Objective To explore and evaluate the hemostatic effects of hemocoagulase in elderly surgery bleeding. Methods 150 cases (60~75 years old)admitted to Affiliated Hospital of Chuanbei Medical College for abdominal operation from June 2011 to June 2012 were used as subject. They were divided radomly into hemocoagulase group (50 cases),reptilase group (50 cases)and physiological saline solution group (50 cases). The hemostatic time,hemorrhagic volume,hemorrhagic volume per square unit,and body coagulation parameters in three groups were observed and compared. Results The hemorrhagic volume in hemocoagulase group was (9.2 ±2.7 )g,average hemostatic time was (124.5 ±45.7 )s,and hemorrhagic volume per square unit was (0.3 ±0.1 )g,which were similar with reptilase group,but significantly different with those in physiological saline solution group (P<0.05 ). In hemocoagulase and reptilase groups,the hemorrhagic and hemoagglution time decreased in 30 minutes and 1 day after operation, the differences were statistically significant when compared with physiological saline solution group (P <0.05 ).Conclusion Hemocoagulase has better hemostatic effect on hemorrhagic capillary in elderly surgery.

Objective To compare the curative effect of anti-relfux plastic stent and common plastic stent in treatment of malignant biliary obstruction.Method 22 cases of anti-reflux biliary plastic stent implantation and 30 cases of common bile duct stent implantation from March 2013 to April 2016 were selected as study subject, then compare the operation time, one-time success rate, postoperative pancreatitis, cholangitis, patency, differences in survival situation.Result There was no significant difference between the two groups in the aspects of the operation time, one-time success rate of recent cholangitis after surgery, postoperative pancreatitis (P > 0.05), but there was significant difference between the three aspects of long term patency, cholangitis, survival period (P < 0.05).Conclusion The anti-relfux biliary stent has good long-term curative effect in treatment of malignant biliary obstruction, which worth of further exploration and research.

Objective To explore the method and clinical effect of laparoscopic anatomical right liver resections. Method The candidates for laparoscopic right hepatic lobectomys were 4 cases including 3 cases of liver hemangioma and 1 case of hepatorrhexis. Results The laparoscopic right hepatic lobectomy we performed saccess bully in all the 4 patients, operation time was (470±42.7)min. The blood loss in operation was ( 1950± 881.3) ml. The postoperative hospital stay was ( 15 ± 2.9) days.There was not complcation. Conclusions Laparoscopic right hepatic libectomy is feasible and safe.For the patients with benign liver disease, it is an operation with less operation wound.

Objective To evaluate the efficacy of laparoscopic Habib 4X (Habib 4X,Angio Dynamics US),a new bipolar radiofrequency (RF) device,in laparoscopic liver resection.Methods Thirty one patients who underwent laparoscopic liver resection using the laparoscopic Habib 4X from Sept 2009 to Apr 2012 were studied retrospectively.Results The laparoscopic Habib 4X was success fully used in 30 patients (malignant,n=18; benign,n=12).The procedures performed included left lateral sectionectomy (n=12),left hemi-hepatectomy (n=1),Ⅴ or Ⅵ segmentectomy (n=9),Ⅴ and Ⅵ bi-segmentectomy (n=2) and wedge exclusion (n=6).The time required for precoagulation and resection was 10～68 min (median 24 min).The mean intraoperative blood loss was 145±75ml (range 8-370 ml).Mild abnormal liver function which returned to normal in 3 to 5 days was detected postoperatively.The mean hospital stay was 7.8±2.6 d (range 3～12 days).There was no patient who developed postoperative bleeding,bile leakage or abdominal abscess.For cancer patients,there was no local recurrence on follow-up.Conclusion Laparoscopic Habib 4X,a device when used in laparoscopic liver resection,resulted in minimal blood loss and quick recovery.It had only mild effect on liver function and it had low morbidity.In addition,it might reduce the risk of local recurrence in malignant tumours.