1.Hepatolithiasis combined with cholangiocarcinoma
Chengwu TIAN ; Huawen ZHU ; Yongshan YU ; Ming QU ; Tianjun JIANG
Chinese Journal of General Surgery 2001;10(1):21-23
Objective To study the diagnosis, treatment and prognosis of hepatolithiasis combined with cholangiocarcinoma. Methods The clinical, pathological and follow-up data of 17 cases of hepatolithiasis combined with cholangiocarcinoma were retrospectively analysed. Results The results showed that the incidence of cholangiocarcinoma in hepatolithiasis was 5% in this series. 17.6% of the patients were diagnosed as cholangiocarcinoma preoperatively. Tumor occurring in intrahepatic ducts was 88.2% and in hepatic porta ducts 11.8%. Nine cases were well-differentiated adenocarcinomas. Only 7(41.2%) cases were radically resected and their average survival time was 26.0 months. Eight(47.1%) patients underwent internal drainage with average survival time 12.4 months. 2(11.7%) cases subject to external drainage with survival time 3.6 months. Conclusions If patients with hepatolithiasis have a long history of recurrent cholangitis, weight-loss in a short period, progressive jaundice or intractable abdominal pain, the possiblility of combined with cholangiocarcinoma should be considered. Resection of the tumor has a better prognosis than that of tumor unresected; and the prognosis of internal drainage is better than that of external drainage.
2.Clinical analysis of complex femoral and tibial fractures treated with Grosse-Kempf intramedullary interlocking nails
Xingren ZHU ; Yaowen QIAN ; Yongshan TIAN ; Xuming DING ; Tiejun GONG ;
Chinese Journal of Orthopaedic Trauma 2002;0(01):-
Objective To investigate the clinical results of the treatment of complex femoral and tibial fractures using Grosse Kempf intramedullary interlocking nails. Methods Grosse Kempf intramedullary interlocking nails were used to treat 38 cases of complex femoral and tibial fractures. 12 cases of them were opened fractures, and 26 cases were closed. There were 24 cases of femoral fractures and 14 cases of tibial fractures. The average age was 33.6 years. Most of them were reduced under x ray monitoring. CPM rehabilitation started after the operation to gain the funtional recovey. After two weeks walking with crutches began. Results After the operation, all the wounds healed by first intention. The average union time of the fractures was 10.5 weeks (8~12 weeks). The average follow up period was 14.5 months. With all the cases rated as good or excellent, the clinical results were satisfactory. Conclusion Grosse-Kempf intramedullary interlocking nails are an effective, strong, convenient and secure implant to treat complex femoral and tibial fractures.