1.Complications following laparoscopic cholecystectomy:Prevention and treatment
Guohui GUO ; Bingjun SHU ; Xin JIN
Chinese Journal of Minimally Invasive Surgery 2001;0(06):-
Objective To discuss the prevention and treatment for complications following laparoscopic cholecystectomy (LC). Methods A total of 902 cases were summarized retrospectively with regard to causes, prevention and treatment of complications following LC. Results Out of the 902 cases, there were 2 cases of bile duct injury, 2 cases of residual calculi of common bile duct, and 4 cases of scrotum emphysema. The bile duct injury and residual calculi were all cured by re-operation, while the scrotum emphysema dissolved of itself without medical treatment. A conversion to open surgery was required in 31 cases. All the cases in the study were cured. Conclusions Emphasis should be laid on the prevention of complications after LC. A prompt conversion to open cholecystectomy is the key to the lowering of complication rate.
2.Disease Course and Outcomes in Patients With the Limited Form of Neuromyelitis Optica Spectrum Disorders and Negative AQP4-IgG Serology at Disease Onset:A Prospective Cohort Study
Xiaodong CHEN ; Jing ZHOU ; Rui LI ; Bingjun ZHANG ; Yuge WANG ; Xiaonan ZHONG ; Yaqing SHU ; Yanyu CHANG ; Wei QIU
Journal of Clinical Neurology 2022;18(4):453-462
Background:
and Purpose Patients presenting with clinical characteristics that are strongly suggestive of neuromyelitis optica spectrum disorders (NMOSD) have a high risk of developing definite NMOSD in the future. Little is known about the clinical course, treatment, and prognosis of these patients with likely NMOSD at disease onset.
Methods:
This study prospectively recruited and visited 24 patients with the limited form of NMOSD (LF-NMOSD) at disease onset from November 2012 to June 2021. Their demographics, clinical course, longitudinal aquaporin-4 immunoglobulin G (AQP4-IgG) serology, MRI, therapeutic management, and outcome data were collected and analyzed.
Results:
The onset age of the cohort was 38.1±12.0 years (mean±standard deviation). The median disease duration was 73.5 months (interquartile range=44.3–117.0 months), and the follow-up period was 54.2±23.8 months. At the end of the last visit, the final diagnosis was categorized into AQP4-IgG-seronegative NMOSD (n=16, 66.7%), AQP4-IgG-seropositive NMOSD (n=7, 29.2%), or multiple sclerosis (n=1, 4.2%). Seven of the 24 patients (29.2%) experienced conversion to AQP4-IgG seropositivity, and the interval from onset to this serological conversion was 37.9±21.9 months. Isolated/mixed area postrema syndrome (APS) was the predominant onset phenotype (37.5%). The patients with isolated/mixed APS onset showed a predilection for conversion to AQP4-IgG seropositivity. All patients experienced a multiphasic disease course, with immunosuppressive therapy reducing the incidence rates of clinical relapse and residual functional disability.
Conclusions
Definite NMOSD may be preceded by LF-NMOSD, particularly isolated/ mixed APS. Intensive long-term follow-up and attack-prevention immunotherapeutic management is recommended in patients with LF-NMOSD.