1.Clinical effects of early laparoscopic cholecystectomy for the patients with acute pancreatitis with gallbladder stone
Wenzhong BAO ; Xiangling MENG ; Liang LI ; Dawei TANG ; Gaochao ZHOU ; Jiawen WANG
Chinese Journal of Hepatobiliary Surgery 2014;20(2):89-91
Objective To study the feasibility and timing of early laparoscopic cholecystectomy (LC) for the patients with mild-to-moderate acute pancreatitis with gallbladder stone.Methods 26 patients with mild-to-moderate acute pancreatitis with gallbladder stone underwent early laparoscopic cholecystectomy.The patients were initially treated with conservative treatment.When the diagnosis was confirmed and the patients were stable,LC was carried out within 48 hours of hospitalization.The results were compared with a delayed group of patients who received delayed LC for acute pancreatitis.Results All the LC operations were successfully carried out.There were no significant differences between the two groups in alkaline phosphatase,alanine aminotransferase,aspartate aminotransferase,blood amylase and urine armylase on postoperative day 1,3,5,7.Patients who received early laparoscopic cholecystectomy had a shorter hospital stay.There were no significant differences between the two groups in the operation time,intraoperative blood loss,postoperative complication rates and recurrence of acute pancreatifis.Conclusion After CBD stones have been ruled out,it is safe and feasible to carry out early laparoscopic cholecystectomy within 48 hours of hospital admission for patients with mild-to-moderate acute pancreatitis with gallbladder stone.
2.Study on acute deep venous thrombosis of lower limb
Xianluo LIU ; Xiaoxing QIAN ; Yongsheng TANG ; Kehui CHEN ; Meimei QIAN ; Xiaogang LIU ; Gaochao ZHOU ; Xiaofeng XU
Chinese Journal of Current Advances in General Surgery 1999;0(04):-
Objective: To evaluate the superiority in diagnosing DVT between venography and duplex ultrasound, and the effectiveness of C-reactive protein (CRP) as a biomarker. Methods: Firstly,the iliac - femoral vein of the dog left hind leg was isolated,and then, the thrombosis model was established by infusing the thrombin after breaking endangium.The recanalization of thrombosis was assessed by duplex ultrasound and venography, and the expression of serum hsCRP was also examined. From 2006 to 2008, 77 patients with acute DVT proximal to the knee joint were admitted. The interval between the onset of DVT and admission was 1-21 days. They were treated mainly with urokinase and low molecular weight heparin for 2 weeks. The assessment of each patient including clinical manifestation, venography, duplex ultrasound and serum highly sensitive C-reactive protein (hsCRP) were performed immediately after admission and 4 weeks after discharge. Results: After medical therapy for 2 weeks, the clinical features prominently subsided in 49 patients, improved in 23 and didn’t ameliorate in 5.4 weeks after discharge, venography showed clot regression in 15 patients; while in the remaining 62 patients the occluded venous lumen were not visualized, duplex ultrasound showed partial lysis of the thrombosis. At admission, the hsCRP was 28.91?29.4mg/L, and it dropped to 8.13?12.7mg/L at 4 weeks after discharge. Conclusion:Duplex ultrasound was effective to assess DVT. The hsCRP was positively related to the severity of DVT.