1.Ultrasound-guided percutaneous aspiration and drainage in the diagnosis and treatment of liver abscess in children:Report of 15 cases
Shubing FANG ; Zhengyu MEI ; Kai YAO
Chinese Journal of Minimally Invasive Surgery 2005;0(09):-
Objective To explore the clinical value of u ltrasound-guided percutaneous aspiration and drainage for bacterial liver absces s in children. Methods Under the guidance of ultrasonography, 15 children with bacterial hepatic abscess underwent percutaneous aspiration or drainage. Among them, 9 were given percutaneous aspiration for 1~4 times, and 6 underwent percutaneous drainage. Results Percutaneous aspirati on or drainage was successfully accomplished in all the 15 children, 14 of whom were cured. The hospital stay was 15~42 days (mean, 26.3 days). No bleeding or b ile leakage happened. Follow-up for 4~12 months (mean, 6.8 months) in 11 childre n showed no recurrence. One patient with no improvement left hospital of his own accord. Conclusions Ultrasound-guided percutaneous aspiration and drainage is a feasible option for the treatment of liver abscess in childre n.
2.Clinical efficacy of laparoscopic left hemihepatectomy for the treatment of intrahepatic bile duct stones
Changwen HUANG ; Guangming LI ; Shubing ZOU ; Lu FANG ; Mingwen HUANG ; Kai WANG ; Siyuan LOU
Chinese Journal of Digestive Surgery 2015;14(2):152-154
Objective To explore the clinical efficacy of laparoscopic left hemihepatectomy for the treatment of intrahepatic bile duct stones.Methods The clinical data of 30 patients with left intrahepatic bile duct stones who were admitted to the Second Affiliated Hospital of Nancbang University from June 2013 to June 2014 were retrospectively analyzed.All the patients underwent laparoscopic left hemihepatectomy by the Glisson intra-and extra-pedicles vascular inflow occlusion techniques together with the removal of choledocholithiasis and right bile duct stones,and T tube placement or laparoscopic primary suture of common bile duct were selected according to the condition of bile duct.All the 30 patients were readmitted to hospital and detected by color Doppler ultrasound (CDUS),computed tomography (CT) and T tube cholangiography at postoperative month 1,and then received CDUS reexamination every 3 months.CT and MRI reexaminations were applied to patients with complication of residual stones if necessary.All the patients were followed up till July 2014.Results All the 30 patients were treated by laparoscopic hepatectomy with left hemihepatic vascular inflow occlusion,including 5 with conversion to open surgery and 25 with successful operation.The Glisson extra-and intra-pedicel vascular inflow occlusion techniques were used in 11 and 14 patients,respectively.The operation time and volume of blood loss were (158 ± 85) minutes and (405 ± 215) mL.Two patients received intraoperative blood transfusion.There were no residual stones in the 8 patients with choledocholithiasis by intraoperative choledochoscope,and primary suture of bile duct and T tube placement were done in 5 and 3 patients,respectively.No patients died.After operation,there were 2 patients with bile leakage and 1 with pleural effusion,and they were cured though drainage.One patient with subphrenic effusion was cured by B ultrasound-guided puncture and drainage.One patient had bleeding with the volume of blood loss of 500 mL,and was cured by conservative treatment.The duration of hospital stay in all the patients was (8.5 ± 2.3)days.No bile leakage and abdomen infection were detected by outpatient examination.The time of followup was 1-12 months,without recurrence of stones.Conclusion Laparoscopic left hemihepatectomy for the treatment of left intrabepatic bile duct stones is safe and feasible with satisfactory outcome.