Objective To explore a new surgical approach to intrahepatic segmental bile ducts.MethodSurgical anatomic relationships between intrahepatic bile ducts and blood vessels in 30 adult liver specimens were studied.Results Left and right hepatic bile duct lie to the superior anterior board of the left and right trunk of the portal vein; left medial and right anterior segmental duct lie to the anterior medial edge of corresponding portal vein branches. Right posterior segmental duct lies on the visceral side of right anterior portal branches in 73%(22/30). and on the visceral side of posterior right branches in 80%(24/30). Left lateral segmental duct lies in the deep visceral side of sagittal portion of left portal vein in 93%(28/30).A new combined operational routes getting to segmental ducts from both visceral and diaphragmatic faces were designed to treat 38 patients with multiple intrahepatic calculis.Conclusion Combined operational routes from both visceral and diaphragmatic facies can easily expose and cut open intra and extra hepatic ducts and the strictures, removing calculi.

OBJECTIVE: To analyze the surgical treatment of parapharyngeal space foreign body and to discuss feasibility of Endoscopic transoral approach. METHOD: Reviewing surgical treatment in eight cases of parapharyngeal space foreign body, nature and location of foreign body. surgical methods, and treatment results were analyzed. RESULT: Eight patients' foreign bodies were all removed by surgical treatment, there were no postoperative infection. Three cases of foreign body were removed through laterocervical approaches, one removed through submandibular approach. In four cases the foreign body were removed through Endoscopy, two of them were transoral approach and the other two were taken out after antiotomy. CONCLUSION Different approaches should be taken in the surgery treatment of parapharyngeal space foreign body according to imaging positioning.
Endoscopy ; Foreign Bodies ; surgery ; Humans ; Pharynx ; pathology ; surgery ; Postoperative Complications ; Treatment Outcome

ObjectiveTo study the significance of the change of serum nitric oxide(NO) level in the obstructive jaundice(OJ) patients complicated with renal dysfunction. MethodsWe studied the level of NO,BUN.Cr inserum and the activity of NOS in 25 OJ patients with renal dysfunction and 26 healthy adults (control group). ResultsThe patients' serum NO level and the activity of NOS were significantly lower than those in control group( P

OBJECTIVE To discuss the therapeutic effect of one stage surgical treatment in the multiple primary hypopharyngeal and cervical thoracic esophageal carcinoma.METHODS The thoracoscopy group: dissecting the esophagus and mediastinal lymph node assisted with thoracoscope, and then opened abdominal cavity to make gastric tube. Head and neck group: doing the cervical lymph node dissection, total laryngectomy, total hypopharyngectomy and total esophagectomy, and then anastomosis of the pharynx with gastric tube. All cases were received conventional radiotherapy and chemotherapy after operation.RESULTS All the cases in this group were successfully underwent the one stage operation. The postoperative complications were pulmonary infection in 3 cases, pleural effusion in 2 cases and tracheal tear in one case. No anastomotic fistula or postoperative deaths occurred. The 3 and 5 year survival rates were 63.6% and 50.0% respectively.CONCLUSION It should take necessary examinations of cervical thoracic esophagus to prevent missing the multiple primary carcinoma of the hypopharyngeal carcinoma. The total laryngectomy, total hypopharyngectomy and total esophagectomy, and anastomosis of the pharynx with gastric tube for multiple primary hypopharyngeal and cervical thoracic esophageal carcinoma is a feasible and active treatment method.

Objective To investigate the diagnosis and surgical treatment of chronic acalculous cholecystitis characterized by absence of gallbladder wall contractability. Methods The clinical data of 42 patients with chronic acalculous cholecystitis in our hospital from January 2006 to December 2008were analysed. The patients were grouped into two groups: laparoscopic cholecystectomy (LC) group in 20 and non-surgical group in 22. The patients' symptoms on follow-up in the two groups were compared. Results The 42 patients with chronic acalculous cholecystitis were diagnosed by symptoms,ultrasound, fatty meal gallbladder contractability studies under ultrasound, fiber optic gastroscopy and magnetic resonance cholangiopancreatography (MRCP). In all patients, there was a complete absence of gallbladder wall contractability. In the LC groups, 20 patients received LC. 18 patients were followed up, and there were no symptoms. Two patients were lost to follow up. In the non-surgical group, 22 patients received non-surgical treatment. In 21 patients who were followed up, 19 patients had symptoms. One patient was lost to follow up. There was a significant difference between the LC group and the non-surgical group (P＜0.05). Conclusions Chronic acalculous cholecystitis characterized by absence of gallbladder wall contractability could be diagnosed by symptoms, ultrasound, fatty meal gallbladder contractability studies under untrasound, and MRCP. The optimal treatment of chronic acalculous cholecystitis characterized by absence of gallbladder wall contractability is LC.