Long-term outcomes of surgical bile duct injury (BDI) repair are affected by multiple factors, such as surgeon's experience, severity of BDI, pathological changes of the proximal duct, and the manner and timing of surgical repair. However, the timing of BDI repair is still controversial still. In this article, the authors reviewed the correlation of pathophysiologic changes of the proximal duct, repair timing and outcome discussed in English references. It was shown that pathophysiologic changes of the proximal duct are a major contributor to the timing of BDI repair.

Objective: To investigate the relationship among personality traits,motive of Internet use and tendency of Internet Addiction.Methods: Scale of Internet use,NEO-PI-R and Chinese Internet Addiction Scale(CIAS) were administrated to 207 university and high school students.Results: ①Tendency of Internet addiction was significantly correlated positively with openness(O)and agreeableness(A),and negatively with neuroticism(N).②Tendency of Internet addiction showed significant difference among motive of entertainment,study,information and intercommunication,and those who had higher tendency of Internet addiction would have stronger motive.③Internet addiction could be validly predicted by motive of information,entertainment and personality traits of neuroticism(N).Conclusion: Tendency of Internet addiction is affected by personality traits and motive of Internet use.

It is a consensus to place stent after cutting bile duct in the hepatobiliary surgery in the past.However,as the development of bile physiological research and surgical technique,especially the raise of medical concepts of rapid recovery,the negative effects which are caused by the placement of stent have been taken seriously gradually.Up to now,whether the stent should be placed after the bile duct is cut has no definite answer yet.

Balloon tamponade hemostasis has been applicated for 50 years,and its appropriate usage can obtain exact curative effect with less adverse reactions.In recent years,with the continuous improvement in surgical therapy,balloon tamponade technique in treating various types of bleeding has accumulated many successful experiences.This paper intends to review the advances in balloon compression technology for recent years.

Objective To evaluate the effect of omeprazole in preventing treatment of hypertensive cerebral hemorrhage with stress ulcer bleeding. Methods A total of 100 patients with hypertensive cerebral hemorrhage were treated with conventional therapy including dehydration, antihypertensive and supporting treatment. The patients were randomly divided into omeprazole group(n=50) and control group( n = 50). The control group received conventional therapyonly, while the omeprazole group received additional omeprazole 40mg, iv, qd, for 14d. Results Omeprazole group stress ulcer 6 eaess(12.0% ) was significantly lower than the control group 12 cases(24.0% );two groups stress ulcer incidence of severity are increasing with the increase of the disease; the mortalities of cerbral hemorrhage were 6.0 % in the omeprazole group and 16.0 % in the control group and the difference had significant meaning(P＞0.05). Conclusion Omeprazole has significant beneficial effect in preventing upper gastrointestinal hemorrhage after hypertensive cerebral hemorrhage.

Objective To introduce the techniques of scanning the common bile duct(CBD) in full length with laparoscopic ultrasonography through the sonic window dorsal to the first portion of the duodenum(FPD). Methods The lower segment of the CBD in 300 cases was scanned in full length through the sonic window dorsal to the FPD. Results In our series, 97.67% of the lower segment of the CBD can be visualized with simple techniques through sonic window dorsal to the FPD. Visualization in 25 cases were improved with injection of saline into the subhepatic space and extraction of gas from the stomach and duodenum. Conclusion Through the sonic window dorsal to the FPD and with simple techniques, the lower segment of the CBD in majority of our cases can be satisfactorily imaged in full length. Visualization can be improved in some individuals with injection of saline into the subhepatic space and extraction of gas from the stomach and duodenum.

Objective To explore diagnosis, treatment and prevention of remnant gallbladder from laparoscopic cholecystectomy (LC). Methods A retrospective analysis was performed for the clinical data of 12 patients treated in our hospital for remnant gallbladder caused by LC from December 1994 to December 2007. Results The occurrent rate of the remnant gallbladder in LC was 0.46%(12/2609). All the 12 patients with remnant gallbladder received surgical operations and 3 of them had remnant gallbladder with stones. Remnant gallbladders in the 12 cases were removed by surgical operations and were cured. Conclusion Ultrosonic or MRI examination is preferable and surgery is the effective treatment for this disease. For avoiding the occurrence of the remnant gallbladder in LC,it is essential to adhere to indications of LC before operation and standards of the surgical procedures.

Objective To analyze the effect of meniscus tear on prognosis of tibial plateau fracture and the effect of fracture on meniscus healing by comparing the outcomes of simple tibial plateau fractures and the fractures combined with meniscus injury. Methods A retrospective analysis was conducted in 57 cases of tibial plateau fractures treated with internal fixation in our hospital from January 2004 to June 2006. Twenty-three of them were complicated with meniscus tear and received repairing. Knee joint functions were evaluated by the HSS (The Hospital for Special Surgery) score. The menisci were examined by Joint-line tenderness, McMurray, Apley and Thessaly tests. The femorotibial angle (FTA), tibial plateau angle (TPA) and posterior slop angle (PA) were measured on X-ray images. Results Fifty cases were followed up for an average Of 15 (6 to 24) months. The HSS scores for the simple tibial plateau fracture and the tibial plateau fracture combined with meniscus tear were 87.9 and 87.1, respectively. There were no statistical signifi-cances in HSS score(t=0.351, P=0.727), FTA, TPA and PA results between the 2 groups. No more positive physical signs of meniscus tear were found in the group of tibial plateau fracture combined with meniscus tear than in the other group. Conclusions Meniscus tear may not affect the postoperative re-habilitation of the knee joint with tibial plateau fracture; neither is there evidence that tibial plateau fracture may hinder meniscus healing.

Objective To explore the surgical methods and clinical applications of single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury.Methods From October 2011 to October 2013,using single operation hole for thorascopic surgery treating encapsulated effusion with atelectasis in 56 cases after thoracic injury,35 males and 21 females,aged 21-68,mean 34 years old.The left encapsulated effusion with atelectasis in 31 cases,the right of encapsulated effusion with atelectasis in 25 cases,atelectasis in 43 cases,partial atelectasis in 9 cases,total atelectasis in 4 cases.Before thorascopic surgery,routine thoracentesis or (and) closed thoracic drainage were performed,but ineffective.Surgical approach for anesthesia with the thorascopic surgery encapsulated effusion dissection + suction drum lung surgery.Thorascopic surgery were completed in single operation hole,postoperative chest tube into the hole from observation.Results The operation time was 55-120 min,average 75 min; blood loss was 25-150 ml,average 65 ml.All patients underwent in single operation hole.The postoperative hospital stay was 7-19 d,average 11.2 d.There were no perioperative mortality and major complications.Conclusions The single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury is exactly effective and simple.It can be used as an effective treatment.

Anatomical hepatic segmentectomy is the treatment of choice for hepatolithiasis. However, in consideration of the volume of residual liver and the liver function, anatomical polysegmentectomy of the bilateral lobes for hepatolithiasis is restricted. Protection of the portal pedicles to the segments preserved and avoidance of ischemia/reperfusion injury to the residual liver parenchyma are critical steps during the operation.A female patient with hepatolithiasis and had a surgical history of choledocholithiasis removal and T-tube drainage received ana tomic polysegmentectomy with segments Ⅰ and Ⅳ preservation at the General Hospital of Kunming Medical College. During the operation, Portal pedicles to the segments Ⅰ , Ⅱ, right lobe,and segments Ⅱ and Ⅲ were isolated prior to liver parenchyma transection. Portal pedicles to segments Ⅰ and Ⅳ were protected under direct visualization. Hepatoduodenal ligament occlusion was not applied during liver parenchyma transaction. Segments Ⅱ- Ⅲ and Ⅴ-Ⅷ were anatomically resected, and segments Ⅰ ,Ⅳ were preserved with satisfactory vascularization. The patient recovered uneventfully and was discharged 14 days after the operation.