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Risk factors for preoperative carcinogenesis of bile duct cysts in adults

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World Journal of Clinical Cases 2021年第22期9卷 6278-6286页

作者： Xin Wu bing-lu li Chao-Ji Zheng Xiao-Dong He Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

BACKGROUND Bile duct cyst(BDC)is a rare congenital bile duct *** incidence of bile duct malignancy in BDC patients is markedly higher than that in the general ***,few studies have been conducted on the risk factors for preoperative carcinogenesis in BDC *** To analyze the risk factors associated with preoperative carcinogenesis in BDC *** The medical records of BDC patients treated at our hospital between January 2012 and December 2018 were retrospectively *** constructed a database and compared the characteristics of BDC patients with dysplasia and carcinoma against those with benign *** risk factors for preoperative carcinogenesis were identified using univariate and multivariate *** The cohort comprised 109 BDC *** patients had preoperative dysplasia or *** and multivariate analyses showed that gallbladder wall thickness>0.3 cm[odds ratio(OR),6.551;95%confidence interval(CI),1.351 to 31.763;P=0.020]and Todani type IV(OR,7.675;95%CI,1.584 to 37.192;P=0.011)were independent factors associated with preoperative *** BDC is a premalignant *** findings show that gallbladder wall thickness>0.3 cm and Todani type IV are independent risk factors for preoperative carcinogenesis of *** are therefore useful for deciding on the appropriate treatment strategy,especially in asymptomatic patients.

关键词： Choledochal cyst Carcinoma Dysplasia Risk factors Gallbladder wall Todani type

Predictive factors for central lymph node metastases in papillary thyroid microcarcinoma

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World Journal of Clinical Cases 2020年第8期8卷 1350-1360页

Papillary thyroid microcarcinoma(PTMC)measures 1 cm or less in its longest *** incidence of PTMC is increasing *** is the primary treatment;however,prophylactic central lymph node dissection is controversial,and discrepancies between different guidelines have been *** prophylactic central lymph node dissection may result in hypoparathyroidism and recurrent laryngeal nerve injury in some patients without lymph node metastasis,while simple thyroidectomy may leave metastatic lymph nodes in high-risk *** selectively perform prophylactic lymph node dissections in high-risk patients,it is important to identify predictive factors for lymph node metastases in patients with *** studies have reported on this,but their conclusions are not entirely *** clinicopathologic characteristics have been identified as risk factors for central lymph node metastases,and the most commonly reported factors include age,gender,tumor size and location,multifocality,bilaterality,extrathyroidal extension,and abnormal lymph node found using ***,we provide an overview of previous studies along with a favorable opinion on or against these factors,with the aim of increasing the understanding of this topic among the medical *** addition,current opinions about prophylactic central lymph node dissection are reviewed and discussed.

关键词： Papillary thyroid carcinoma Papillary thyroid microcarcinoma Central lymph node dissection Prophylactic Risk factor Prognosis

Active gastrointestinal diverticulum bleeding diagnosed by computed tomography angiography

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World Journal of Gastroenterology 2014年第37期20卷 13620-13624页

作者： Xie-Qun Xu Tao Hong bing-lu li Wei liu Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical College

A diverticulum is a bulging sack in any portion of the gastrointestinal tract. Small intestine diverticular disease is much less common than colonic diverticular disease. The most common symptoms include non-specific epigastric pain and a bloating sensation. Major complications include diverticulitis, gastrointestinal bleeding, acute perforation, intestinal obstruction, intestinal perforation, localized abscess, malabsorption, anemia,volvulus and bacterial overgrowth. We report one case of massive jejunal diverticula bleeding and one case of massive colonic diverticula bleeding, both diagnosed by acute abdominal computed tomography angiography and treated successfully by surgery.

关键词： Diverticulum Gastrointestinal diverticular bleeding Angiography Computed tomography angiography Endoscopy

Ileo-ileal intussusception caused by diffuse large B-cell lymphoma of the ileum

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World Journal of Gastroenterology 2013年第45期19卷 8449-8452页

作者： Xie-Qun Xu Tao Hong bing-lu li Wei liu Department of General Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College

The occurrence of adult intussusception from small intestinal lymphoma is quite *** present an82-year-old man with a two-month history of intermittent abdominal pain,nausea and *** symptoms included moderate abdominal tenderness in the right lower *** tomography scan of the abdomen revealed a mass in the terminal ileum with the sign of"bowel within bowel"which was suspicious of ileo-ileum *** patient underwent laparoscopic segmental ileal *** evaluation revealed a diffuse large B cell non-Hodgkin’s lymphoma of the *** postoperative course was uneventful.

关键词： Adult intussusception Lymphoma Small intestine Ileum

Current status and progress in laparoscopic surgery for gallbladder carcinoma

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World Journal of Gastroenterology 2023年第16期29卷 2369-2379页

作者： Jia Sun Tian-Ge Xie Zu-Yi Ma Xin Wu bing-lu li Department of General Surgery State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China

Gallbladder carcinoma(GBC)is the most common biliary tract malignancy associated with a concealed onset,high invasiveness and poor *** surgery remains the only curative treatment for GBC,and the optimal extent of surgery depends on the tumor *** resection can be achieved by simple cholecystectomy for Tis and T1a ***,whether simple cholecystectomy or extended cholecystectomy,including regional lymph node dissection and hepatectomy,is the standard surgical extent for T1b GBC remains *** cholecystectomy should be performed for T2 and some T3 GBC without distant *** radical surgery is essential for incidental gallbladder cancer diagnosed after *** locally advanced GBC,hepatopancreatoduodenectomy may achieve R0 resection and improve long-term survival outcomes,but the extremely high risk of the surgery limits its *** surgery has been widely used in the treatment of gastrointestinal *** was once regarded as a contraindication of laparoscopic ***,with improvements in surgical instruments and skills,studies have shown that laparoscopic surgery will not result in a poorer prognosis for selected patients with GBC compared with open ***,laparoscopic surgery is associated with enhanced recovery after surgery since it is minimally invasive.

关键词： gallbladder metastasis curative treatment

Ileal duplication mimicking intestinal intussusception:A congenital condition rarely reported in adult

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World Journal of Gastroenterology 2013年第38期19卷 6500-6504页

作者： bing-lu li Xin Huang Chao-Ji Zheng Jiao-lin Zhou Yu-Pei Zhao The First Department of General Surgery Peking Union Medical College Hospital

Intestinal duplication is an uncommon congenital condition in young adults.A 25-year-old man complained of chronic,intermittent abdominal pain for 3 years following previous appendectomy for the treatment of suspected *** discomfort and pain,suggestive of intestinal obstruction,recurred after operation.A tubular mass was palpable in the right lower *** tomography enterography scan identified suspicious intestinal intussusception,while Tc-99m pertechnetate scintigraphy revealed a cluster of strip-like abnormal radioactivity in the right lower *** exploratory laparotomy,a tubular-shaped ileal duplication cyst was found arising from the mesenteric margin of the native ileal segment located 15 cm proximal to the ileocecal *** was performed along with the removal of the duplication disease,and the end-to-end anastomosis was done to restore the gastrointestinal tract *** examination showed ileal duplication with ectopic gastric *** patient experienced an eventless postoperative recovery and remained asymptomatic within 2 years of postoperative follow-up.

关键词： Ileal duplication cyst Adulthood Computed tomography enterography Tc-99m pertechnetate scintigraphy

Extrathyroidal Implantation of Thyroid Hyperplastic/neoplastic Cells after Endoscopic Thyroid Surgery

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Chinese Medical Sciences Journal 2014年第3期29卷 180-184页

作者： Cao Xi Xie-qun Xu Tao Hong bing-lu li Wei liu Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical College

Objective To report a case of the implantation of thyroid hyperplastic or neoplastic tissue after endoscopic thyroidectomy and discuss this complication in aspects of prevalence, pathogenesis, protection, and therapies. Methods A systematic search of literature from the PubMed database was conducted for identifying eligible studies on implantation of thyroid hyperplastic or neoplastic cells after endoscopic thyroid surgery. Results Overall, 5 reported cases on patients suffering from endoscopic thyroid surgery with implantation of thyroid hyperplastic or neoplastic cells were included in the systematic review. Conclusions Unskilled surgeons, rough intraoperative surgical treatment, scarification or rupture of tumor, contamination of instruments, chimney effect, aerosolization of tumor cells may be associated with the implantation after endoscopic thyroidectomy. To minimize the risk of such complication, we should be more meticulous and strict the endoscopic surgery indications.

关键词： endoscopic thyroid surgery benign thyroid tumor malignant thyroid tumor subcutaneous tissue implantation

A long adult intussusception secondary to transverse colon cancer

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World Journal of Gastroenterology 2013年第22期19卷 3517-3519页

作者： Xie-Qun Xu Tao Hong Wei liu Chao-Ji Zheng XiaoDong He bing-lu li Department of General Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College

The occurrence of adult intussusception arising from colorectal cancer is quite rare. We present the case of a 76-year-old man with sudden abdominal pain and vomiting. Clinical symptoms included severe abdominal distension and tenderness. Computed tomography scan of the abdomen revealed left-sided colocolic intussusception with a lead point. The patient underwent a left hemicolectomy with right transverse colostomy. Pathologic evaluation revealed moderately differentiated adenocarcinoma invading the muscularis propria; the regional lymph nodes were negative for cancer cells. The postoperative course was uneventful.

关键词： Adult intussusception Colon cancer Surgery Hemicolectomy

Choledochoduodenal fistula caused by migration of endoclip after laparoscopic cholecystectomy

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World Journal of Gastroenterology 2014年第16期20卷 4827-4829页

作者： Tao Hong Xie-Qun Xu Xiao-Dong He Qiang Qu bing-lu li Chao-Ji Zheng Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical College

The wide use of surgical endoclips in laparoscopic surgery has led to a variety of *** endoclips migrating into the common bile duct after laparoscopic cholecystectomy is rare.A migrated endoclip can cause obstruction,serve as a nidus for stone formation,and cause *** the exact pathogenesis is still unknown,it is probably related to improper clip application,subclinical bile leak,inflammation,and subsequent necrosis,allowing the clips to erode directly into the common bile *** present a case of endoclip migrating into the common bile duct and duodenum,resulting in choledochoduodenal fistula after laparoscopic cholecystectomy and a successful reconstruction of the biliary tract by a hepaticojejunostomy with a Roux-en-Y *** case shows that surgical endoclips can penetrate into the intact bile duct wall through serial maceration,and it is believed that careful application of clips may be the only way to prevent their migration after laparoscopic cholecystectomy.

关键词： Biliary obstruction Laparoscopic cholecystectomy Choledochoduodenal fistula