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Utility of multiple endoscopic techniques in differential diagnosis of gallbladder adenomyomatosis from gallbladder malignancy with bile duct invasion: A case report

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World Journal of Clinical Cases 2020年第2期8卷 464-470页

作者： Li-Jia Wen Jun-Hong Chen Yong-Jin Chen Kai Liu Department of hepatopancreatobiliary surgery The First Hospital of Jilin University

BACKGROUND Gallbladder adenomyomatosis(GAM) is a benign lesion, characterized by thickening of the gallbladder wall and a focal mass, which overlap with the features of gallbladder malignancy. Consequently, differential diagnosis of GAM from gallbladder cancer is difficult and approximately 20% of suspected malignant biliary strictures are postoperatively confirmed as benign lesions.Herein, we report a case in which a preoperative diagnosis of GAM was made by a combination of endoscopic and imaging techniques.CASE SUMMARY A 40-year-old man was referred to our hospital chiefly for a fever and right upper abdominal pain with dark urine. Enhanced computed tomography showed thickening of the gallbladder wall and a mass in the gallbladder neck with involvement of the hepatic bile ducts, which was suspected to be malignant.Gallbladder malignancy with bile duct invasion was ruled out by subsequent endoscopic examinations, including endoscopic retrograde cholangiopancreatography, intraductal ultrasound, and Spy Glass. Endoscopic examinations showed a homogeneous hyperechoic lesion with smooth margins of benign bile duct stricture suggestive of inflammatory stenosis of the bile duct.The patient underwent laparoscopic cholecystectomy. GAM was postoperatively diagnosed and confirmed based on the histopathology results, which are consistent with the preoperative diagnosis. Notably, no malignant event occurred in the patient during a 12-mo follow-up period.CONCLUSION A combination of endoscopic techniques may help in the differential diagnosis of GAM from gallbladder cancer.

关键词： Gallbladder adenomyomatosis Differential diagnosis Endoscopic retrograde cholangio-pancreatography Intraductal ultrasound SpyGlass Case report

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Complements are involved in alcoholic fatty liver disease, hepatitis and fibrosis

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World Journal of Hepatology 2018年第10期10卷 662-669页

作者： Cheng-Jie Lin Zhi-Gao hu Guan-Dou Yuan Biao Lei Song-Qing he Department of hepatopancreatobiliary surgery the first Affiliated Hospital of Guangxi Medical University

The complement system is a key component of the body's immune system. When abnormally activated, this system can induce inflammation and damage to normal tissues and participate in the development and progression of a variety of diseases. In the past, many scholars believed that alcoholic liver disease(ALD) is induced by the stress of ethanol on liver cells, including oxidative stress and dysfunction of mitochondria and protease bodies, causing hepatocyte injury and apoptosis. Recent studies have shown that complement activation is also involved in the genesis and development of ALD. This review focuses on the roles of complement activation in ALD and of therapeutic intervention in complement-activation pathways. We intend to provide new ideas on the diagnosis and treatment of ALD.

关键词： Alcoholic liver disease complement system proteins Complement regulator liver cells hepatocyte injury

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Diagnostic value of elevated serum carbohydrate antigen 199 level in acute cholangitis secondary to choledocholithiasis

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World Journal of Clinical Cases 2018年第11期6卷 441-446页

作者： Yong Mei Li Chen Ci-Jun Peng Jun Wang Peng-Fei Zeng Guo-Xing Wang Wen-Ping Li Yan-Qing Luo Chao Du Kai Liu Kun Xiong Kai Leng Chun-Lin Feng Ji-Hu Jia Department of hepatopancreatobiliary surgery the Third Affiliated Hospital of Zunyi Medical University Diagnostics Laboratory Affiliated Hospital of Zunyi Medical University Department of hepatopancreatobiliary surgery Affiliated Hospital of Zunyi Medical University

AIM To investigate the diagnostic value of abnormal serum carbohydrate antigen 199(CA199) level in acute cholangitis secondary to choledocholithiasis.METHODS In this retrospective cohort study, the clinical data of 727 patients with choledocholithiasis admitted to the Third Affiliated Hospital of Zunyi Medical College from June 2011 to June 2017 were collected. Among these patients, 258 patients had secondary acute cholangitis and served as observation group, and the remaining 569 choledocholithiasis patients served as the control group. Serum liver function indexes and tumor markers were detected in both groups, and the receiver operating characteristic(ROC) curves were constructed for markers showing statistical significances. The cutoff value, sensitivity, and specificity of each marker were calculated according to the ROC curves. RESULTS The results of liver function tests showed no significant differences between the two groups(P > 0.05). Tumor markers including serum CA125, CA153, carcinoembryonic antigen, and alpha fetoprotein levels were also not significantly different(P > 0.05); however, the serum CA199 level was significantly higher in the observation group than in the control group(P < 0.05). The ROC curve analysis showed that the area under the curve was 0.885(95%CI: 0.841-0.929) for CA199, and the cutoff value of 52.5 kU/L had the highest diagnostic accuracy, with a sensitivity of 86.8% and a specificity of 81.6%.CONCLUSION Abnormally elevated serum CA199 level has an important value in the diagnosis of acute cholangitis secondary to choledocholithiasis. It may be a specific inflammatory marker for acute cholangitis.

关键词： Carbohydrate antigen 199 Tumor marker Choledocholithiasis Inflammatory marker Diagnosis Acute cholangitis

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Solid pseudopapillary tumor of the pancreas in male patients: Report of 16 cases

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World Journal of Gastroenterology 2014年第22期20卷 6939-6945页

作者： Yun-Qiang Cai Si-Ming Xie Xun Ran Xing Wang Gang Mai Xu-Bao Liu Department of hepatopancreatobiliary surgery West China HospitalSichuan University

AIM:To investigate the clinical characteristics,surgical strategies and prognosis of solid pseudopapillary tumors(SPTs)of the pancreas in male patients.METHODS:From July 2003 to March 2013,116 patients were diagnosed with SPT of the pancreas in our institution.Of these patients,16 were male.The patients were divided into two groups based on gender:female(group 1)and male(group 2).The groups were compared with regard to demographic characteristics,clinical presentations,surgical strategies,complications and follow-up outcomes.RESULTS:Male patients were older than female patients(43.1±12.3 years vs 33.1±11.5 years,P=0.04).Tumor size,location,and symptoms were comparable between the two groups.All patients,with the exception of one,underwent complete surgical resection.The patients were regularly followed up.Themean follow-up period was 58 mo.Two female patients(1.7%)developed tumor recurrence or metastases and required a second resection,and two female patients(1.7%)died during the follow-up period.CONCLUSION:Male patients with SPT of the pancreas are older than female patients.There are no significant differences between male and female patients regarding surgical strategies and prognosis.

关键词： Frantz tumor Pancreas neoplasm Solid pseudopapilla

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Laparoscopic splenectomy for splenic littoral cell angioma

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World Journal of Gastroenterology 2015年第21期21卷 6660-6664页

作者： Yun-Qiang Cai Xing Wang Xun Ran Xu-Bao Liu Bing Peng Department of hepatopancreatobiliary surgery West China HospitalSichuan University

AIM:To establish the safety and feasibility of laparoscopic splenectomy(LS) for littoral cell angioma(LCA).METHODS:From September 2003 to November 2013,27 patients were diagnosed with LCA in our institution.These patients were divided into two groups based on operative procedure:LS(13 cases,Group 1) and open splenectomy(14 cases,Group 2).Data were collected retrospectively by chart review.Comparisons were performed between the two groups in terms of demographic characteristics(sex and age); operative outcomes(operative time,estimated blood loss,transfusion,and conversion); postoperative details(length of postoperative stay and complications); and follow-up outcome.RESULTS:LS was successfully carried out in all patients except one in Group 1,who required conversion to hand-assisted LS because of perisplenic adhesions.The average operative time for patients in Group 1 was significantly shorter than that in Group 2(127 ± 34 min vs 177 ± 25 min,P = 0.001).The average estimated blood loss in Group 1 was significantly lower than in Group 2(62 ± 48 m L vs 138 ± 64 m L,P < 0.01).No patient in Group 1 required a blood transfusion,whereas one in Group 2 required a transfusion.Two patients in Group 1 and four in Group 2 suffered from postoperative complications.All the complications were cured by conservative therapy.There were no deaths in our series.All patients were followed up and no recurrence or abdominal metastasis were found.CONCLUSION:LS for patients with LCA is safe and feasible,with preferable operative outcomes and longterm tumor-free survival.

关键词： Laparoscopy Minimal invasiveness Splenictumor Splenectomy Littoral cell angioma

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Emergency laparoscopic partial splenectomy for ruptured spleen:A case report

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World Journal of Gastroenterology 2014年第46期20卷 17670-17673页

作者： Yun-Qiang Cai Chun-Lin Li Hua Zhang Xin Wang Bing Peng Department of hepatopancreatobiliary surgery West China HospitalSichuan University

Splenic rupture is a common consequence of blunt abdominal trauma.Emergency splenectomy is indicated when conservative management is not effective.With better understanding of the immunologic function of the spleen,surgeons have begun to perform the splenic-preserving surgery.However,it is technical challenge to perform emergency laparoscopic partial splenectomy for patient with spleen rupture.A 15-year-old male patient suffered from gradeⅢspleen injury basing on the American association for the surgery of trauma splenic injury scale.Conservative treatment failed to success basing on the dramatically decreased hemoglobin level.During the laparoscopic exploration,we found that two individual ruptures were associated with the upper pole of spleen.An emergency laparoscopic partial splenectomy was successfully carried out.The operative time was approximate 150 min and the estimated blood loss was 200 m L.The post-operative course was uneventful and the patient was discharged on the 7th post-operative day.

关键词： Laparoscopy Minimal invasive Partial splenectomy S

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Patient-derived xenograft model in colorectal cancer basic and translational research

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Animal Models and Experimental Medicine 2023年第1期6卷 26-40页

作者： Xiaofeng Liu Zechang Xin Kun Wang hepatopancreatobiliary surgery department Ⅰ Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing)Peking University Cancer Hospital and InstituteBeijingChina

Colorectal cancer(CRC)is one of the most popular malignancies globally,with 930000 deaths in 2020.The evaluation of CRC-related pathogenesis and the discovery of po-tential therapeutic targets will be meaningful and helpful for improving CRC treat-ment.With huge efforts made in past decades,the systematic treatment regimens have been applied to improve the prognosis of CRC patients.However,the sensitivity of CRC to chemotherapy and targeted therapy is different from person to person,which is an important cause of treatment failure.The emergence of patient-derived xenograft(PDX)models shows great potential to alleviate the straits.PDX models possess similar genetic and pathological characteristics as the features of primary tu-mors.Moreover,PDX has the ability to mimic the tumor microenvironment of the original tumor.Thus,the PDX model is an important tool to screen precise drugs for individualized treatment,seek predictive biomarkers for prognosis supervision,and evaluate the unknown mechanism in basic research.This paper reviews the recent advances in constructed methods and applications of the CRC PDX model,aiming to provide new knowledge for CRC basic research and therapeutics.

关键词： colorectal cancer drug discovery patient-derived xenograft model precision medicine tumor microenvironment

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Downregulation of orosomucoid 2 acts as a prognostic factor associated with cancer-promoting pathways in liver cancer

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World Journal of Gastroenterology 2020年第8期26卷 804-817页

作者： Han-Zhang Zhu Wei-Jiang Zhou Ya-Feng Wan Ke Ge Jun Lu Chang-Ku Jia Department of hepatopancreatobiliary surgery Hangzhou First People’s HospitalThe Affiliated Hospital of Medical School of Zhejiang University

BACKGROUND Liver cancer has a high mortality and morbidity rate throughout the world.In clinical practice,the prognosis of liver cancer patients is poor,and the complex reasons contribute to treatment failures,including fibrosis,hepatitis viral infection,drug resistance and metastasis.Thus,screening novel prognostic biomarkers is of great importance for guiding liver cancer therapy.Orosomucoid genes(ORMs)encode acute phase plasma proteins,including orosomucoid 1(ORM1)and ORM2.Previous studies showed their upregulation upon inflammation,but the specific function of ORMs has not yet been determined,especially in the development of liver cancer.AIM To determine the expression of ORMs and their potential function in liver cancer.METHODS Analysis of the expression of ORMs in different human tissues was performed on data from the HPA RNA-seq normal tissues project.The expression ratio of ORMs was determined using the HCCDB database,including the ratio between liver cancer and other cancers,normal liver and other normal tissues,liver cancer and adjacent normal liver tissues.Analysis of ORM expression in different cancer types was performed using The Cancer Genome Atlas and TIMER database.The expression of ORMs in liver tumor tissues and adjacent normal tissues were further confirmed using Gene Expression Omnibus data,including GSE36376 and GSE14520.The 10-year overall survival(OS),progression-free survival(PFS)and relapse-free survival(RFS)rates between high and low ORM expression groups in liver cancer patients were determined using the Kaplan-Meier plotter tool.Gene Set Enrichment Analysis(GSEA)was employed to explore the ORM2-associated signaling network.Correlations between ORM2 expression and tumor purity or the infiltration level of macrophages in liver tumor tissues were determined using the TIMER database.The correlation between ORM2 gene levels,tumor-associated macrophage(TAM)markers(including CD68 and TGFβ1)and T cell immunosuppression(including CTLA4 and PD-1)in liver tumor tissues and liver GTEx was determin

关键词： Orosomucoid gene Specific expression Downregulation Prognostic factor Tumor promoter signaling Immune suppression

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A new three-step procedure for pancreatic head carcinoma with invasion of superior mesenteric artery

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Hepatobiliary & Pancreatic Diseases International 2018年第4期17卷 286-289页

作者： Rui Tang Jia-Hong Dong Department of hepatopancreatobiliary surgery Beijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua University

Pancreatic head carcinoma is characterized by high malignancy and a low survival rate and its mortality ranks fourth for malignant tumors with a 5-year survival rate of only 5%[1].Treatment of this cancer relies on surgical resection.However,the resection rate is only about 20%,because majority of the patients are classified as unresectable when diagnosed due to distant metastasis or

关键词： SMA A new three-step procedure for pancreatic head carcinoma with invasion of superior mesenteric artery

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Surgical treatment for liver cancer

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World Journal of Gastroenterology 2010年第8期16卷 927-933页

作者： Nicole C Tsim Adam E Frampton Nagy A Habib Long R Jiao Department of hepatopancreatobiliary surgery Division of SurgeryHammersmith Hospital campusImperial College London

Primary liver cancer is amongst the commonest tumors worldwide,particularly in parts of the developing world,and is increasing in incidence. Over the past three decades,surgical hepatic resection has evolved from a high risk,resource intensive procedure with limited application,to a safe and commonly performed operation with a range of indications. This article reviews the approach to surgical resection for malignancies such as hepatocellular cancer,metastatic liver de-posits and neuroendocrine tumors. Survival data after resection is also reviewed,as well as indications for curative resection.

关键词： Liver cancer Surgical resection Indications Hepatocellular carcinoma Colorectal liver metastases Neuroendocrine tumors Non-colorectal non-neuroendo-crine

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