The author studies dynamically the changes of the liver tissue reaction to various suture materials during the period 5-90 days in the 96 rats.From the result of comparative experimental sdudy of the effect on tissue reaction, we had found: All suture materials produce an intense inflammatory reaction for approximately five days after implantation, thereafter the liver tissue reaction to various suture materials makes a great difference. The least reaction suture is the nylon, the lagest reaction suture is the chromic catgut, dacron and silk are between them.The good "hand" of dacron, which ties like silk, and the slight inflammatory reaction produced this polyester do much to recommened its use in the liver.

Vascular injury is a severe complication when combined with biliary injuries in laparoscopic cholecystectomy. The most frequent injury is damage to the right branch of the hepatic artery. The incidence ranges between 6. 7% and 61.1%. When bile duct transection is combined with vascular injury, the clinical course is complicated by liver ischaemia or necrosis, biliary stricture, and liver lobar atrophy which sometimes necessitating liver resection or even transplantation. Reconstruction of vascular injury is helpful when the injury is identified early.

To investigate the cause of donor death in living donor liver transplantation(LDLT), we reviewed all published articles in English on LDLT from the Foreign Medical Journal Full-Text Service (FMJS) and searched the literature for donor deaths before 2008. We identified 12 donor deaths. The rate of donor death is 0.2%. Any donor death would be a catastrophe for the donor's family and for the medical team. It is imperative to avoid donor death in LDLT.

The pneumoperitoneum may reduce the renal blood flow which was demonstrated both in experimental and clinical research. Greater change could be seen as the pressure of pneumoperitoneum increased,which may induce lower GFR, decrease urine output ,increase the level of plasma Scr?BUN and so on.All these changes were related to the variety of hemodynamics?nerval-endocrine factors releasing?body position and sorts of insufflated gas.Ischemia-reperfusion injury also is an ignorable factor. Pneumoperitoneum may influence the kidney function , which is reversible under certain pressure and operating time,and were concerned with multiple mechanism. More obvious damage to the dysfunctional kidney could occur under high pressure of pneumoperitoneum.

Objective To investigate the effects of CO 2 pneumoperitoneum during laparoscopic cholecystectomy (LC) on pulmonary functions in chronic pulmonary failure rabbits and their mechanisms. Methods A total of 50 healthy male rabbits ( oryctolagus cuniculus ) were randomly divided into 4 groups: normal control group (N 0: n=5, no pneumoperitoneum), experimental control group (T 0: n=5, no pneumoperitoneum), 10 mmHg experimental group (T 10 : n=20, 10 mmHg pneumoperitoneum) and 15 mmHg experimental group (T 15 : n=20, 15 mmHg pneumoperitoneum). After the successful establishment of emphysema rabbit models, CO 2 pneumoperitoneum was conducted and maintained for 2 hours at the pressure of 10 mmHg (1.33 kPa) and 15 mmHg (2.00 kPa), respectively. Pulmonary functions (total respiratory resistance, central resistance and total airway resistance) of the 4 groups were measured by pulse oscillation technique before and after the pneumoperitoneum, respectively. Results Total respiratory resistance, central resistance and total airway resistance increased after the establishment of emphysema models. And they decreased at the end of pneumoperitoneum compared with those before pneumoperitoneum ( q=17.824, P

Objective To investigate the feasibility and ways of closed establishment of pneumoperitoneum for laparoscopic procedures in patients with a history of abdominal surgery. [WT5”HZ]Methods[WT5”BZ] Between September 1991 and December 1998, 963 patients with a history of abdominal surgery received closed establishment of pneumoperitoneum. The difficulties with closed establishment were classified as false and real types. Veress needle penetrating into falciform ligament, mesentery, great omentum or retroperitoneal fat tissue caused false difficulty, while the difficulty due to Veress needle penetrating into abdominal viscera or because of extensive adhesion was known as real difficulty.[WT5”HZ] Results[WT5”BZ] 18 cases for false and real difficulty were transfered to open surgery.Two cases suffered visceral injuries for laparoscopic cholecystectomy, including jejunum and ileum injuries in one each case. The occurrence rate of visceral injuries accounted for 0 2% in this group.[WT5”HZ] Conclusion[WT5”BZ] This result demonstrates that closed establishment of pneumoperitoneum is safe and feasible in most patients with abdominal operative history. Abiding by the rule of closed establishment pneumoperitoneum and conversion to laparotomy in time in real difficulty is important to avoid visceral injuries.

Objective The value of laparoscopic ultrasonographic scanning (LUS) in laparoscopic cholecystectomy (LC) and the way of scanning extrahepatic biliary system were reported. Methods 80 patients with gallstone receiving LC had real－ time color Doppler LUS of the extrahepatic biliary system. Results The sonic picture of major extrahepatic bile duct could be clearly visualized by LUS. While the image of the part posterior to duodenum could also be seen satisfactory with the method modified by the authors. But viewing the image of exact cystic duct needs further study.Conclusion LUS gives distinct intraoperative sonographic images of extrahepatic bile ducts , thereby the operator can precisely locate the ducts without injurying them. LUS can be considered as an important and safe supplement to LC.

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 investigate the reasons for the changes of serum ALT, AST after laparoscopic cholecystectomy. Methods 69 patients admitted in Oct, 1999 were randomly divided into two groups. The gallbladder was resected with monopolar cautery laparoscopically and cystic bed was routinely coagulated in 35 patients, group a. The gallbladder was removed with microscissors and the cystic artery was clipped with titanium clip in 34 patients, group B. Hepatic tissue in bulk of 1cm X 1cm and close to the gallbladder bed was sampled for histological study for all patients in the two groups. The serum ALT and AST levels were measured on the 1st, 5th ,postoperative day. Results Comparing with group B, the serum ALT and AST levels in group A were significantly higher on the 1th postoperative day ( P

ObjectiveTo compare the hospital charges incu rred for laparoscopic cholecystectomy (LC) and open cholecystectomy (OC).MethodsT he authors selected 100 cases of LC and 100 cases of OC of 1991 (initial per iod of LC) and 2000 (mature period of LC), respectively. Comparisons on hospital charges be tween the two procedures of both periods were made. ResultsT hat total charges of LC (2575 86?261 61)yuan were significantly higher than those of OC (1240 61?382 67)yuan ( t =28 805, P