Objective To investigate the cause and therapeutic principle of bile leakage after cholecystectomy.Method Materials of 12 cases of bile leakage in 1516 cases of cholecystectomy have been summarized and analyzed from January 1992 to December 1999.Results The incidence for bile leakage was 0.79%(12/1516).Causes of bile leakage included injury of bile duct in 2 cases,injury of liver tissue that the gallbladder was embedded in 7 ,leakage of stump of cystic duct, pentrating injury of common bile duct,and remain of gallbladder mucose in one each.10 cases underwent conservative therapy, 2 cases received reoperation, all were cured. Conclusions Bile leakage is related to anatomy, pathology and operation, malpractice was main cause for bile leakage.Therapeutic plan would be selected according to cause and amount of bile leakage.

Objective To evaluate the effect of surgical treatment for primary hepatocellular carcinoma(HCC) with bile duct thrombi(BDT).Methods Eleven cases were diagnosed as HCC with BDT by B ultrasound,CT,MRCP or ERCP.Hepatectomy and choledochotomy were performed,resecting the primary tumor and cleaning the BDT completely,followed with TACE.Results No patients died during operation.The survival time of 9 patients who received hepatectomy and BDT clearance ranged from 3 to 38(average 18.5) months,and that of the other two patients received TACE and BDT clearance survived 6 and 11 months respectively.Conclusion Accurate diagnosis and radical hepatectomy with complete BDT clearance are effective treatment for HCC with BDT.

Objective To evaluate the clinical efficacy and outcomes of percutaneous cholecystostomy(PC) under type-B ultrasonic guide as an alternative treatment option for critically ill patients of acute cholecystitis.Methods The clinical data of 53 high-risk patients of acute cholecystitis were retrospectively analyzed,who received PC from January 1999 to August 2005.Results All cases were successfully punctured and intubated,and 4 received reoperation because of blocked tube or fall-off.Fifty-two(97.3%) gained bile drainage effectively.No complications occurred due to the procedures in the cholecystostomy and intubation.One patient required emergency cholecystectomy on day 1 after the procedures because of deteriorating conditions.Forty-one accepted selective cholecystectomy in 2 weeks to 3 months after cholecystostomy.The follow-up period was 6 months to 3 years.Conclusion PC is an effective,convenient and safe method in managing acute cholecystitis in high-risk patients,with high achievement ratio and less complications.

BACKGROUND:Intensity-time (I/T) curve examination is a monitoring technology used for diagnosis of nerve damage,muscle disease and prognostic evaluation using current stimulation and qualitative or quantitative analysis.It also has significance to the diagnosis of lumbar disc herniation (LDH).Whether it can be used in LDH prognostic evaluation is poorly understood.OBJECTIVE:To explore the effectiveness of I/T curve in diagnosis and prognostic evaluation of LDH.METHODS:I/T curves of 113 LDH patients were measured by CX-3 electrodiagnostic equipment,and the results were compared with their unaffected sides and analyzed after physiotherapy.A total of 253 curves were measured,including 107 biceps femoris,101 gastrocnemius and 45 tibialis anterior muscle curves.All patients were sequential treated by traction,medium frequency,ultrashort wave,electric acupuncture as well as infrared radiation following I/T diagnosis,once a day,10 days for a course,with 10 days interval in 3 courses,I/T curves were performed after 3 courses.The therapeutic effect was evaluated by using I/T results combined with clinical symptom and physical signs.RESULTS AND CONCLUSION:The first estimated percentage by I/T curved line were 36.36% (controlled by normal nerve),62.85% (controlled by part of the denervated),0.79% (controlled by the completely denervated) and 63.64% (controlled by total abnormal nerve).After the physiotherapy,the effectiveness of the complete recovery was 92.86% by the normal nerve as well as 58.82% by the abnormal nerve.Above all,the practical value could be concluded from the diagnosis,evaluation and effectiveness of LDH used by I/T curve line.The therapeutic effectiveness controlled by the normal nerve is much better than that controlled by the abnormal.