610041China Laboratory of Pathology West China HospitalSichuan UniversityChengdu 610041China Department of General Surgery Andaki Medical CollegePokharaNepal

Background: The survival benefits of additional resection of the positive proximal ductal margin (PM) in hilar cholangiocarcinoma (HCCA) remains controversial. This retrospective study investigated the effectiveness of additional resection of the invasive cancer PM under different levels of preoperative carbohydrate antigen 19-9 (CA19-9). Methods: Patients who underwent hepatectomy for HCCA from 2000 to 2017 were analyzed. Surgical variables, resection margin status, length of the PM (LPM), prognostic factors, and survival were evaluated. Results: A total of 228 patients were enrolled: 175 PM(?) without additional resection patients (group A), 21 PM(?) after additional resection (group B), 16 PM(+) without additional resection (group C), and 16 PM(+) after additional resection (group D). The median survival of group B (20.99 months) was similar to that of group A (23.00 months;P=0.16), and both were significantly better than those of group C (11.60 months) and D (9.50 months), especially when preoperative CA19-9>150 U/mL (P10 mm was significantly better compared with those with an LPM ≤10 mm, especially when preoperative CA19-9 was >150 U/mL (P10 mm group, the survival of group B was comparable with that of group A (P>0.05). Conclusions: HCCA patients could get a survival benefit from a negative PM resulting from additional resection. Survival could be comparable with that of negative PM without additional resection among HCCA patients. An LPM >10 mm is possibly more associated with better survival compared with whether additional resection of the positive PM is performed under different levels of preoperative CA19-9.

关键词： Klatskin tumor margins of excision bile ducts antigens neoplasm carbohydrate antigen 19-9 (CA19-9)

不同胆管空肠吻合技术治疗成人Ⅰ型胆总管囊肿的比较分析

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastroenterology Report 2018年第1期6卷 54-60,I0002页

作者： Wenjie Ma Yongqiong Tan anuj shrestha Fuyu Li Rongxing Zhou Junke Wang Haijie Hu Qin Yang Department of Biliary Surgery West China Hospital of Sichuan UniversityChengduChina Operation Room West China Hospital of Sichuan UniversityChengduChina Department of General Surgery Andaki Medical CollegePokharaNepal

目的:比较囊肿完全切除与不完全切除(残留近端1 cm胆总管囊壁)的Roux-en-Y胆管空肠吻合治疗成人Ⅰ型胆总管囊肿的安全性和可行性。方法:回顾性分析1998年1月至2015年12月间收治的267例成人Ⅰ型胆总管囊肿患者的病例资料,其中171例行囊... 详细信息

目的:比较囊肿完全切除与不完全切除(残留近端1 cm胆总管囊壁)的Roux-en-Y胆管空肠吻合治疗成人Ⅰ型胆总管囊肿的安全性和可行性。方法:回顾性分析1998年1月至2015年12月间收治的267例成人Ⅰ型胆总管囊肿患者的病例资料,其中171例行囊肿完全切除的Rouxen-Y胆管空肠吻合术(PBD 0-cm组),96例行囊肿不完全切除的Rouxen-Y胆管空肠吻合术(PBD 1-cm组)。比较两组患者术后短期及长期并发症发生情况。结果:两组患者在手术时间和吻合口直径方面的差异均无统计学意义。PBD 1-cm组围手术期并发症发生率显著高于PBD 0-cm组(28.1%vs 14.0%,P=0.005),尤其是术后胆管炎(7.3%vs 1.2%,P=0.021)。两组患者术后吻合口狭窄、反流性胆管炎、肝内胆管结石和胆漏等长期并发症的差异均无统计学意义(均P>0.05)。PBD 1-cm组和PBD 0-cm组各有1例患者分别于术后5月和术后25月出现胰胆管恶变。而PBD 1-cm组有1例患者于术后10月出现吻合口恶变。结论:虽然保留部分囊壁可以降低Ⅰ型胆总管囊肿切除术中的吻合难度,但由于相对较高的术后并发症发生率和恶变概率,该吻合方式值得商榷。对于Ⅰ型胆总管囊肿患者,囊肿完全切除后以健康的近端胆管进行吻合是必要的。

关键词：胆总管囊肿 Roux-en-Y胆管空肠吻合术胆汁引流成年人

Xanthogranulomatous cholecystitis mimicking gallbladder carcinoma:An analysis of 42 cases

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第44期21卷 12653-12659页

作者： Yi-Lei Deng Nan-Sheng Cheng Shui-Jun Zhang Wen-Jie Ma anuj shrestha Fu-Yu Li Fei-Long Xu Long-Shuan Zhao Department of Hepatopancreatobiliary Surgery The First Affiliated Hospital of Zhengzhou University Department of Biliary Surgery West China Hospital of Sichuan University

AIM: To review and evaluate the diagnostic dilemma of xanthogranulomatous cholecystitis(XGC) ***: From July 2008 to June 2014, a total of 142 cases of pathologically diagnosed XGC were reviewed at our hospital, among which 42 were misdiagnosed as gallbladder carcinoma(GBC) based on preoperative radiographs and/or intra-operative findings. The clinical characteristics, preoperative imaging, intra-operative findings, frozen section(FS) analysis and surgical procedure data of these patients were collected and ***: The most common clinical syndrome in these 42 patients was chronic cholecystitis, followed by acute cholecystitis. Seven(17%) cases presented with mild jaundice without choledocholithiasis. Thirtyfive(83%) cases presented with heterogeneous enhancement within thickened gallbladder walls on imaging, and 29(69%) cases presented with abnormal enhancement in hepatic parenchyma neighboring the gallbladder, which indicated hepatic infiltration. Intra-operatively, adhesions to adjacent organs were observed in 40(95.2%) cases, including the duodenum, colon and stomach. Thirty cases underwent FS analysis and the remainder did not. The accuracy rate of FS was 93%, and that of surgeon's macroscopic diagnosis was 50%. Six cases were misidentified as GBC by surgeon's macroscopic examination and underwent aggressive surgical treatment. No statistical difference was encountered in the incidence of postoperative complications between total cholecystectomy and subtotal cholecystectomy groups(21% vs 20%, P > 0.05).CONCLUSION: Neither clinical manifestations and laboratory tests nor radiological methods provide apractical and effective standard in the differential diagnosis between XGC and GBC.

关键词： Xanthogranulomatous cholecystitis Gallbladder carc

Prognostic factors and long-term outcomes of hilar cholangiocarcinoma:A single-institution experience in China

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2016年第8期22卷 2601-2610页

作者： Hai-Jie Hu Hui Mao anuj shrestha Yong-Qiong Tan Wen-Jie Ma Qin Yang Jun-Ke Wang Nan-Sheng Cheng Fu-Yu Li Department of Biliary Surgery West China Hospital of Sichuan University Department of Respiratory Medicine West China Hospital of Sichuan University Department of General Surgery Gandaki Medical College

AIM: To evaluate the prognostic factors of hilar cholangiocarcinoma in a large series of patients in a single ***: Eight hundred and fourteen patients with a diagnosis of hilar cholangiocarcinoma that were evaluated and treated between 1990 and 2014, of which 381 patients underwent curative surgery, were included in this study. Potential factors associated with overall survival(OS) and disease-free survival(DFS) were evaluated by univariate and multivariate ***: Curative surgery provided the best long-term survival with a median OS of 26.3 mo. The median DFS was 18.1 mo. Multivariate analysis showed that patients with tumor size > 3 cm [hazard ratio(HR) = 1.482, 95%CI: 1.127-1.949; P = 0.005], positive nodal disease(HR = 1.701, 95%CI: 1.346-2.149; P < 0.001), poor differentiation(HR = 2.535, 95%CI: 1.839-3.493; P < 0.001), vascular invasion(HR = 1.542, 95%CI: 1.082-2.197; P = 0.017), and positive margins(HR = 1.798, 95%CI: 1.314-2.461; P < 0.001) had poor OS outcome. The independent factors for DFS were positive nodal disease(HR = 3.383, 95%CI: 2.633-4.348; P < 0.001), poor differentiation(HR = 2.774, 95%CI: 2.012-3.823; P < 0.001), vascular invasion(HR = 2.136, 95%CI: 1.658-3.236; P < 0.001), and positive margins(HR = 1.835, 95%CI: 1.256-2.679; P < 0.001). Multiple logistic regression analysis showed that caudate lobectomy [odds ratio(OR) = 9.771, 95%CI: 4.672-20.433; P < 0.001], tumor diameter(OR = 3.772, 95%CI: 1.914-7.434; P < 0.001), surgical procedures(OR = 10.236, 95%CI: 4.738-22.116; P < 0.001), American Joint Committee On Cancer T stage(OR = 2.010, 95%CI: 1.043-3.870; P = 0.037), and vascular invasion(OR = 2.278, 95%CI: 0.997-5.207; P = 0.051) were independently associated with tumorfree margin, and surgical procedures could indirectly affect survival outcome by influencing the tumor resection margin. CONCLUSION: Tumor margin, tumor differentiation, vascular invasion, and lymph node status were independent factors for OS and DFS

关键词： Hilar cholangiocarcinoma Prognosis Surgical outcome Survival Tumor-free margin