1.The use of a pedicled umbilical vein graft to repair the defect in the bile duct in Mirizzi's syndrome: a study of 35 patients
Dengke CAO ; Hu ZHANG ; Haiwei LIU
Chinese Journal of Hepatobiliary Surgery 2011;17(9):738-740
ObjectiveTo review our experience in the use of a pedicled umbilical vein graft in the repair of the defect in the bile duct in Mirizzi's syndrome. MethodsThis is a retrospective study on the use of a pedicled umbilical vein graft to repair the defect in the bile duct in 35 patients with Mi rizzi's syndrome. These patients suffered for Mirizzi's syndrome type Ⅱ in 19 patients, type Ⅲ in 15 patients, and type Ⅳ in 1 patient. ResultsThere was no peri-operative death. Five patients developed postoperative biliary leak which healed spontaneously after drainage of the bile collection. All patients had been followed up for at least 6 months, and 27 patients had been followed up for 3 years.There was no biliary complication. ConclusionsBile duct reconstruction with a pedicled umbilical vein graft is simple. It is a good procedure to repair the defect in the bile duct in Mirizzi's syndrome.
2.Transcatheter arterial chemoembolization combined with radiotherapy for the treatment of advanced cervical cancer
Jun ZHU ; Jianjun LUO ; Wen ZHANG ; Yong HUANG ; Dengke LI ; Yueyong CAO
Journal of Interventional Radiology 2010;19(3):194-197
Objective To discuss the clinical value of interventional transcatheter arterial chemoembolization(TACE)combined with subsequent pelvic radiotherapy in treating patients with advanced cervical cancer.Methods According to the therapeutic scheme,195 patients with phase Ⅱb or beyond advanced cervical cancer were divided into two groups: (1)study group(n=99),treated with TACE combined with subsequent pelvic radiotherapy(I.e.combination group);(2)control group(n=96),treated with radiotherapy alone(I.e.radiotherapy alone group).The short-term and long-term clinical results as well as the occurrence of complications were compared between two groups.Results Different degrees of the tumor shrinkage were found in patients of both groups after treatment.The short-term remission rate of the study group was significantly higher than that of the control group,and the difference between two groups was statistically significant(P=0.012).After the procedure,the anaemia in patients of study group was markedly corrected.The difference in hemoglobin between preoperative levels and postoperative ones was significant(T-test,P<0.01).Long-term follow-up for 3 years the survival rate of the study group was higher than that of the control group(P=0.032).Both the recurrence rate and metastatic rate at one and three years after the therapy in the study group were distinctly lower than that in the control group(P<0.05).No significant difference in one-year,five-year survival rate and in five-year recurrent rate existed between two groups.The main short-term complications included digestive untoward reaction,bone marrow depression,hepatic and renal toxicity,etc.,which could be well relieved after active symptomatic medication.The longterm complications included radiodermatitis,radiocystitis and/or radioproctitis.The incidence of radiocystitis and radioproctitis in the study group was significantly lower than that in the control group(P<0.05).Conclusion TACE combined with subsequent pelvic radiotherapy is an effective therapy for advanced cervical cancer,its clinical result is superior to simple radiotherapy.This therapy tan enhance both the short-term and the tong-term effects,relieve the clinical symptoms,reduce the occurrence of long-term complications,thus,improve the quality of life and prolong the survival time of patients.