Pancreatoduodenectomy was performed in 131 cases for peri-ampullar carcinoma between 1957~1993. Early operative complications occurred in 61 cases, the incidence was 46.5%. 13 cases died with a mortality of 9.9%. This article discussed the prevention of three major complications namely pancreatic fistula, biliary fistula and massive bleeding.The key means in the prevention of pancreatic fistula included isolating the stump completely, minimizing the tension of anastomtic sterna,accurate suturing of the layers of anastomosis, inserting drainage in the pancreatic duct routinely and placing the anastomotic sites of choledochojejunostomy and pancreatoje-junostomy in a distance of 10 centimeters. In case pancreatic fistula occurred, drainage is very important and TPN could improve its cure rate. To prevent bile leakage, tube strut and drainage should always be used.In choledochojejunostomy, to prevent massive bleeding and shock, careful hemostasis in operation and reduction in the quantity of bank blood transfusion are important measures. Child's reconstruction of the alimentary tract is the procedure of choice.

Callstone section is a very important method in histochemical study of gallstones. The way of Fourier Transform Infrared Spectroscopy (FT-IR) on the polyvinyl alchol-paraffin embedded a series gallstone section can be used to identify the variation of compositions in different sections of gallstones,and provides a new simple method to study directly the mechanism of the gallstone formation.

We randomly selected gallstone samples from 100 cases treated in our hospital, and observed the centers of the gallstones using the method of dissolving the centers of gallstone and staining ther smears. We found that 20 per cent of the gallstones in which the centers contain the ascarid ova(including one ease of larva); among the positive results the gallstones of gallbladder were 20.31% percent (13/64), of the common bile duct 19.44% percent (7/36).

Primary carcinoma of the gallbladder(PCG) is the most common malignant tumor in biliary system and its morbility has been rising year by year in our country.Because there is no specific clinical manifestation,patients diagnosed finally as PCG have mostly been in intermediate or advanced stage,thus losing the chance of radical resection of gallbladder carcinoma and having a poor prognosis.In this article we analyze the high risk factors,diagnosis of imageology,study of molecular biology,therapeutic progression and existent problems about PCG,by reviewing the related literature about diagnosis and treatment of PCG and the clinical data of 945 patients with PCG who were treated in our hospital in recent fifty years.We realize that early diagnosis of PCG is still difficult nowadays,it is very significant for secondary prevention of PCG to continue to carry out the foundamental and clinical study of PCG.Combined therapy that mainly includes surgical operation remains cardinal therapeutic management,and gene therapy has gradually developed to become a new therapy and displays favourable prospect of application.

Objective　To evaluate the effect of vascular endothelial growth factor (VEGF) on tumor angiogenesis, and its usage in tumor therapy. Methods　The recent literatures about VEGF and angiogenesis were reviewed and analyzed. The advances of VEGF study were summarized. The effects of anti-angiogenesis in tumor biological therapy were introduced.Results　Angiogenesis had been identified as an important factor for promoting tumor growth. VEGF was a basic and pivotal factor in tumor angiogenesis. The anti-angiogenesis treatments aimed at VEGF, including the applications of VEGF inhibitor and gene therapy of adenovirus medium, had got great progress. Conclusion　 VEGF is a leading factor of tumor angiogenesis, the anti-angiogenesis therapy aimed at VEGF has probably provided a new chance to malignant tumor treatment.

Sphincter of Oddi dysfunction(SOD) is grouped under the functional gastrointestinal diseases.Due to lack of typical symptoms and signs,the diagnosis of SOD is difficult.The proposal to classify SOD significantly improves diagnosis and has important clinical significance in selecting treatment.This paper reviews the researches on classification,recent progress in diagnosis and treatment of SOD.

Primary carcinoma of the gallbladder (PCG)is the common malignant tumor in the biliary system.Because there is no specific clinical manifestation, patients diagnosed with PCG are mostlyin intermediate or advanced stages.Therefore, they lose the chance of radical resection of gallbladder carcinoma and have a poor prognosis.Radiotherapy and chemotherapy are not effective palliative measures.Immunotherapy has become an alternative strategy besides operation, chemotherapy and radiotherapy.Treatment with DCs vaccines, as a new method of immunotherapy, has become more and more important.Here we review treatment with DCs vaccines in primary carcinoma of gallbladder.

Gallbladder volvulus is defined as the rotation of the gallbladder on its mesentery along the axis of the cystic duct and cystic artery. It is an unusual and rare occurrence with a predilection for women in their sixth or eighth decades of life. Only about 400 cases have been reported in the literature. The etiology of gallbladder volvulus remains speculative; however, the presence of a redundant mesentery is a prerequisite for torsion. Clinical symptoms are non-specific. Some form of right upper quadrant abdominal pain is nearly always present. Although recent advances in radiographic studies have aided in the diagnosis of many diseases,radiographic studies remain nonspecific in diagnosing gallbladder torsion. Laboratory evaluations are often nonspecific. An elevated white blood cell count is a frequent finding.Liver function tests are commonly normal. Gallbladder volvulus leads to gangrene or perforation because of occlusive obstruction of biliary drainage and blood flow. With early diagnosis and surgical intervention, the disease maintains a low mortality. Here, we present a review of the literature about gallbladder volvulus in order to enhance recognition of gallbladder volvulus.

Indoleamine 2,3-dioxygenase(IDO)is the rate-limiting enzyme in the catabolism of trypto-phan along the kynurenine pathway.Over expression of IDO is one of the reasons which are responsible for immune tolerance of tumor.IDO also affects the effects of the vaccine of the dendritic cell in the tumor therapy.Lipopolysaccharide(LPS),cytokines and so on can regulate the expression of IDO via different regulating mechanisms.IDO participates in the local immune tolerance of tumor by three kinds of mechanisms.Further research on this immunological regulatory mechanism will be significant for tumor immunotherapy.

Gastrointestinal cancer is the most prevalent cancer among malignant tumors,with a upward trend in incidence.Since there is absence of specific clinical manifestation as well as low diagnostic rate,patients diagnosed with cancer of digestive tract are mostly in intermediate or advanced stages.Therefore,they lose the best chance of surgery and have a poor prognosis. Metabonomics,a kind of high sensitivity research technology,shows great potential in the exploration of occurrence and development of malignant tumor.The aim of this study was to review the progress of application in gastrointestinal cancer by metabonomics.