ObjectiveTo review surgical management of the complications caused by iatrogenic endoscopic sphincterotomy(EST).MethodsEleven patients with complications of EST were surgically treated, including 4 patients with hemorrhage, 3 patients with perforation, 3 patients with perforation plus hemorrhage, and one patient with perforation plus severe pancreatitis. ResultsTwo patients with perforation plus hemorrhage and the patient with perforation plus severe pancreatitis died, other patients survived.ConclusionEarly diagnosis and surgical intervention was very important to lower the mortality. For patients suffering from perforation and hemorrhage or pancreatitis, it′s very important to make an unobstructed peritoneal drainage as well as other maneuvers.

Objective To sum up and discern the high risk factors of iatrogenic duodenl injuries and to evaluate the value of the treatment according to the new trauma scaling,so as to to facilitate and guide clinical research.Methods 21 patients with iatrogenic duodenal trauma hospitalized and From Jan.1985 to Oct.2005,in our hospital were collected and retrospectively reviewed,the duodenum organ iatrogenic injury scale was classified and developed depending on the clinical finding and referring to the injury scale by the American Association for the Surgery of Trauma(A.A.S.T.)in 1990.Results The iatrogenic duodenal injuries result from various surgery and endoscopic procedures,most from a sequelae to pertinent biliary operation and(or)iatrogenic technical errors of instrumention.High risk factors responsible for the iatrogenic injuries include inflammatory conglutination,biliary systems anomalies or anatomic variations,duodenal Vater's papilla with neoplasma or diverticulum,surgeohs with less experience or over self-confidence or some procedures with violence and specific correctable errors,and so on.According to the new grading scheme,the duodenal injuries of the 21 cases were classified as follows:grade I-5 cases,grade II-6 cases,grade III-5 cases,grade IV-3 cases,and grade V-2 cases.Among the patients,3 cases were treated by drainage.2 cases underwent simple repair.8 cases were treated with repair and drainage.8 cases underwent enterorrhaphy and drainage.Conclusions Knowledge about causal factors of such iatrogenic processes can play a crucial role in their prevention,correct diagnosis,and management.Having the iatrogenic duodenal scaling done well,appears to be an accurate and practical way to select an optimum and flexible treatment and improve the patients's prognosis.

Objective To explore the clinical value and feasibility of the open bile duct operative instruments in laparoscopic common bile duct exploration.Methods 43 operations of laparoscopic common bile duct exploration were accomplished by using open bile duct operation instruments for exploring common bile duct and removing stones without choledochofiberscopy.Results 43 operations of laparoscopic common bile duct exploration were achieved successfully by exploring common bile duct and removing stones with open bile duct operative instruments with no postoperative remanent stones of the common bile duct and no open operation was needed.The follow-up in 38 patients for 6 months showed that there was no postoperative complication.Conclusions This method has the advantages of convenient manipulation,safety and better effect,low cost.It was deserved to be extended.

Objective To Investigate the expression of secondary lymphoid tissue chemokine (SLC) and its relationship with angiogenisis,pathological feature and prognosis of pancreatic cancer (PC).Methods SLC mRNA expression and microvessel density(MVD) were detected in 22 cases with PC with immunohistochemistry and reverse transcription-polymerase chain reaction(RT-PCR) respectively and compared with its clinical features.Results Mean MVD of PC was 57?12 and enhanced expression of SLC mRNA was detected in 17 cases(77%),The positive rate of SLC mRNA was significantly lower in cases of without metastasis and at early clinical stage(stage Ⅰ+Ⅱ)than that with metastasis and at advanced stage(stage Ⅲ+Ⅳ).MVD was significant higher in SLC mRNA-enhanced PC than in SLC mRNA reduced PC(P

Objective To improve diagnosis and therapy of intussusception in adult.Methods The clinical datas of 57 hospitalized cases with intussusception in adult were collected from Jan.1997 to May. 2006.Results 19 cases were diagnosised preoperation37 of 57 cases wereoperated on ,among them ,11 cases benigh,26 cases with malgnent disease.2 cases died of serious condition,the others recovery smoothly, 43 cases followed up for 8 mon to 8 years without relapse one.Conclusions The key is to emphasis on the disease and the primary choice was to operat on.

Objective To evaluate the TriVex system in the treatment of varicose veins of lower extremities,focusing on postoperative complications and management.Methods Clinical data of 108 patients (146 legs) of varicose veins of the lower extremity undergoing TriVex procedure were retrospectively analyzed.Deep veinons patency was verified in all patients by preoperative sonography.Above knee stripping of the great saphenous vein was done first when necessary.The below knee phlebectomy of the side branches was done with the new system (Trivex System/Smith and Nephew).Postoperative patients were followed-up,and results were evaluated.Results Procedure was successful in all cases.98 cases were followed up for 1 ～ 24 months.The mean operation time per leg was (34±8) minutes.Complications were as following:26 legs (17.8%) developed postoperative hematoma which was healed by conservative therapy including two cases in which the tension seroma,which was successfully managed by puncture aspiration.Transien skin numbness or paraesthesia developed in 13.0% (19/146).Subcutaneous induration in 11.6%(17/146) cases.Residual varicose and recurrence in 3.4% (5/146).Incision related complications developed in 4.8% (7/149) cases.Conclusion Transilluminated powered phlebectomy (TriVex) is a safe and effective cosmetic procedure for less invasive varicose vein surgery.