Objective To study the effect of percutaneous transhepatic gallbladder drainage (PTGBD) combined with laparoscopic cholecystectomy (LC) in treatment of acute severe cholecystitis.Method The perioperative data of patients treated with PTGBD combined with LC and patients treated with emergency LC were analyzed.Results There were no significant difference between the two groups on surgical duration (t =0.601,P =0.551) and postoperative hospital stay (t =0.979,P =0.331).Blood loss [PTGBD + LC (79.43 ± 46.27) ml,LC (125.84 ± 64.18) ml ; t =3.641,P ＜ 0.05],peritoneal drainage time [PTGDB + LC (3.29 ± 1.58) d,LC (4.63 ± 2.31) d ; t =3.131,P ＜ 0.05] and postoperative oral intake time [PTGBD +LC (2.91 ±1.58)d,LC (4.21 ±2.22)d; t =2.669,P＜0.05] were significantly different between the two groups.The rate of laparotomy,mortality and postoperative complications in the emergency LC group were higher than those in the PTGBD combined with LC group.Conclusions PTGBD combined with LC in the treatment of acute severe cholecystitis was significantly better than emergency LC.

Objective:To investigate the preoperative and intraoperative risk factors of clinical pancreatic fistula after laparoscopic pancreaticoduodenectomy (LPD).Methods:Clinical data of 100 patients undergoing LPD at the Second Department of Hepatobiliary and Pancreatic Surgery of the First Hospital of Jilin University from Jan 2019 to May 2019 were studied.Results:The total incidence of pancreatic fistula was 8%, and the incidence of clinical pancreatic fistula (grade B, C) was 6%. Univariate analysis found that gender (male), preoperative pancreatic plain CT value <33HU, soft texture of the pancreas, long operation time, alcoholic consuming history may be risk factors for pancreatic fistula after LPD( P<0.05), and further multivariate analysis found gender (male), preoperative pancreatic plain CT value <33 HU, soft texture of the pancreas were independent risk factors for clinical pancreatic fistula after LPD( P<0.05). Conclusions:Male patients, preoperative pancreatic plain CT value <33HU, soft texture of the pancreas were respectively independent risk factors predicting post-LPD clinical pancreatic fistula.