Portal vein thrombosis is a common though serious complication after splenectomy in patients with liver cirrhosis and portal hypertension.Its pathogenesis may be primarily associated with the coagulation mechanism and the changes of hemorheology.The clinical presentations of portal vein thrombosis after splenectomy depend on the course of disease,as well as site and degree of obstruction.The principle of treatment is to improve microcirculation,relieve the platelet aggregation and prevent further progress of the thrombosis.But in clinical settings,signs and symptoms of portal vein thrombosis were generally atypical.Any misdiagnosis or delayed treatment may expose the patients under risk.This article focuses on the risk factors,potential mechanisms and recent progress on the prevention of post-splenectomy portal vein thrombosis.

Organ transplantation is the first effective treatment for end-stage organ failure. However, early acute rejection after organ transplantation is often an important factor leading to transplantation failure. In order to reduce the incidence of rejection after organ transplantation, it is often necessary to use potent immunosuppressants to induce the immune system of recipients before or during transplantation. As a common method of covering immunosuppressive therapy in the early stage of organ transplantation, antibody immunoinducers can significantly reduce the occurrence of early acute rejection after organ transplantation, and delay or reduce the application of calcineurin inhibitor drugs, which is conducive to protecting renal function, promoting graft function recovery and long-term survival of recipients. This article reviews the application of antibody inducers in solid organ transplantation.

Objective To analyze the perioperative complications and prognosis of surgical treatment of pancreatic ductal stones.Methods 60 patients diagnosed to have pancreatic ductal stones and were admitted into our hospital from January 2009 and December 2014 were enrolled into this retrospective study.There were 47 males and 13 females.The average age was (44.1 ± 12.0).Results All patients underwent surgical operation and there was no perioperative death.Perioperative complications occurred in 7 patients (11.7％), including pancreatic fistula in 4 patients, delayed gastric emptying in 1 patient, abdominal infection in 1 patient, anastomotic bleeding in 1 patient.Eight patients developed elevated amylase levels.The fasting time was 3.4 ± 1.2 days and the hospital stay was 10.0 ±4.0 days.The follow-up rate was 88.3％ (53/60), at a mean follow-up of 27 months.In 51 patients who presented with abdominal pain, 43 patients (84.3％) had complete pain relief and 7 patients (13.7％) had partial pain relief.In 14 patients with preoperative diabetes mellitus, 1 patient had improvement and 2 patients recovered from diabetes.Two additional patients were diagnosed to have diabetes two years after the operation.Of the 2 patients who were shown to have pancreatic cancer on histopathological study, 1 patient was lost to follow-up while another patient died at 27 months after the operation.The patients diagnosed to have epithelial dysplasia were followed-up and none developed pancreatic cancer.Conclusions The relationship between chronic pancreatitis and pancreatic ductal stones was very close.Chronic pancreatitis also caused exocrine and endocrine dysfunction.Surgical operation plays an important role in symptomatic relief and in delaying pancreatic dysfunction.

Objective To investigate the infection characteristics and drug resistance of methicillin resistant Staphylococcus aureus after liver transplantation.Methods Retrospectively analyzed the clinical data of 170 patients who underwent liver transplantation in Beijing Chaoyang Hospital,Capital Medical University between January 2011 and April 2016.The incidence,pathogenic characteristics,distribution and drug resistance of methicillin resistant Staphylococcus aureus were analyzed.Results In this research,the methicillin resistant Staphylococcus aureus infection occurred in 23 cases after liver transplantation,and the incidence rate was 13.53％ (23/170).There were 27 strains of pathogens had been isolated,and 74.07％ (20/27) of pathogens were isolated from peritoneal drainage fluid.The most common methicillin resistant Staphylococcus aureus were Staphylococcus haemolyticus,Staphylococcus epidermidis and Staphylococcus hominis,accounting for 29.63％ (8/27),22.22％ (6/27) and 14.81％ (4/27).Drug sensitivity results indicated that the methicillin resistant Staphylococcus aureus were completely resistant to Penicillin,Oxacillin and Methicillin antibiotics.And the pathogens were extensively drug-resistant to Ciprofloxacin,Levofloxacin and Moxifloxacin,the resistance rates were 63％ (15/24),63％ (15/24) and 58％ (14/24).But the pathogens were sensitive to Teicoplanin,Vancomycin and Linezolid,and there have not been detected drug-resistant bacteria.Conclusions The infection of methicillin resistant Staphylococcus aureus is one of the most common pathogens after liver transplantation.Routine prophylactic antibiotics are not useful for the treatment,however,Teicoplanin,Vancomycin and Linezolid can be used as the first choice of treatment.

Objective To explore the clinical effect of radio-frequency ablation in the treatment of advanced pancreatic cancer.Methods Retrospectively analyzed the clinical data of 28 cases of radio-frequency ablation in the treatment of advanced pancreatic cance between January 2008 and December 2012 in 304 hospital.And choosed made 140 cases patients who only underwent the conservative treatment as the control group at the same period.Then compared the data of two groups patients.Results The mean tumor diameter was (4.8 ± 1.6) cm.The average radio-frequency time was (17.7 ± 4.3) minutes.There was no patient occurred of pancreatic fistula or postoperative bleeding,and no patient dead.Peri-operation pain relief rate was 88.9％.Twenty-three patients were followed up,and the follow up rate was 82.1％.The patients' survival rate who underwent radio-frequency ablation of 1 month,6 months and 1 year were 95.7％,65.2％ and 38.2％.The average survival time was (14.6 ± 2.2) months.And the data was significantly higher than that of the control group patients (97.4％,45.3％,19.1％,P =0.0306).Conclusions The radio-frequency ablation was one of an effective treatment method for the advanced pancreatic cancer patients.It can prolong the survival time of pancreatic cancer patients and alleviate the patient's pain.

Objective:To explore the influence of fatty liver donor on the prognosis of benign liver disease liver transplantation.Methods:The clinical data of 229 recipients and donors who underwent liver transplantation at Beijing Chaoyang Hospital affiliated to Capital Medical University from January 2015 to December 2019 due to benign liver diseases were retrospectively analyzed. According to the degree of fatty degeneration of the donor liver, the patients were divided into non-fatty liver group( n=168), mild-medium fatty liver group( n=43), and severe fatty liver group( n=18). First, the overall prognosis after liver transplantation was analyzed, the general data of the donor and recipient were compared, and the perioperative complications of the three groups were compared. Finally, survival analysis was performed to compare the long-term prognosis of the three groups. Measurement data with the normal distribution were represented as ( Mean± SD), comparisons among groups were analyzed using t test. Comparisons of counting data between groups were analyzed using chi-square test. The theoretical frequency was less than 1. Fisher exact probability method was used, and variance analysis was used for the comparison among the multiple groups. Results:The overall 1-year, 3-year, and 5-year survival rates of the patients were 86.9%, 70.7%, 70.7%, respectively, and the average survival time was 53.1 months. The general data of donors and recipients were not significantly different among the three groups. The probability of perioperative transplanted liver failure, delayed liver function recovery, and acute kidney injury in recipients with severe fatty liver was significantly higher than that of mild to moderate fatty liver group and non-fatty liver group ( P<0.05). The results of survival analysis showed that the 1-year, 3-year, and 5-year survival rates of the non-fatty liver group were 90.5%, 71.7%, 71.7%, the mild-moderate group were 88.4%, 76.7%, 64.0% and the severe fatty liver group were 61.1%, 49.4%, 49.4%, the survival rate of patients with severe fatty liver was significantly lower than that of the other two groups ( P<0.05). Conclusion:Donor weight-grade steatosis leads to a higher incidence of transplanted liver failure, delayed liver function recovery, acute kidney injury, and worse long-term prognosis.

Pancreatic carcinoma is one of the most common digestive malignant tumor. It has a high degree of malignancy and poor prognosis. The overall 5-year survival rate is less than 10%. Portal vein system invasion is one of risk factors for poor long-term prognosis of pancreatic carcinoma, and radical surgery is the only effective way to achieve long-term survival. According to the clinical practice, our center proposed a new classification of pancreatic carcinoma with portal vein system invasion for the purpose of reconstructing the portal vein system. We also formulated treatment strategies for different classification and carried out operation of allogeneic vascular replacement in clinical practice. This paper introduces our relevant clinical experience.

Portal vein gas (PVG) is a kind of imaging sign which has been attracting widespread attention in recent years, and its appearance is often accompanied by serious or fatal situation. PVG is not an indication of surgery and the treatments depend on potential diseases. When there are serious potential abdominal diseases, the emergency surgical intervention will be needed. The potential diseases that cause PVG mainly include infectious, ischemic, mechanical and medical. The prognosis is not related with PVG, but is affected by the pathogenesis. Although more and more reports about PVG have been reported in recent years, the research on its pathogenesis is less. Based on the review of the previous literatures, the pathogenesis, risk factors, imaging manifestations, treatment and prognosis of PVG were discussed.

Persistent ascites is a rare complication in the perioperative period after liver transplantation,it will seriously affect patients' prognosis.The reasons of persistent ascites may be associated with chyle leakage,abdominal infection,portal hypertension and so on.There are also some reasons still unclear.The related examination should be completed as soon as possible to find out the probable reasons.The key to successful treatment depends on the definite diagnosis of the reasons.The treatment strategy and prognosis of persistent ascites due to different reasons.This article focuses on the reasons,risk factors and treatment methods of persistent ascites after liver transplantation.

Intrahepatic cholangiocarcinoma (ICC) is a malignant tumor originating from the liver, which with high malignancy and poor long-term prognosis. Radical resection is the only effective treatment for intrahepatic cholangiocarcinoma. In recent years, with the deepening understanding of the biological behavior and clinical characteristics of intrahepatic cholangiocarcinoma, its clinical stage, surgical indications, surgical methods, lymph node dissection and other surgical treatment strategies have also changed. This article reviews the current status of surgical treatment of intrahepatic cholangiocarcinoma based on the latest clinical research progress.