Objective To discuss the value of intraoperative transnasal cholangiography in endoscopic sphincterotomy(EST) combined with laparoscopic cholecystectomy(LC) for treating cholelithiasis complicated with choledocholithiasis.Methods The EST was carried out to treat common bile duct stones and to conduct the endoscopic nasobiliary drainage(ENBD).During the LC the cholangiography was performed by way of ENBD.Results Intraoperative cholangiography was successfully completed in all 46 cases,with a cholangiography time of 5~15 min(mean,8.2 min).Secondary common duct stones migrated from the gallbladder were found by cholangiography in 4 cases,in 2 of which the stones were removed under endoscope during the procedure,and in 2 of which the stones were

Twenty five patients with incarcerated stone in distal common bile duct were treated with mini-blasting lithotrite under choledochoscope from June 2008 to September 2010.The clinical data of patients were retrospectively analyzed.The successful rate of surgery was 100％.The clearance rate of first procedure was 92％ (23/25),2 cases underwent second procedure and all were successful.There were no severe operative complications including bile duct injury,perforation,hemorrhage or bile leakage.Miniblasting lithotrite is a safe and effective method for treating incarcerated stone in distal common bile duct.

Objective To investigate the safety,efficacy,and clinical value of a fracture reduc-tion and fixation system.Methods The design and application of components[Kirschner wire(K-wire)limiter and K-wire guiding locking device]of the fracture reduction and fixation system were described.Six surgeons implanted K-wires into synthetic bones using the K-wire limiter or by percep-tion respectively,and the length of K-wire protrusion was assessed.K-wire guiding locking device combined with locking plates and two 1.5 mm K-wires,two 1.5 mm K-wires,as well as two 2.0 mm K-wires were used to fix a fracture model constructed by synthetic bones,and the torque at failure was measured.Results The K-wire limiter reduced the length of K-wire protrusion(P＜0.001).The failure torque of fractures fixed by K-wire guiding locking device with locking plates and two 1.5 mm K-wires was larger than those fixed with two 1.5 mm K-wires and two 2.0 mm K-wires(P＜0.05).Conclusion The fracture reduction and fixation system offers a new technique for reducing and recon-structing fractures,assessing and optimizing the position of locking plate screws,as well as protecting the blood supply of fractures.

Objective To investigate the safety,efficacy,and clinical value of a fracture reduc-tion and fixation system.Methods The design and application of components[Kirschner wire(K-wire)limiter and K-wire guiding locking device]of the fracture reduction and fixation system were described.Six surgeons implanted K-wires into synthetic bones using the K-wire limiter or by percep-tion respectively,and the length of K-wire protrusion was assessed.K-wire guiding locking device combined with locking plates and two 1.5 mm K-wires,two 1.5 mm K-wires,as well as two 2.0 mm K-wires were used to fix a fracture model constructed by synthetic bones,and the torque at failure was measured.Results The K-wire limiter reduced the length of K-wire protrusion(P＜0.001).The failure torque of fractures fixed by K-wire guiding locking device with locking plates and two 1.5 mm K-wires was larger than those fixed with two 1.5 mm K-wires and two 2.0 mm K-wires(P＜0.05).Conclusion The fracture reduction and fixation system offers a new technique for reducing and recon-structing fractures,assessing and optimizing the position of locking plate screws,as well as protecting the blood supply of fractures.