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Outpatient single-incision laparoscopic cholecystectomy in 22 patients with gallbladder disease

Hepatobiliary & Pancreatic Diseases International 2010年第6期9卷 629-633页

作者： Wu Ji,Kai Ding,Rong Yang,Xing-Dong liu,Ning li and jie-shou li Research Institute of General Surgery,Jinling Hospital, Nanjing University School of Medicine,Nanjing 210002,China Research Institute of General Surgery Jinling Hospital Nanjing University School of Medicine Nanjing 210002 China.

BACKGROUND:Transumbilical single-incision laparoscopic cholecystectomy(SILC)is a new *** has been described by some authors as scarless *** our knowledge,however, there has been no study on outpatient *** present study was designed to determine the safety,feasibility and benefits of transumbilical outpatient SILC. METHODS:Twenty-two patients underwent transumbilical outpatient SILC at our department from December 2008 to October *** all patients,the preoperative work-up and operation were completed in the outpatient *** perform the operation,a 2-to 2.5-cm semi-circular incision was made around the umbilicus and three 5-mm trocars were inserted separately by direct puncture.A 5-mm flexible laparoscope, an UltraCision harmonic scalpel and curved instruments were used to perform the laparoscopic cholecystectomy(LC) procedure. RESULTS:All patients except one were operated on successfully. The conversion rate to standard LC was 5%.In the 21 successfully completed patients,the median duration of operation was 56.5 minutes and estimated operative blood loss was 16.2 *** time to resume liquid food was 10.8 hours and semi-liquid food was 16.2 hours after the *** patients went home on the same day,and 12 on the second day after the *** mean postoperative hospital observation time was 18.5 *** retention was observed in 1 *** follow-up was conducted for all patients at 2 weeks after *** patients were satisfied with the good cosmetic effect of the *** total satisfaction rate was 95%.CONCLUSIONS:Outpatient SILC is a safe and feasible technique for operating with fewer scars and reducing perioperative discomfort at the same time.A direct puncture method to insert trocars is technically *** a flexible laparoscope and curved instruments make the procedure easier and more time-saving.

关键词： single-incision surgery outpatient surgery laparoscopic cholecystectomy natural orifice transluminal endoscopic surgery

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Role of laparoscopic subtotal cholecystectomy in the treatment of complicated cholecystitis

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Hepatobiliary & Pancreatic Diseases International 2006年第4期5卷 584-589页

作者： Wu Ji, ling-Tang li and jie-shou li Research Institute of General Surgery, Nanjing General Hospital of Nanjing PLA Command Area, Nanjing 210002, China Research Institute of General Surgery Nanjing General Hospital of Nanjing PLA Command Area Nanjing 210002 China.

BACKGROUND: Laparoscopic cholecystectomy (LC) has become the 'gold standard' in treating benign gallbladder diseases. Increasing laparoscopic experience and techniques have made laparoscopic subtotal cholecystectomy (LSC) a feasible option in more complex procedures. In recent years, few studies with a few cases of LSC have reported good results in patients with various types of cholecystitis. This study was designed to evaluate the feasibility, indications, characteristics and benefits of LSC in patients with complicated cholecystitis. METHODS: Altogether, 3485 patients were scheduled to receive LC during the past 4 years at our institute. Among them, 168 patients with various complicated forms of cholecystitis were treated by LSC. Meanwhile, the other 3317 patients who received standard LC were enrolled as the control group. Perioperative data from the two groups were collected and retrospectively analyzed. RESULTS: In the LSC group, 135 patients suffered from acute calculic cholecystitis, 18 from chronic calculic cholecystitis with cirrhotic portal hypertention, and 15 from chronic calculic atrophy cholecystitis with severe fibrosis. These patients constituted 4.8% of the total patients who underwent LC (168/3485) in the same period at our institute. In 122 patients, the cystic duct and artery were clipped before division. In another 46 patients, the gallbladder was initially incised at Hartmann's pouch. Five patients (3.0%) were converted to open subtotal cholecystectomy. The median operation time for LSC was 65.5±15.2 minutes, estimated operative blood loss was 71.5±15.5 ml, and the time to resume diet was 20.4±6.3 hours. Thirteen patients (7.7%) had local complications. The mean postoperative hospital stay was 4.2±2.6 days. In the LC group, 2887 had chronic calculic cholecystitis, 312had acute calculic cholecystitis, 47 had chronic calculic atrophy cholecystitis, and 71 had polypus. Seventeen patients (0.5%) were converted to open cholecystectomy. The median o

关键词： laparoscopic cholecystectomy cholecystitis cirrhotic portal hypertension complication bile duct injury

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Risk factors for leukopenia in patients with gastrointestinal fistula

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Chinese Medical Journal 2010年第23期123卷 3433-3437页

作者： ZHOU Zheng REN Jian-an liU Hai-yan GU Guo-sheng li jie-shou The Research Institute of General Surgery Jinling HospitalMedical School of Nanjing University Nanjing Jiangsu 210093China Intensive Care Unit First Affiliated Hospital of Anhui MedicalUniversity Hefei Anhui 230022 China

Background White blood cell count is an important index to the outcome of patients. In hospital, leukopenia is accompanied by high mortality, morbidity and treatment costs. However, in infectious diseases, the reasons responsible for leucopenia was not well elucidated. We investigated patients with gastrointestinal fistula to find risk factors for *** A prospective case control investigation was carried out in the Gastrointestinal Fistula Center, General Surgical Institute of Jinling Hospital. Cases included gastrointestinal fistula patients with leukopenia （n=98） and controls composed of gastrointestinal fistula patients with normal white blood cell count （n=78）. The two groups were compared for risk factors of leucopenia by statistical *** Factors associated with an increased risk for leukopenia included bacterial infection （25.5%） and hypoalbuminaemia （61.2%）. Multivariable Logistic regression analysis identified bacterial infection （80%）, urinary catheter （70%） and central vein catheter （60%） as the independent determinants for mortality in *** In patients with gastrointestinal fistula, two independent factors for leukopenia and three significant predictors of mortality were elucidated. We suggest that clinicians give patients more supportive management and apply prevention strategies to treat and prevent leukopenia.

关键词： risk factors leukopenia gastrointestinal fistula

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Retrospective analysis of 56 patients with advanced gastric cancer treated with combination of intravenous and intra-arterial intensified neoadjuvant chemotherapy

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Chinese Medical Journal 2012年第5期125卷 780-785页

作者： li Guo-li liU Kun BAOYang CAO Jian-ming XU Jian WANG Xu-ling WU Bo li jie-shou Research Institute of General SurgeryJinling Hospital NanjingUniversity School of Medicine Nanjing Jiangsu 210-002 China Department of Medical ImagingJinli-ng-Hospital NanjingUniversity School of Medicine Nanjing Jiangsu 210-002 China Department of-Pathology Jinli-ng-Hospital NanjingUniversity School of Medicine Nanjing Jiangsu 210002 China

Background Pre-operative chemotherapy has gained widespread interest while treating advanced gastric cancer in eastern countries. However, there is currently no established standard regimen for gastric cancer. The aim of this research was to explore the value of preoperative chemotherapy with a combination of intravenous and intra-arterial intensified chemotherapy in advanced .qastric cancer.

关键词： advanced gastric cancer preoperative chemotherapy intra-arterial chemotherapy intravenous chemotherapy ways of drug administration

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后基因组时代营养代谢与支持研究

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中华医学杂志 2005年第36期85卷 2544-2546页

作者：李幼生黎介寿南京军区南京总医院全军普通外科研究所 210002

随着20世纪90年代人类基因组测序草图的完成,生命科学进入了后基因组时代.现代生物技术对生命科学的发展产生了深远的影响,营养代谢与支持作为生命科学的重要组成部分与现代生物技术的结合更为密切,所取得的进展已影响到人类的疾病治疗... 详细信息

随着20世纪90年代人类基因组测序草图的完成,生命科学进入了后基因组时代.现代生物技术对生命科学的发展产生了深远的影响,营养代谢与支持作为生命科学的重要组成部分与现代生物技术的结合更为密切,所取得的进展已影响到人类的疾病治疗模式与健康.现就后基因组时代营养代谢与支持的发展现状及发展方向谈一下我们的观点和体会。

关键词：后基因组时代营养代谢人类基因组测序 20世纪90年代现代生物技术生命科学治疗模式

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克罗恩病外科治疗的特点

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中国实用外科杂志 2007年第3期27卷 181-182页

作者：黎介寿南京军区南京总医院解放军普通外科研究所江苏南京210002

克罗恩病(CD)是炎性肠病(IBD)之一,在1761年为Morgagni所描述,1932年Crohn等著文详加叙述后,始被命名为Crohn disease。但至今仍不清楚致病因素。该病多发于北美、北欧等地区的青年人,且有家族性的可能,但世界各地也都有发生。我国也有... 详细信息

克罗恩病(CD)是炎性肠病(IBD)之一,在1761年为Morgagni所描述,1932年Crohn等著文详加叙述后,始被命名为Crohn disease。但至今仍不清楚致病因素。该病多发于北美、北欧等地区的青年人,且有家族性的可能,但世界各地也都有发生。我国也有此类病人,且近年来虽无流行病学的调查,但临床诊治的数量为之增加,可能是诊治水平提高,认识意向有所加强的缘故,生活环境的改变也可能促使此病的增多。CD虽为炎性肠病,以药物治疗为主,但也常涉及外科治疗。据统计,CD患病20年以上的病人中有78%须接受外科治疗。因此,腹部外科医生需要了解这一疾病有关特性。由于CD的病因不明,故尚无针对性很强的药物或外科手术治疗方法,所有治疗均只能是症状控制性治疗,延长缓解期,减轻发作期的症状。手术治疗是针对它的并发症,如梗阻、出血、穿孔、脓肿、炎性肿块、肠内外瘘等。这些并发症施行的手术术式虽与其他原因所致的类似情况相似,主要是切除并发症的肠段或对侵蚀成瘘的器官(膀胱、阴道等)进行修复,但需要了解它的一些特点给予相应的处理。[第一段]

关键词：外科治疗克罗恩病炎性肠病药物治疗并发症致病因素流行病学临床诊治

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损伤控制外科理念在胰十二指肠钝性损伤处理中应用

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中国实用外科杂志 2015年第3期35卷 237-239页

作者：黎介寿南京大学医学院临床学院南京军区南京总医院解放军普通外科研究所江苏南京210002

在闭合性腹部钝性损伤中,胰腺因其解剖位置关系,其损伤少于其他实质性器官,而与十二指肠同时受损的机会增多。胰腺破损,淀粉酶等消化酶可直接进入周围组织,激活后有消化、损毁组织的作用,影响组织的修复、愈合。损伤控制外科理念在胰十... 详细信息

在闭合性腹部钝性损伤中,胰腺因其解剖位置关系,其损伤少于其他实质性器官,而与十二指肠同时受损的机会增多。胰腺破损,淀粉酶等消化酶可直接进入周围组织,激活后有消化、损毁组织的作用,影响组织的修复、愈合。损伤控制外科理念在胰十二指肠损伤处理中的应用具有特定的意义,是当前处理该类损伤得到共识的处理原则,改善了治疗效果,减少了严重并发症的发生。

关键词：损伤控制外科胰十二指肠损伤

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对“损伤控制性外科”的理解

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中华创伤杂志 2009年第1期25卷 3-5页

作者：黎介寿南京军区南京总医院解放军普通外科研究所南京大学临床学院210002

“损伤控制性外科（damage control surgery）”理念从20世纪90年代开始逐渐在文献中出现，应用面也越来越广。凡以手术作为治疗手段之一的专科都引入了这一理念，且将范围由创伤处理扩展至非创伤疾患的处理，可见这一理念有着很高的理... 详细信息

“损伤控制性外科（damage control surgery）”理念从20世纪90年代开始逐渐在文献中出现，应用面也越来越广。凡以手术作为治疗手段之一的专科都引入了这一理念，且将范围由创伤处理扩展至非创伤疾患的处理，可见这一理念有着很高的理论价值，也有着十分有效的实用价值。

关键词：损伤控制性外科创伤处理手术作为实用价值

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对Fast-track Surgery(快通道外科)内涵的认识

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中华医学杂志 2007年第8期87卷 515-517页

作者：黎介寿中国人民解放军普通外科研究所南京军区南京总医院南京大学临床学院南京220001

近年来，国际外科文献检索资料中，Fast-track surgery一词频繁出现，也有不少以此为题的文章，涉及到各个区域的手术，效果甚佳，明显的加快了病人的康复，缩短了手术后住院日。国内，外科学术会议也对此感兴趣，进行了讨论。在英语中F... 详细信息

近年来，国际外科文献检索资料中，Fast-track surgery一词频繁出现，也有不少以此为题的文章，涉及到各个区域的手术，效果甚佳，明显的加快了病人的康复，缩短了手术后住院日。国内，外科学术会议也对此感兴趣，进行了讨论。在英语中Fast-track一词常用以描述事物能迅速完成的途径和方法，Fast-track surgery当指手术快速完成之意。但Surgery一词在此并非单指手术操作的部分，而是指手术治疗的完整过程，涵盖术前准备到治疗结束出院。

关键词：手术操作手术治疗术后住院日文献检索快通道外科

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Effect of Alemtuzumab on Intestinal Intraepithelial Lymphocytes and Intestinal Barrier Function in Cynomolgus Model

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Chinese Medical Journal 2015年第5期128卷 680-686页

作者： lin-lin Qu Ya-Qing Lyu Hai-Tao Jiang Ting Shan Jing-Bin Zhang Qiu-Rong li jie-shou li Department of Biliary Surgery The Affiliated Hospital of Qingdao University Qingdao Shandong 266000 China Department of General Surgery Institute of General Surgery Jinling Hospital Nanjing Jiangsu 210002 China

Background：Alemtuzumab has been used in organ transplantation and a variety of hematologic malignancies （especially for the treatment of B-cell chronic lymphocytic leukemia）.However,serious infectious complications frequently occur after *** reason for increased infections postalemtuzumab treatment is unknown at this *** explore the effect ofalemtuzumab on intestinal intraepithelial lymphocytes （IELs） and intestinal barrier function in cynomolgus model to explain the reason of infection following alemtuzumab ***：Twelve male cynomolguses were randomly assigned to either a treatment or control *** treatment group received alemtuzumab （3 mg/kg,intravenous injection） while the control group received the same volume of physiological *** IELs were isolated from the control group and the treatment group （on day 9,35,and 70 after treatment） for counting and flow cytometric ***,intestinal permeability was monitored by enzymatic spectrophotometric technique and enzyme-linked immunosorbent ***：The numbers of IELs were decreased significantly on day 9 after treatment compared with the control group （0.35 ± 0.07 × 10^8 and 1.35 ± 0.09 × 10^8,respectively; P 〈 0.05） and were not fully restored until day 70 after *** were significant differences among four groups considering IELs *** addition,the proportion ofapoptotic IELs after alemtuzumab treatment was significantly higher than in the control group （22.01 ± 3.67 and 6.01 ± 1.42,respectively; P 〈 0.05）.Moreover,the concentration of D-lactate and endotoxin was also increased significantly on day 9 after ***：Alemtuzumab treatment depletes lymphocytes in the peripheral blood and intestine of cynomolgus *** induction of apoptosis is an important mechanism of lymphocyte depletion after alemtuzumab ***,intestinal barrier function may be disrupted after alemtuzumab treatment.

关键词： Alemtuzumab Barrier Function Infection Intestinal lntraepithelial Lymphocytes Lymphocyte Depletion

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