Objective To explore the feasibility of laparoscopic-assisted pancreaticoduodenectomy.Methods The clinical data of 5 patients in our hospital from January to May 2010 were analyzed. 2 patients were pre-operatively diagnosed to have lower common bile duct adenocarcinoma, and 2 patients were preoperatively diagnosed to have adenocarcinoma of the descending duodenum, 1 patient was intra-oparatively diagnosed to have pancreatic head cancer. During the operation, laparoscopic exploration was performed, then gallbladder, distant bile duct, distant stomach, duodenum, part of jejunum and head of pancreas were disassociated, then the digestive tract was reconstructed under open abdomen surgery. Results All the operations of the 5 cases were successfully performed, with an average operation time ( 339 ± 54) min and an intra-operative blood loss of (538 ± 106)ml, and there was no intra-operative blood transfusion. The patients'bowel function recovered (4.0 ± 1.0 ) d postoperatively and were discharged ( 15.8 ± 4.7 ) d postoperatively.1 patient developed pancreatic fistula and was cured with conservative treatment. Conclusions Laparoscopicassisted pancreatoduodenectomy is minimally invasive with short operation time and fast postoperative recovery,which is worth of further clinical study.

AIM:To evaluate the relationship between RUNX3,cyclin E,P21,biological features and survival in gastric cancer patients.METHODS:RUNX3 was examined using immunohistochemical staining.Cyclin E and P21 were analyzed by flow cytometry.Survival was evaluated by Kaplan-Meier survival curves.RESULTS:The positive-expression rate of RUNX3,cyclin E and P21 in tumor tissue from 56 patients with gastric cancer were 44.6%,64.3% and 32.1%,respectively.RUNX3 expression was correlated with lymph node metastasis and distant metastasis(P0.05).Using Kaplan-Meier survival curves and the Log-rank test,there was correlation between RUNX3,cyclin E and survival(P0.05).CONCLUSION:RUNX3 may be related with tumorigenesis and tumor progression by affecting P21 expression.The detection of RUNX3 and cyclin E may be helpful in evaluating the clinicopathological parameters and prognosis in gastric carcinoma patients.

Pancreatic portal hypertension is a rare clinical syndrome which caused by pancreatic disease.The most significant symptoms are isolated gastric varices,splenomegaly and normal liver func-tion.The key of treatment are the primary disease and splenectomy.The prognosis of pancreatic portal hy-pertension depends on pancreatic disease and complications like gastrointestinal bleeding.