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Intrahepatic biliary cystadenocarcinoma: clinical analysis of 4 cases

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Hepatobiliary & Pancreatic Diseases International 2009年第1期8卷 71-74页

作者： Yu, Qiang Chen, Tao Wan, Yun-Le Min, Jun Cheng, Yu Guo, Hua Sun Yat Sen Univ Affiliated Hosp 2 Dept Gen Surg Guangzhou 510120 Peoples R China

BACKGROUND: Intrahepatic biliary cystadenocarcinoma (IBC) is a low-incidence disease which is often misdiagnosed because of insufficient recognition. This study aimed to investigate the clinical features, diagnosis and treatment of the disease. METHOD: The clinical data of 4 IBC patients treated in the Second Affiliated Hospital of Sun Yat-Sen University were retrospectively analyzed. RESULTS: The 4 patients complained of right upper abdominal pain and mass or masses. One patient presented with moderate fever and chills, and two had moderately impaired liver function. The levels of carbohydrate antigens (CA125 and CA19-9) were significantly elevated and the level of carcinoembryonic antigen was slightly elevated in 3 patients. The level of serum transaminase was elevated in 2 patients, and the level of serum total bilirubin elevated in 2. Intrahepatic cystic masses ranging from 5.0 to 20.5 cm in diameter were found in all patients by ultrasound and CT/MR scan. Three of the 4 patients were misdiagnosed on admission as having hepatic cyst and one as having hepatic abscess. Radical removal of masses was performed in three patients after pathological diagnosis. One patient died from tumor recurrence 7 years after operation, 2 were followed up for 12 and 17 months without evidence of recurrence. The high risk patients who received palliative therapy were closely followed up. CONCLUSIONS: The diagnosis of IBC without specific clinical features mainly depends on imaging and pathological examination. Increased levels of serum CA125 and CA19-9 might contribute to the diagnosis and prognosis of some IBC patients. Radical excision is the only effective treatment.

关键词： liver neoplasm bile ducts liver cystadenocarcinoma

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Effect of the extrahepatic bile duct anatomy on choledocholithiasis and its clinical significance

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1363-1370页

作者： Zheng Cao Jia Zhou Li Wei Hai-Yu He Jun Li Department of Gastroenterology The Second Affiliated Hospital of Kunming Medical UniversityKunming 650000Yunnan ProvinceChina

BACKGROUND A comprehensive understanding of the extrahepatic bile duct anatomy is vital to guide surgical procedures and perform endoscopic retrograde *** irregularities within the extrahepatic bile duct may increase susceptibility to bile duct *** To investigate the anatomical risk factors associated with extrahepatic bile ducts in patients diagnosed with choledocholithiasis,with a specific focus on preventing stone recurrence after surgical intervention and endoscopic *** We retrospectively analyzed the medical records of 124 patients without choledocholithiasis and 108 with confirmed choledocholithiasis who underwent magnetic resonance cholangiopancreatography examinations at our center between January 2022 and October *** regression analyses were conducted to identify the anatomical risk factors influencing the incidence of common bile duct *** Multivariate logistic regression analysis revealed that several factors independently contributed to choledocholithiasis *** independent risk factors for choledocholithiasis were diameter of the common hepatic[adjusted odds ratio(aOR)=1.43,95%confidence interval(CI):1.07-1.92,adjusted P value=0.016]and common bile(aOR=1.68,95%CI:1.27-2.23,adjusted P valueducts,length of the common hepatic duct(aOR=0.92,95%CI:0.84-0.99,adjusted P value=0.034),and angle of the common bile duct(aOR=0.92,95%CI:0.89–0.95,adjusted P valuebile duct were directly associated with choledocholithiasis *** risk factors include an enlarged diameter of the common hepatic and bile ducts,a shorter length of the common hepatic duct,and a reduced angle of the common bile duct.

关键词： bile ducts Extrahepatic Choledocholithiasis Cholangiopancreatography Magnetic resonance Cholangiopancreatography Endoscopic retrograde

Robotic-assisted cholecystectomy: stepping stone to expertise or vogue?

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Hepatobiliary Surgery and Nutrition 2024年第2期13卷 301-303页

作者： Dimitrios Ntourakis Evangelia Triantafyllou Christiana Roidi Panagiotis Lainas Division of Surgery School of MedicineEuropean University CyprusNicosiaCyprus Minimally Invasive Surgery Unit Athens Medical Center Palaio Faliro ClinicAthensGreece Department of Minimally Invasive Digestive&Bariatric Surgery Metropolitan HospitalHEAL AcademyAthensGreece

We read with great interest the study by Kalata et *** in JAMA Surgery comparing the safety of robotic-assisted cholecystectomy(RAC)*** cholecystectomy(LC)(1).This nationwide cohort study from the United States includes more than one million patients who had a cholecystectomy from January 1,2010 to December 31,*** impressive 37-fold increase in the use of RAC is reported during this ***,RAC was found to have a three times higher rate of bile duct injuries requiring surgical repair with choledochojejunostomy or hepaticojejunostomy within one year from surgery when compared to ***,RAC in comparison to LC had a higher incidence of postoperative biliary interventions with endoscopic retrograde cholangiopancreatography and common bile duct exploration[7.4%vs.6.0%;relative risk(RR)=1.25;95%confidence interval(CI):1.16-1.33].In addition,an instrumental variable analysis was undertaken to investigate the causality of this result and found that RAC had two times more bile duct injuries requiring surgical reconstruction when compared to LC(0.4%vs.0.2%;RR=1.88;95%CI:1.14-2.63).

关键词： Robotic surgical procedures laparoscopy intraoperative complications cholecystectomy bile ducts

New approaches to diagnostics and treatment of cholangiocellular cancer based on photonics methods

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Frontiers of Optoelectronics 2020年第4期13卷 352-359页

作者： Dmitry V.YAKOVLEV Dina S.FARRAKHOVA Artem A.SHIRYAEV Kanamat T.EFENDIEV Maxim V.LOSCHENOV Liana M.AMIRKHANOVA Dmitry O.KORNEV Vladimir V.LEVKIN Igor V.RESHETOV Victor B.LOSCHENOV Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry Russian Academy of SciencesMoscow 117997Russia Prokhorov General Physics Institute of Russian Academy of Sciences Moscow 119991Russia University Clinical Hospital No.1 Oncology CenterI.M.Sechenov First Moscow State Medical University(Sechenov University)Ministry of Health of the Russian FederationMoscow 119991Russia Department of Laser Micro- Nano-and BiotechnologyInstitute of Engineering Physics for BiomedicineNational Research Nuclear University MEPhIMoscow 115409Russia

Cholangiocellular cancer(CCC)is an oncological disease of the bile ducts characterized by a high mortality *** date,the use of standard methods for the diagnosis and treatment of CCC has not been able to reduce mortality from this *** work presents the results of fluorescence diagnostics(FD),which consists in using a modified optical fiber and photodynamic therapy(PDT)using a therapeutic laser instead of a low-intensity *** technique was tested on 43 patients in a clinical *** results obtained indicate a direct correlation between spectroscopic and video FD ***,a direct correlation was found between the photobleaching of a chlorin e6-based photosensitizer,with the commercial names of PhotoIon Radachlorin and Photoran and stricture *** findings demonstrate the possibility of using a therapeutic laser with a wavelength of 660 nm for both diagnosis and treatment of bile ducts cancer,which results in a significant reduction of the operation time without decreasing its effectiveness.

关键词： cholangiocellular cancer(CCC) fluorescent diagnostics(FD) photodynamic therapy(PDT) chlorin e6 PhotoIon spectroscopic method video fluorescent method photobleaching cancer bile ducts tumor intraoperation diagnostics photosensitizer(PS)

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小儿外科性黄疸81例手术治疗分析

中华小儿外科杂志 1982年第2期3卷 89-91页

作者：王凤兰陶文芳哈尔滨医科大学附属第二医院小儿外科

Surgical jaundice in children is not uncommon in clinic. Most of them are obstructive *** longer time of the obstruction, the worse injury of the liver function. The later cases can cause biliary cirrhosis, which gives bad effect in children. So it is; very important to differentiate medical jaundice from surgical *** paper collected 81 cases of surgical jaundice in children during 1958～1980, including 25 cases of congenital; biliary atresia, 51 cases with congenital choledochal cyst, 2 cases with congenital biliary hypoplasia, 2 cases with perforation of the extrahepatic bile ducts, 1 case with inspissated bile *** paper discussed the operation's indication for congenital malformations of the biliary tract.

关键词：小儿外科性黄疸手术治疗分析 Children congenital choledochal cyst children biliary cirrhosis 肝功能损害 paper bile ducts operation 梗阻时间胆汁淤积 medical 肝硬化肝实质 during time

先天性胆总管囊肿合并肝内胆管扩张的诊断与治疗

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中华小儿外科杂志 1984年第4期5卷 225-226页

作者：冯家钧江启俊陶文芳胡佐民哈尔滨医科大学附属第二医院小儿外科

From 1962 to 1980,40 cases were admitted to our hospital for it,10 of them accompanied with serious complications,including cholangitis,choleperitonitis caused by cyst rupture,cholehepatocirrhosis,disturbance in blood coagulation caused by obstructive jaundice,subcutaneous blood tasis,epistaxis,hematoma in the cranial cavity,hemiplegia,as well as dilation of the intrahepatic bile ducts,cystic formation,gallstone,petechia and *** order to prevent and reduce their occurrence,the following measures are suggested:regular physical check-ups,doctor's better understanding of the disease,early diagnosis and treatment.

关键词：先天性胆总管囊肿肝内胆管扩张诊断与治疗 obstructive jaundice blood coagulation 治疗效果肝内胆管囊性扩张 understanding bile ducts 临床报道及时诊断发育异常胆管囊肿 physical better order 认识疾病患儿分型