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Emergency laparoscopic pancreatoduodenectomy as treatment for pancreatic head cancer-induced acute gastrointestinal hemorrhage,safe or not?

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Hepatobiliary Surgery and Nutrition 2021年第1期10卷 146-148页

作者： Mengqing Sun Yingxin Wei Shuo Li Ziwen Liu xianlin han Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijingChina

We have read with great interests the article by Jin and colleagues entitled“Laparoscopic pancreaticoduodenectomy for pancreatic cancer:a hope or hype?”recently published in HepatoBiliary Surgery and Nutrition(1).They came out with a conclusion that Laparoscopic pancreaticoduodenectomy(LPD)could be a safe and feasible approach for the patients with pancreatic cancers even at their advanced stage,and may also obtain comparable long-term oncologic *** really agree with this *** would here also like to report one of our experiences of an emergency LPD case of the treatment of pancreatic head cancer induced acute gastrointestinal hemorrhage,which could be the first case to the best of our knowledge based on literature research.

关键词： Surgery hemorrhage treatment head

Pancreatic carcinoma disguised as type 1 autoimmune pancreatitis with a mass-forming appearance: a clinical dilemma

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 997-1000页

作者： Zhiyu Yan Xiaoyan Chang Xiaoyin Bai xianlin han Yunlu Feng Aiming Yang Department of Gastroenterology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijingChina +4 M.D.Program Chinese Academy of Medical Sciences&Peking Union Medical CollegeBeijingChina Department of Pathology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijingChina Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijingChina

In December 2022,a 69-year-old male was presented to the local hospital due to upper abdominal discomfort,gradually developing jaundice with itching,dark urine,and pale-colored stools,with symptoms first appearing ten months *** examinations revealed alanine aminotransferase(ALT)at 507 U/L,aspartate aminotransferase(AST)at 528 U/L,total bilirubin(TBIL)at 226.5μmol/L,and direct bilirubin(DBIL)at 135.2μmol/L.

关键词： urine pancreatitis autoimmune

Laparoscopic radical distal pancreatectomy with portal venous tumor thrombectomy for the treatment of pancreatic acinar cell carcinoma after neoadjuvant chemotherapy

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 991-996页

作者： Mengqing Sun Xuesong Bai Xiaoyan Chang Huanwen Wu Yuejuan Cheng Xiaodong He xianlin han Peking Union Medical College Hospital Chinese Academy of Medical SciencesBeijingChina

We have read the article“Current status and future prospect of surgical treatment for pancreatic cancer”,published in HepatoBiliary Surgery and Nutrition in 2020(1).This article mentions that in the past two decades,there has been significant development and progress in the surgical treatment of pancreatic cancer,significantly improving the tumor resection rate and reducing perioperative mortality and the incidence of severe complications.

关键词： Surgery treatment Laparoscopic chemotherapy

Strategies to enhance shotgun lipidomics for comprehensive analysis of cellular lipids

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Oil Crop Science 2017年第4期2卷 195-210页

作者： Chunyan Wang xianlin han Barshop Institute for Longevity and Aging Studies Department of Medicine-DiabetesDepartment of Biochemistry and Structural BiologyUniversity of Texas Health San Antonio

The discipline of lipidomics, as coined in 2003, has made profound advances and been rapidly expanded. Direct infusion-based shotgun lipidomics contributes a major part of the research in this discipline. However, despite of its numerous advantages over other lipidomics platforms, the classical shotgun lipidomics approach suffers ion suppression and has the difficulties to assess low abundance lipid classes, particularly those less ionizable or that do not yield sensitive and specific fragments. To overcome this obstacle and broaden coverage, strategies have been developed based on unique chemistry and/or physics of lipid classes of interest to enhance shotgun lipidomics. This article overviews the recent enhancements of shotgun lipidomics, including prefractionation, acid/base hydrolysis, derivatization, charge feature utilization. We believe that, by this versatile platform, comprehensive coverage of cellular lipidomes would be achieved in more accurate and effective manner. Therefore, application of the enhanced shotgun lipidomics would greatly accelerate lipidomics research to substantiate the aberrant lipid metabolism, signaling, trafficking, and homeostasis under pathological conditions and their underpinning biochemical mechanisms. It would also facilitate precision medicine studies.

关键词： derivatization lipid metabolism lipidomics mass spectrometry shotgun lipidomics phospholipids

Examining influence of violence against physicians on Chinese medical students＇ career choice

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Chinese Medical Journal 2014年第24期127卷 4287-4289页

作者： han xianlin Wang Yinong Zhao Jun Pan Hui Yu Jianchun Department of General Surgery Department of Education Peking Union Medical College Hospital Beijing 100730 China Department-of-Student Affairs Peking Union Medical College Beijing 100730 China

In recent years, ＂violent events against physicians＂ occurs frequently in China due to various reasons. They have been widely reported by Chinese and International media. Lancet recently published a couple of articles, entitled ＂Ending violence against doctors in China＂1 in May 2012 and ＂Appeal from Chinese doctors to end violence＂2 in November 2013. In early 2014 the BBC produced two reports about violence against physicians in China, and the Times Weekly raised the question ＂Why China＇s Doctors Are Getting Beat Up？＂, illustrating that engaging in frontline medical care in China is becoming a nightmare and disclosed the increasing harsh medical environment in China.3

关键词： violence against physicians medical students physician patient relationship career choice

Real-world insights for the evolving intervention strategy for non-mild acute pancreatitis:35-year experience in a Chinese Tertiary Center

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Journal of Pancreatology 2024年第2期7卷 111-118页

作者： Xiaxiao Yan Jingya Zhou Jian Cao Qiang Xu xianlin han Duan Wang Shengyu Zhang Dong Wu Department of Gastroenterology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Medical Records Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China WHO Family of International Classifications Collaborating Center of China Beijing 100730China Department of Radiology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

Background:With the accumulation of experience and evidence,guidelines for invasive intervention for acute pancreatitis(AP)have continuously evolved,followed in Peking Union Medical College Hospital(PUMCH).We aimed to review AP case series to help understand the impact of guideline evolution on the management and prognosis of AP in real-world ***:This was a single-center study of AP patients who had received invasive interventions from 1988 to *** demographics,baseline severity,imaging findings,and the indication,timing,and specific modalities of invasive interventions were *** composite primary endpoint was death during hospitalization or major complications after *** endpoints included pancreatic fistula,incision infection,number of interventions,length of intensive care stay,length of hospitalization,and total medical ***:A total of 195 patients were *** most common indication for invasive intervention was suspected infection,followed by persistent *** step-up and delayed strategies reduced the incidence of major complications or *** 35 years,the number of patients requiring surgery has gradually declined,and more patients need only minimally invasive procedures for *** incidence of the primary outcome decreased as well as the duration of ***:The management of AP patients at PUMCH in the last 35 years has undergone therapeutic guideline changes that support the efficacy and safety of the deferred step-up strategy in real-world practice.

关键词： Acute pancreatitis Drainage Invasive intervention Necrosectomy Step-up

Early drain removal after major pancreatectomy reduces postoperative complications:a single-center,randomized,controlled trial

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Journal of Pancreatology 2020年第2期3卷 93-100页

作者： Dai Menghua Liu Qiaofei Xing Cheng Kleeff Jorg Liao Quan Guo Junchao han xianlin Xu Qiang Wang Shunda Department of General Surgery Peking Union Medical College Hospital(PUMCH)Peking Union Medical College&Chinese Academy of Medical SciencesBeijingChina Department of Visceral Vascular and Endocrine SurgeryMartin-Luther-University Halle-WittenbergHalleGermany

Objectives:Timing of drain removal and its effects on complications after major pancreatectomy remain *** designed this study to assess whether early drain removal after major pancreatectomy influences the incidence of complications in the patients with low risk of postoperative pancreatic fistula(POPF).Methods:This is a single-center randomized controlled trial(RCT).A total of 144 patients undergoing pancreaticoduodenectomy(PD)and distal pancreatectomy(DP)who met the criteria,including drain amylase on postoperative day(POD)1 and 3 less than 5000 U/L and drain output within POD 3 less than 300 mL/d,were randomly assigned to early drain removal(POD 3)or standard drain removal(≥POD 5).The primary outcome was major complications(Clavien-Dindo grades 2-4),and the secondary outcome was POPF,reintervention treatment,readmission,and total medical expense within 3 months after ***:A total of 5 patients in early drain removal group had at least 1 major complications(grades 2-4),compared to 15 patients in standard drain removal group(P=.028).The incidence of grade B/C pancreatic fistula was not significantly different(2.8%vs 0%).Multivariate analysis demonstrated that early drain removal was an independent factor associated with a reduced risk of major complications(P=.039,odds ratio=0.314).Majority of major complications occurred in PD patients,and only very few cases occurred in DP *** analysis showed that early drain removal significantly reduced the major complications only in the patients undergoing ***:This single-center RCT shows early drain removal on POD 3 is safe for both DP and PD patients,under our *** drain removal could reduce the incidence of major complications in patients undergoing PD.

关键词： Complications Distal pancreatectomy Drain removal Pancreaticoduodenectomy

第502例——血小板减少、巨脾、DIC、自发性脾破裂

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中华内科杂志 2023年第10期62卷 1249-1252页

作者：金相红韩显林贾丛伟庄俊玲陈苗中国医学科学院、北京协和医学院、北京协和医院血液内科北京100730 中国医学科学院、北京协和医学院、北京协和医院基本外科北京100730 中国医学科学院、北京协和医学院、北京协和医院病理科北京100730

1例青年男性,既往血小板减少症7年余,本次因巨脾、发热起病,快速进展至弥散性血管内凝血(DIC)、失血性休克,考虑自发性脾破裂,急诊行脾切除术,组织病理学诊断为脾紫癜。脾紫癜罕见,病因及病理机制尚不明确。自发性脾破裂合并DIC死亡率极... 详细信息

1例青年男性,既往血小板减少症7年余,本次因巨脾、发热起病,快速进展至弥散性血管内凝血(DIC)、失血性休克,考虑自发性脾破裂,急诊行脾切除术,组织病理学诊断为脾紫癜。脾紫癜罕见,病因及病理机制尚不明确。自发性脾破裂合并DIC死亡率极高,本例患者得以成功救治,本文分享诊治经过。

关键词：脾大脾破裂弥漫性血管内凝血脾紫癜

围手术期加速康复外科理念用于胆囊癌患者的诊治经验初探

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中华外科杂志 2022年第4期60卷 372-377页

作者：吴昕李秉璐孙嘉郑朝纪何小东刘卫洪涛韩显林中国医学科学院北京协和医学院北京协和医院基本外科北京100730

目的探讨加速康复外科(ERAS)理念在胆囊癌患者围手术期应用的有效性和安全性。方法回顾性分析2017年1月至2021年12月北京协和医院连续收治的164例胆囊癌患者的临床和病理学资料。男性69例(42.1%),女性95例(57.9%),年龄(64.0±10.3)岁(范... 详细信息

目的探讨加速康复外科(ERAS)理念在胆囊癌患者围手术期应用的有效性和安全性。方法回顾性分析2017年1月至2021年12月北京协和医院连续收治的164例胆囊癌患者的临床和病理学资料。男性69例(42.1%),女性95例(57.9%),年龄(64.0±10.3)岁(范围:37~89岁)。按照是否在围手术期应用ERAS理念进行管理,将患者分为ERAS组(53例)和常规组(111例)。应用倾向性评分匹配法对两组患者的基本信息进行平衡,并对匹配后两组患者的围手术期资料进行分析比较。分类资料用χ^(2)检验或Fisher确切概率法进行组间比较;符合和不符合正态分布的定量资料分别以t检验和Mann-Whitney U检验进行组间比较。结果ERAS组和常规组各有45例患者匹配成功。两组患者的基本信息保持平衡,手术时间、出血量、并发症和住院费用等方面的差异均无统计学意义(P值均>0.05)。ERAS组患者下床时间更早[1(1)d比2(2)d;Z=-3.839,P<0.01],排气时间更早[2(1)d比3(1)d;Z=-3.013,P=0.003],饮水时间更早[2(1)d比2(1)d;Z=-3.647,P<0.01],并且术后住院时间[5(2)d比7(4)d;Z=-3.984,P<0.01]和总住院时间[8(4)d比13(6)d;Z=-3.605,P<0.01]更短。两组共有12例患者发生术后并发症,根据Clavien-Dindo并发症分级标准,Ⅰ级6例、Ⅱ级4例、Ⅲa级2例。所有并发症均经积极治疗后好转。结论ERAS理念用于胆囊癌患者的围手术期处理是安全且有效的,可加快患者康复、缩短住院时间,且未增加并发症和住院费用。

关键词：胆囊肿瘤胆道外科手术加速康复外科住院时间倾向性评分匹配