Objective To evaluate the safety and therapeutic value of endoscopic sphincterotomy by endoscope to the patients with common duct stones after their gallbladders resected. Methods 158 patients with common duct stones after their gallbladders resected were given the treatments of endoscopic sphincterotomy and nasobiliary drainage in recent 4 years. Results 153 of 158 patients got succeed. The symptoms obviously improved such as jaundice and fever and epigastric distention and so on. As for the postoperative complications, the hyperamylasemia occurred in 85 patients of all patients,and active hemorrhage in 2 patients,and acute pancreatitis in 16 patients,and cholangitis in 5 patients,but no one occurred biliary fistula,no one died,too. Conclusion EST is the best way for us to treat the patients with common duct stones after their gallhladders resected by endoscope,and its curative effect is sure and its safety coefficient is higher.

Objective To explore the effect of a multidisciplinary management program led by case managers on the tolerance to enteral nutrition,and the indicators for nutrition and inflammation in critically ill patients.Methods Fifty-one critically ill patients hospitalised in our hospital between January and June 2021 were assigned to a control group and another fifty-one critically ill patients hospitalised in our hospital between July and December 2021 were assigned to an observation group.The patients in control group received conventional nutritional support,while those in the observation group received the enteral nutrition managed with the case manager led multidisciplinary management program for 7 days.The tolerance to enteral nutrition,nutrition index and infection index were compared.Results One patient in the control group was withdrawn due to worsen conditions and another in the observation group was withdrawn as well because of incomplete medical data.It was found that the observation group was significantly better than the control group in the tolerance to enteral nutrition as well as the serum albumin,haemoglobin,white blood cells and C-reactive protein(all P<0.05).Conclusion The case manager led multidisciplinary management program is effective in the enhancement of tolerance to enteral nutrition and in the improvement of nutritional and inflammatory indicators in the critically ill patients.