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new anastomosis method for choledochojejunostomy by the way behind antrue pyloricum

Chinese Medical Journal 2013年第24期 4633-4637页

作者： yang xin-wei yang jue wang kui zhang bao-hua shen feng wu meng-chao Eastern Hepatobiliary Surgery Hospital Second Military MedicalUniversity Shanghai 200438 China

Background Reflux cholangitis has been the most common In this study we intended to evaluate the perioperative and choledochojejunostomy. complication after Roux-en-Y choledochojejunostomy. long-term efficacy of a new anastomosis method for Methods Clinical data of 143 eligible patients who underwent choledochojejunostomy in the Eastern Hepatobiliary Surgery Hospital affiliated to the Second Military Medical University, China between January 2007 and December 2010 were retrospectively analyzed. Among the patients, 38 consecutive cases underwent this new anastomosis method for choledochojejunostomy （improved group, IG） and 105 underwent standard Roux-en-Y choledochojejunostomy （control group, CG）. Changes in the incidence of cholangitis, the time of beginning to eat liquid meals, post-operative delayed gastric emptying and liver function between the two groups were compared. Results There was no statistical difference in the levels of alanine transaminase, alkaline phosphomonoesterase and gamma-glutamy transferase between the two groups. The time of beginning to eat liquid meals was significantly shorter in IG than CG （P 〈0.05）. The incidence of delayed gastric emptying was lower in IG than CG, with statistical tendency between the two groups （P=0.052）. Among nine patients with different degrees of acute cholangitis in the two groups, one patient （2.6%） in IG and eight （7.6%） in CG suffered from acute cholangitis within six months of follow-up after discharge, but with no statistical difference between the two groups （P 〉0.05）. Of the nine patients with acute cholangitis, none in IG and four in CG were hospitalized for further treatment （P 〉0.05）. Conclusions Patients in IG had satisfactory perioperative and long-term prognosis with shorter time of beginning to eat liquid meals and lower incidence of delayed gastric emptying. This new procedure of choledochojejunostomy by the way behind antrue pyloricum was easy and safe to perform with no mortality and low complicat

关键词： cholangitis choledochojejunostomy anastomosis, prognosis

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A new anastomosis method for choledochojejunostomy by the way behind antrue pyloricum

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中华医学杂志(英文版) 2013年第24期126卷 4633-4637页

作者： yang xin-wei yang jue wang kui zhang bao-hua shen feng wu meng-chao Eastern Hepatobiliary Surgery Hospital Second Military Medical University

Background Reflux cholangitis has been the most common complication after Roux-en-Y *** this study we intended to evaluate the perioperative and long-term efficacy of a new anastomosis method for *** Clinical data of 143 eligible patients who underwent choledochojejunostomy in the Eastern Hepatobiliary Surgery Hospital affiliated to the Second Military Medical University,China between January 2007 and December 2010were retrospectively *** the patients,38 consecutive cases underwent this new anastomosis method for choledochojejunostomy(improved group,IG) and 105 underwent standard Roux-en-Y choledochojejunostomy(control group,CG).Changes in the incidence of cholangitis,the time of beginning to eat liquid meals,post-operative delayed gastric emptying and liver function between the two groups were *** There was no statistical difference in the levels of alanine transaminase,alkaline phosphomonoesterase and gamma-glutamy transferase between the two *** time of beginning to eat liquid meals was significantly shorter in IG than CG(P 0.05).Of the nine patients with acute cholangitis,none in IG and four in CG were hospitalized for further treatment(P >0.05).Conclusions Patients in IG had satisfactory perioperative and long-term prognosis with shorter time of beginning to eat liquid meals and lower incidence of delayed gastric *** new procedure of choledochojejunostomy by the way behind antrue pyloricum was easy and safe to perform with no mortality and low complication rates.

关键词： cholangitis choledochojejunostomy anastomosis prognosis

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Imaging features and appropriate treatment strategy of a rare biliary tract neoplasm

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Chinese Medical Journal 2013年第13期126卷 2573-2576页

作者： yang xin-wei yang jue zhang bao-hua shen feng wang kui wu meng-chao Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 China

Mucin-producing bile duct tumors （MPBTs） are characterized by intraductal papillary tumorsproducing large amounts of mucin. The tumor comprises macroscopically prominent intraductal papillary neoplastic epithelia and produces a large amount of viscid mucin, resulting in dilatation of the bile ducts.1 These tumors of the peripheral bile duct, which include benign and malignant lesions, have also been referred to as intraductal growth- type peripheral cholangiocarcinomas,2 mucin-producing cholangiocellular carcinomas,3 intraductal papillary neoplasms （IPNs） of the biliary tract,4 IPNs of the liver,5 or IPNs of the bile duct.6 MPBTs have been the subject of recent attention due to its peculiar histopathology, biological and clinical behavior, varied radiological manifestations, and good prognosis of the patients] Due to the rarity of this disease entity and the non-specific clinical presentation, MPBTs are not well characterized. The purpose of this study was to define the precise diagnosis and correct management of MPBTs with the help of nine clinical cases observed in the last 10 years. The preoperative differential diagnosis, surgical procedure, and postoperative course of these nine cases were retrospectively reviewed.

关键词： biliary tract neoplasms mucin-producing bile duct tumors surgery prognosis

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