ObjectiveTo summarize the clinical value and experience of choledochoscope in hepatobiliary surgery.MethodsClinical data of 210 patients with bile duct stones underwent choledochoscope treatment were retrospectively analyzed.Results210 patients had no deaths and no residual stones.The surgery time was less than 2h,and the maximum time limit of repeatedly taking the stone was 13 months.ConclusionCholedochoscope in the treatment of bile duct stones was minimally invasive,safe and reliable treatment method.

Objective To study the clinical efficacy and safety of endoscopic papillary large balloon dilation (EPLBD) in the treatment of common bile duct (CBD) stones.Methods This retrospective study of EPLBD for CBD stoneswas conducted between May 2015 and March 2017 on 116 patients.The patients were divided into two groups based on the different methods of treatment:group A (the EPLBD group) and B(the EST + EPBD group).Results Treatment with EPLBD when compared with EST + EPBD produced similar outcomes with regard to the overall stone removal rates (96.2％ vs.93.5％,P ＞ 0.05) and complete ductal clearance in one session (92.6％ vs.92％,P ＞0.05).There were no significant differences in the rates of overall complication (22.2％ vs.22.2％,P ＞ 0.05),hemorrhage (7.4％ vs.11.3％,P ＞ 0.05),post-ERCP pancreatitis (9.3％ vs.6.6％,P ＞ 0.05) and acute cholangitis (5.6％ vs.8.1％,P ＞0.05).When compared with EST + EPBD,mechanical lithotripsy was performed less in the EPLBD group (16.6％ vs.27.4t％,p ＜ 0.05).Conclusions EPLBD was an effective and safe method to treat CBD stones.EPLBD reduced the use of mechanical lithotripsy when compared with EST + EPBD.

OBJECTIVE: To assess the geometrical matching of a new anatomical adaptive titanium mesh cage (AA-TMC) with the endplate and its effect on cervical segmental alignment reconstruction in single- and two-level anterior cervical corpectomy and fusion (ACCF) and compare the compressive load at the endplate between the AA-TMC and the conventional titanium mesh cage (TMC). METHODS: Twelve cervical cadaveric specimens were used to perform single- and two-level ACCF. The interbody angle (IBA), interbody height (IBH) and the interval between the AA-TMC and the endplate were evaluated by comparison of the pre- and postoperative X-ray images. The maximum load at the endplate was compared between the AA-TMC and TMC based on American Society for Testing and Materials (ASTM) F2267 standard. RESULTS: No significant differences were found between the preoperative and postoperative IBA and IBH in either single-level ACCF (11.62°±2.67° 12.13°±0.69° and 23.90±2.18 mm 24.23±1.13 mm, respectively; > 0.05) or two-level ACCF (15.63°±5.06° 16.16°±1.05°and 42.93±3.51 mm 43.04±1.70 mm, respectively; > 0.05). The mean interval between the AA-TMC and the endplate was 0.37 ± 0.3 mm. Compared to the conventional TMC, the use of AA-TMC significantly increased the maximum load at the endplate in both single-level ACCF (719.7±5.5 N 875.8±5.2 N, < 0.05) and two-level ACCF (634.3±5.9 N 873±6.1 N, < 0.05). CONCLUSIONS The use of AA-TMC in single-level and two-level ACCF can significantly increase the maximum load at the endplate to lower the possibility of implant subsidence and allows effective reconstruction of the cervical alignment.
Biomechanical Phenomena ; Cervical Vertebrae ; Humans ; Prostheses and Implants ; Spinal Fusion ; Surgical Mesh ; Titanium ; Treatment Outcome