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Continuous suture of the pancreatic stump and Braun enteroenterostomy in pancreaticoduodenectomy

World Journal of Gastroenterology 2015年第9期21卷 2731-2738页

作者： Hong-Bo Meng Bo Zhou Fan Wu Jie Xu Zhen-Shun Song Jian Gong Mahbuba Khondaker Bin Xu Department of General Surgery Shanghai 10th People’s HospitalTongji University School of Medicine Department of Obstetrics and Gynecology Shanghai 10th People’s HospitalTongji University School of Medicine GI Division Renji HospitalShanghai Institute of Digestive DiseasesShanghai Jiao-Tong University School of Medicine Tongji University School of Medicine

AIM:To investigate a new modification of pancreaticoduodenectomy(PD)-a mesh-like running suturing of the pancreatic remnant and Braun's ***:Two hundred and three patients underwent PD from 2009 to 2014 and were classified into two groups:Group A(98 patients),who received PD with a mesh-like running suturing for the pancreatic remnant,and Braun's enteroenterostomy; and Group B(105 patients),who received standard *** data,intraoperative findings,postoperative morbidity and perioperative mortality between the two groups were compared by univariate and multivariate ***:Demographic characteristics between Group A and Group B were *** were no significant differences between the two groups concerning perioperative mortality,and operative blood loss,as well as the incidence of the postoperative morbidity,including reoperation,bile leakage,intraabdominal fluid collection or infection,and postoperative *** relevant postoperative pancreatic fistula(POPF) and delayed gastric emptying(DGE) were identified more frequently in Group B than in Group *** A(PD with a mesh-like running suturing of the pancreatic remnant and Braun's enteroenterostomy) was independently associated with decreased clinicallyrelevant POPF and DGE,with an odds ratio of 0.266(95%CI:0.109-0.654,P =0.004) for clinically relevant POPF and 0.073(95%CI:0.010-0.578,P =0.013) for clinically relevant ***:An additional mesh-like running suturing of the pancreatic remnant and Braun's enteroenterostomy during PD decreases the incidence of postoperative complications and is beneficial for patients.

关键词： Pancreaticoduodenectomy Delayed gastric emptying B

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Decision making for pancreatic resection in patients with intraductal papillary mucinous neoplasms

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World Journal of Gastroenterology 2013年第9期19卷 1451-1457页

作者： Bin Xu Wei-Xing Ding Da-Yong Jin Dan-Song Wang Wen-Hui Lou Department of General Surgery Shanghai Tenth People's Hospital Tongji University School of Medicine Department of General Surgery Zhong Shan Hospital Fudan University

AIM: To identify a practical approach for preoperative decision-making in patients with intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. METHODS: Between March 1999 and November 2006, the clinical characteristics, pathological data and computed tomography/magnetic resonance imaging (CT/MRI) of 54 IPMNs cases were retrieved and analyzed. The relationships between the above data and decision-making for pancreatic resection were analyzed using SPSS 13.0 software. Univariate analysis of risk factors for malignant or invasive IPMNs was performed with regard to the following variables: carcinoembryonic antigen, carbohydrate antigen 19-9 (CA19-9) and the characteristics from CT/MRI images. Receiver operating characteristic (ROC) curve analysis for pancreatic resection was performed using significant factors from the univariate analysis. RESULTS: CT/MRI images, including main and mixed duct IPMNs, tumor size > 30 mm or a solid component appearance in the lesion, and preoperative serum CA19-9 > 37 U/mL had good predictive value for determining pancreatic resection (P < 0.05), but with limitations. Combining the above factors (CT/MRI images and CA19-9) improved the accuracy and sensitivity for determining pancreatic resection in IPMNs. Using ROC analysis, the area under the curve reached 0.893 (P<0.01, 95%CI: 0.763-1.023), with a sensitivity, specificity, positive predictive value and negative predictive value of 95.2%, 83.3%, 95.2% and 83.3%, respectively. CONCLUSION: Combining preoperative CT/MRI images and CA19-9 level may provide useful information for surgical decision-making in IPMNs.

关键词： Intraductal papillary mucinous neoplasms Surgical decision-making Carbohydrate antigen 19-9 Computed tomography/magnetic resonance imaging Predictor

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Transvaginal cholecystectomy vs conventional laparoscopic cholecystectomy for gallbladder disease:A meta-analysis

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World Journal of Gastroenterology 2015年第17期21卷 5393-5406页

作者： Bin Xu Bo Xu Wen-Yan Zheng Hai-Yan Ge Li-Wei Wang Zhen-Sun Song Bin He Department of Hepato-Biliary-Pancreatic Surgery Shanghai Tenth People’s HospitalTongji University School of Medicine Department of Anesthesiology and SICU Xinhua HospitalShanghai Jiaotong University School of Medicine Department of Surgical Intensive Care Unit Zhongshan HospitalFudan University Department of Gastrointestinal Surgery East Hospital of ShanghaiTongji University School of Medicine Department of Medical Informatics School of Public HealthJilin University

AIM:To compare the results of transvaginal cholecystectomy(TVC) and conventional laparoscopic cholecystectomy(CLC) for gallbladder ***:We performed a literature search of Pub Med,EMBASE,Ovid,Web of science,Cochrane Library,Google Scholar,Meta Register of Controlled Trials,Chinese Medical Journal database and Wanfang Data for trials comparing outcomes between TVC and *** were extracted by two *** difference (MD), standardized mean difference(SMD),odds ratios and risk rate with 95%CIs were calculated using fixed- or random-effects *** heterogeneity was evaluated with the χ2 *** fixed-effects model was used in the absence of statistically significant *** randomeffects model was chosen when heterogeneity was ***:There were 730 patients in nine controlled clinical *** significant difference was found regarding demographic characteristics(P > 0.5),including anesthetic risk score,age,body mass index,and abdominal surgical history between the TVC and CLC *** groups had similar mortality,morbidity,and return to work after *** in the TVC group had a lower pain score on postoperative day 1(SMD:-0.957,95%CI:-1.488 to-0.426,P < 0.001),needed less postoperative analgesic medication(SMD:-0.574,95%CI:-0.807 to-0.341,P < 0.001) and stayed for a shorter time in hospital(MD:-1.004 d,95%CI:-1.779 to 0.228,P = 0.011),but had longer operative time(MD:17.307 min,95%CI:6.789 to 27.826,P = 0.001).TVC had no significant influence on postoperative sexual function and quality of *** cosmetic results and satisfaction were achieved in the TVC ***:TVC is safe and effective for gallbladder ***,vaginal injury might occur,and further trials are needed to compare TVC with CLC.

关键词： Transvaginal cholecystectomy Conventionallaparoscopic cholecystectomy natural orifice Endoscopicsurgery Meta-analyses

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