Objective To review the advances in techniques of hepatic blood occlusion in hepatectomy.Methods The related literatures were reviewed and analysed.Results There were many techniques of hepatic blood occlusion.The most frequently used and studied techniques were hemihepatic vascular occlusion and intermittent hepatic inflow occlusion.Hepatic vascular exclusion was employed when hepatic veins and/or vena cava would be damaged.Total vascular exclusion and other techniques were rarely used.Conclusion To reduce blood loss in hepatectomy and make patient safe,based on the situation of the patient,the technique should be ingeniously selected.

Objective To summarize the application and advancement of liver transplantation for hepatic metastasis from neuroendocrine tumor. Methods Domestic and overseas publications on the study of liver transplantation for hepatic metastasis from neuroendocrine tumor in recent years were collected and reviewed. Results Liver transplantation can offer good relief of symptoms, long disease-free intervals, and potential cure in individual patients with hepatic metastatic tumor. Important selection criteria are well-differentiated tumors and a low proliferation rate (Ki67

Objective To review the advances in overcoming multidrug resistance of tumors caused by mdr1 gene. Methods Different ways of overcoming multidrug resistance of tumors caused by mdr1 gene in the literatures were reviewed. Results One of the important reasons causing multidrug resistance was due to the overexpression of mdr1 gene and its product P-glycoprotein. There were two ways to overcome multidrug resistance of tumors through mdr1 genes mRNA and its product P-glycoprotein effectively.Conclusion The clinical test of the unitary way to overcome multidrug resistance of tumors is unsatisfactory, combining different ways to overcome multidrug resistance of tumors will be the hot spot of tumors research in the future.

Objective To explore the relationship between mdr1 gene expression of hepatocellular carcinoma (HCC) and pathological characteristics,chemotherapy and prognosis. Methods The mdr1 gene expression of HCC in 56 patients with the methods of immunohistochemistry was studied. The results were analysed with the pathological data by statistic methods. Results The positive expression of mdr1 gene in cancer tissues and pericancerous tissues of HCC were 30/56(53.6%) and 19/56 (33.9%) respectively. The difference was statistically significant (? 2=4.39, P

Objective To report the diagnosis and treatment of hilar cholangiocarcinoma.Methods The relevant information about the hispathological feature, transfer ways, clinical manifestation, laboratory examination, imaging feature, immunohistochemical examination and treatment ways were gathered from previous original articles, and checking the latest issues of appropriate journals.Results The clinical manifestation, laboratory examination, and imaging feature of hilar cholangiocarcinoma were due to the neoplasm obstructing bile duct and sequent infection of bile duct. The diagnosis was depanded on the combining clinical manifestation, laboratory examination and imaging feature. The value of immunohistochemical examination was not clear. Radical surgery was the best treatment of unique curing the neoplasm. By-pass surgery was used in the late phase patients to solve the obstruction of bile and digest duct. The effect of unique chemical treatment was not perfect. It did’t generally propose the treatment of orthotopic liver transplantation.Conclusion The perfect prognosis of hilar cholangiocarcinoma is depended on early diagnosis and redical surgery.

Objective To introduce the birth and development of model of end-stage liver disease(MELD) and evaluate its effect on liver transplantation(LT) as a new scoring system.Methods Literatures of MELD applied in LT were analyzed retrospectively.Results MELD scoring system was used for predicting the prognosis of patients with end-stage liver disease and the death risk of candidates on waiting LT extensively and the order of organ sharing was determined by its predicable results.Conclusion MELD has been had a successful initial implementation for predicting the short-term survival probability and mortality in patients with end-stage liver disease,and meeting the goal of providing a system of allocation that emphasizes the urgency of the candidate while diminishing the reliance on waiting time,which has been proven to be a powerful tool for auditing the liver allocation system.

Objective To study the advances in use of imaging in the evaluation of living donor liver.Methods The literatures in recent years on the use of imaging in evaluation of living donor liver were reviewed.Results Preoperative computed tomography(CT) and magnetic resonance imaging(MRI) in the donor allowed accurate determination of liver volume and rough determination of macrovesicular hepatic steatosis of the liver.CT angiography could assess the anatomy of hepatic artery,portal vein and hepatic veins.Intraoperative cholangiography allowed detection of the anatomy of the biliary tree.Conclusion Imaging techniques are widely used in the evaluation of liver volume,vasculature and biliary system in the living donor liver.

Objective To investigate the feasibility of a new clinical staging of primary liver cancer (PLC). Methods 1*!038 PLC cases were surgically treated in our hospital from January 1990 to December 1998. Of those, 504 patients receiving liver resection were classified with the TNM staging and new clinical staging. Both staging systems were correlated with survival rates. Results In TNM staging, 24 cases (4 8%) were in stage Ⅰ, 66 cases (13 1%) in Ⅱ, 385 cases (76 4%) in Ⅲ, and 29 cases (5 8%) in Ⅳa. The 5 year survival rates were 79 2%, 62 1%, 32 2% and 0, respectively. As with the new clinical staging, 27 cases (5 4%) were in stage Ⅰa, 81 cases (16 1%) in Ⅰb, 224 cases (44 4%) in Ⅱa, 141 cases (27 9%) in Ⅱb, and 31 cases (6 2%) in Ⅲa. The 5 year survival rates were 70 3%,53 1%,40 2%, 22 7% and 0 respectively. Conclusion While both the TNM staging and new clinical staging have significant correlation with the selection of treatment and evaluation of prognosis, the new staging is more useful in clinical practice.

ObjectiveTo investigate the effect and mechanism of ischemic preconditioning (IP)on preservation/reperfusion injury of rat liver graft.MethodsOne hundred and twenty eight male Sprague Dawley rats undergoing orthotopic liver transplantation were randomly divided into 4 groups: group A (control group), group B (IP group), group C (adenosine,Ado group), and group D (inhibitor of NO synthesis,NAME group).ResultsPosttransplantation one week survival rate, 2 hrs reperfusion serum NO, and hepatic tissue adenosine in IP group and Ado group were 88%(7/8) and 88%(7/8), (33 0?6 1)??mol/l and (29 1?6 5)??mol/l, ( 7 2? 1 8)??mol/g and (5 7?1 3)??mol/g, respectively, while in control group they were 38%(3/8),( 15 4? 3 0)?mol/l, and (3 69?0 54)??mol/g, respectively(all P 0 05). However, hepatic tissue adenosine level was (5 56?1 19)??mol/g, higher than that in control group( P

Objective To investigate the common reasons,prophylaxes and treatment of postoperative complications in orthotopic liver transplantation (OLT).Method Seventy two patients who underwent OLT during recent three years were collected and analyzed retrospectively.Results OLT was performed on 50 cases with benign diseases including terminal liver cirrhosis 34;and 22 cases with and malignant diseases including hepato cellular carcinoma 19 cases.Fifty four complications were occurred postoperatively,including secondary abdominal cavity bleeding (4 cases ),severe infection of ascites (2 cases),stress gastric ulcer with bleeding and perforation (1 cases),biliary leak (6 cases),pulmonary infection (21 cases),and enteric fungal infection (5 cases).There were no primary dysfunction of liver and vascular complications.Follow up 2-41 months, without biliary complications and chronic liver dysfunction occurred 6 cases death postoperative,6 cases death on follow-up period.Total surrival rate is 83.33%, 32 cases alive more than 1 year,the longest surrival cases is 41 months postoperative.Conclusions It is suggested that the cases with cirrhosis are main indication for liver transplantation.The patients with liver cirrhosis always combinated of liverdisfunction,coagulopaphy,malnutrition and poor immune functions and we should pay attention to replace that of coagulation factors,antibiotics using and nutrition support perioperatively.Good surgical technique is the key point for preventing vascular complications.