Objective To improve the pancreaticoenterostomy technique and drainage in panereatieoduodenectomy, so as to prevent postoperative pancreatic leakage. Methods One hundred and thirty-eight panereaticoduodenectomy cases underwent parachute continuous running suture of pancreaticojejunostomy and extra drainage of the anastomotic stoma. Results The average time of the double-deck continuous invaginated pancreaticoenterostomy was 11 minutes, and there was no pancreaticoenterostomy leakage in all cases, lntraoperative blood loss was 353±61 ml, the average hospital stay was 19.2 days. Pulmonary infection developed in 6 cases, three cases suffered from postoperative upper gastrointestinal bleeding due to stress ulcer, two cases from functional delayed gastric emptying. All these complications were cured by conservative treatment, and there was no mortality in these series. Conclusions The parachute continuous running suture of pancreaticojejunostomy and extra drainage has the advantages of easy performance, saving time and less complications, and is an effective way in the prevention of panereatieojejunostomy leakage.

Auxiliary liver transplantation reserves whole or part of recipient' native liver while implanting the graft. It call be classified as auxiliary heterotopic liver transplantation and auxiliary orthotopic liver transplantation according to the location of the graft. On the basis of graft volume. it can be categorized as whole liver auxiliary liver transplantation and partial liver auxiliary liver transplantation. Either cadaveric or living donor is available. Because auxiliarg orthotopic liver transplantation is only the partial liver transplantation, so it is also called aunliry orthotopic partial liver transplantation. The. technique of auxiliary liver transplantation progresses with the devehopment of liver transplantation. Great attention is paid to auxiliary liver transplantation because of its special superiority, in spite of some unresolved problems.

Objective:In order to study the morphological diversification in heterotopic liver auxiliary transplantation(HLAT). Methods:HLAT model in rats was established, the status of rats survival and graft function was evaluated postoperatively by rheometer, SPECT electrical microscope etc. Results:Rat HLAT model was feasible, the operative success rate was 93.3%, one week postoperative survival rate was 80%,the survival time without complications was more than 3 months. The function of the native liver was not affected, as the time goes by, the graft become atrophic after 45 days postoperatively. Conclusion:In HLAT model, the function of the native liver was not affected, 45-days-after the transplantation, the graft become atrophic.

Objective:To compare the efficacy of traditional open thyroidectomy and modified Miccoli in the treatment of benign thyroid diseases.Methods:The data of 343 patients with benign thyroid disease in Xi′an Central Hospital and Xi′an Third Hospital were retrospectively analyzed. According to the surgical method, the patients were divided into the observation group (modified Miccoli operation, n=169) and the control group (traditional open operation, n=174). The operation effect, postoperative recovery, patient satisfaction, postoperative complications and recurrence within 1 year of follow-up were compared between the two groups.Count data were represented by n(%), measurement data consistent with normal distribution were represented by Mean± SD, and non-normal data were represented by M( P25, P75). T test or Wilcoxon rank sum test were used to compare the measurement data between groups according to their distribution characteristics. Comparison of statistical data between groups was made by chi-square test. Results:The intraoperative blood loss and postoperative drainage volume of the patients in the observation group were 26.2 (6.9, 40.8) ml and (33.4±8.6) ml, respectively, which were significantly less than those in the control group 50.6 (37.5, 63.7) ml and (35.7±9.5) ml (all P<0.05). The postoperative recovery time in the observation group was (3.9±2.8) d, which was significantly shorter than that in the control group (5.1±2.4) d ( P=0.001). Postoperative complications such as hoarseness, subcutaneous ecchymosis, scar formation and decreased parathyroid function were significantly different between the two groups ( P<0.05). The recurrence rate of 7.69% in the observation group was significantly lower than that of 19.54% in the control group 12 months after operation ( P<0.05). Conclusions:The modified Miccoli in the treatment of benign thyroid diseases not only has the advantages of less trauma, faster postoperative recovery, less pain and higher patient satisfaction, but also has lower postoperative complications and recurrence rate, which is worthy of clinical promotion and application.

OBJECTIVETo analyze the clinical features of patients with gallbladder cancer from 17 hospitals in 5 Northwestern provinces (autonomous region) of China from 2009 to 2013.

METHODSA total of 2 379 cases with gallbladder cancer in 17 tertiary hospitals from 5 Northwestern provinces of China from January 2009 to December 2013 were reviewed retrospectively. The clinical data was collected by standardized "Questionnaire for Clinical Survey of Gallbladder Cancer in Northwestern Area of China". χ² test was used to analyze the data.

RESULTS(1) Gallbladder cancer from 17 hospitals accounted for 1.6%-6.8% of all bile tract diseases from 2009 to 2013 in Northwestern China, average was 2.7%. Gallbladder cancer accounted for 0.4%-0.9% of abdominal surgery, average was 0.7%. (2) The incidence of gallbladder cancer was higher in the aged females, the ration of female to male was 1.0 to 2.1. The average age of gallbladder cancer was (64 ± 11) years. The occupation of patients was mainly farmers (χ² = 147.10, P < 0.01). (3) 57.2% of the gallbladder cancers were associated with gallstones. (4) The main pathological patterns of gallbladder cancer were moderate and poor differentiated adenocarcinoma, showing an aggressive malignancy. TNM stage IV accounted for 55.1% of all cases, which was associated with the poor prognosis. (5) The curative resection rate was 30.4%.

CONCLUSIONSGallbladder cancer is common in the aged females and mainly at advanced stage. The screening and follow-up of high-risk groups with ultrasound and other methods regularly could increase the early diagnosis rate of gallbladder cancer, aggressive surgical resection combined with other comprehensive treatment could improve the prognosis of patients.

Adenocarcinoma ; epidemiology ; pathology ; Aged ; China ; epidemiology ; Female ; Gallbladder Neoplasms ; epidemiology ; pathology ; Gallstones ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Retrospective Studies