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Chinese Journal of Hepatobiliary Surgery

2002 (v1, n1) to Present ISSN: 1671-8925

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Status and advance in chemotherapy for biliary tract carcinoma

Wanyuan BAO ; Gang SHE ; Feng ZHU

Chinese Journal of Hepatobiliary Surgery.2014;20(10):758-761. doi:10.3760/cma.j.issn.1007-8118.2014.10.020

Biliary tract carcinoma is a rare cancer with poor prognosis.Although having limited clinical benefit,chemotherapy represents the cornerstone of management for patients with inoperable and postoperative recurrence of cholangiocarcinoma.Substantial breakthroughs in the study of chemotherapy for treatment in advanced cholangiocarcinoma are rare due to the heterogeneity of cholangiocarcinoma,the use of various chemotherapeutic agents and the small size of existing patient cohorts.Currently,no standard chemotherapeutic strategies exist for cholangiocarcinoma,though some combinatorial stratagies,such as gemcitabine plus cisplatin,have proven to prolong survival significantly.Still,further studies are needed to improve the treatment of patients with biliary tract cancer.

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Endoscopic diagnosis and treatment of malignant obstructive jaundice

Ying SHI ; Xiaoxing CHEN

Chinese Journal of Hepatobiliary Surgery.2011;17(10):865-870. doi:10.3760/cma.j.issn.1007-8118.2011.10.027

Malignant obstructive jaundice is biliary obstruction caused by malignant tumors.When a patient presents to a doctor,he/she is usually too late to be operated,so endoscopic treatment has gradually replaced surgery in its management.Diagnostic endoscopic methods include endoscopic retrograde cholangiopancreatography (ERCP),endoscopic ultrasonography (EUS),and per oral cholangioscopy (POCS),etc.Biliary stent placement at ERCP is the mainstay of endoscopic palliation for jaundice.Other methods include EUS-guided bilioenteric drainage (EGBD),endoscopic radiofrequency ablation,intraluminal brachytherapy of bile duct,endoscopic photodynamic therapy,etc.Magnetic Compression Anastomosis Technique (MCAT) is a new technology which has been developed recently,and its role in the management of malignant obstructive jaundice remains to be seen.Science and technology have brought along progress in endoscopic and consumable technologies.It is predicted that in the future,endoscopic diagnosis and treatment will have more applications.

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Laparoscopic cholecystectomy and laparoscopic common bile duct exploration in treatment of cholecvstolithiasis and choledocholithiasis

Bujian PAN ; Mengtao ZHOU ; Maiyu XU ; Feng CHEN ; Hongliang SONG

Chinese Journal of Hepatobiliary Surgery.2011;17(10):816-819. doi:10.3760/cma.j.issn.1007-8118.2011.10.007

Objective To study the use of laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) in patients with cholecystocholedocholithiasis.Methods From July 2006 to June 2010,127 patients with cholecystocholedocholithiasis were treated either by LC+LCBDE (n=78) or LC+endoscopic sphincterotomy (EST,n=49).The treatment success rate,complications,retained bile duct stones rate,recovery of gastrointestinal function and hospital-stay were retrospectively analyzed.Results The LCBDE+ LC group:The operative success rate was 94.87 %.The incidence of postoperative complications was 5.41 %.The EST+ LC group:Complete removal of bile duct stones was achieved in 46 of 48 patients (95.92%).The incidence of postoperative complications was 12.77%.There was a significant difference in the incidences of postoperative complications between the EST+ LC group and the LCBDE+ LC group (P<0.05).The operative time and the cost for hospital stay between the two groups were significantly different (P<0.05).After a follow-up of 3.2 years (mean,range 1-5 years),there was no significant difference in long-term complications such as bile duct recurrent stones,duodenal papilla stenosis and cholangitis between the two groups (P<0.05).ConclusionsLCBDE was a safe,efficacious and feasible minimal invasiveness treatment for cholecystocholedocholithiasis.Primary closure of common bile duct in selected cases brought additional benefits to the minimal invasive technique.

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The expression of osteopontin and its nucleating role in gallbladder bile of patients with cholesterol gallstone

Lin YANG ; Jinhong CHEN ; Duan CAI ; Liying WANG ; Xiliang ZHA

Chinese Journal of Hepatobiliary Surgery.2011;17(10):809-812. doi:10.3760/cma.j.issn.1007-8118.2011.10.005

Objective To investigate the role of osteopontin (OPN) in cholesterol gallstone formation.MethodsGallbladder bile was obtained from patients with cholelithiasis (n=36,the experimental group) and from donors of liver transplantation (n=19,the control group).OPN,calcium ion and lipid were analysed quantitively.The nucleating role of OPN in bile was evaluated using nucleating time (NT) approach.ResultsOPN inhibited cholesterol nucleation in a dose dependent manner.OPN (50 μg/ml and 100 μg/ml) prolonged NT by 48.90% (91.51%) and 17.07% (32.93%) in lithogenic and control bile,respectively.OPN (100 μg/ml) also inhibited the nucleating effect induced by calcium ion.Furthermore,a combination of OPN (50 μg/ml) and calcium prolonged NT by 75.78% and 33.96% in lithogenic and control bile,respectively.A combination of OPN (100 μg/ml) and calcium prolonged NT by 125.9% and 62.26% in the 2 groups.The contents of osteopontin and calcium were significantly lower in lithogenic bile than control bile (P<0.05).On the other hand,the cholesterol saturation index and the contents of cholesterol,phospholipid and bile acid were significantly higher (P<0.05).ConclusionsOPN inhibited cholesterol gallstone formation.It may be involved in the pathogenesis of cholelithiasis.

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Analysis on 128 cases of advanced pancreatic cancer treated by high intensity focused ultrasound

Kun WANG ; Zhiqiang MENG ; Zhen CHEN ; Luming LIU ; Junhua LIN ; Zhenhua ZHOU ; Hao CHEN ; Peng WANG ; Lianyu CHEN

Chinese Journal of Hepatobiliary Surgery.2011;17(10):871-872. doi:10.3760/cma.j.issn.1007-8118.2011.10.028

Objective To evaluate the analgesic efficacy and effect of high intensity focused ultrasound (HIFU) in the treatment of advanced pancreatic cancer.Methods128 patients with pancreatic cancer ( Ⅲ stage 41 case,Ⅳ stage 87 case) were treated by HIFU.According to some parameters,such as the clinical symptoms,imaging examinations and survival analysis to assess the efficacy of HIFU treatment.Results22.9% patients’ serum Ca19-9 decreased.The cancer pain was relieved in 72.5% patients.Coagulated-necrosis by CT/MRI examination was observed.PR,SD and PD of all were 11.7%,70.3% and 18.0% respectively.1-year survival rate was 16.7% for all patients,and median survival time was 7.0 months.1-year survival rate and median survival time for Ⅲ stage group were 28.5% and 9.0 months,that of 10.8% and 6.0 months for Ⅳ stage group respectively.ConclusionHIFU may benefit to advanced pancreatic cancer patient by stabilizing tumors,relieving pain and prolonging life expectancy with less side effects.

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The mechanism of pseudomonasaeruginosa mannose sensitive hamemagglutination vaccine in inducing apoptosis of hepatocellular carcinoma

Tao LI ; Zhaoyou TANG ; Jianwei ZHOU ; Jia FAN ; Sanyuan HU ; Xuting ZHI

Chinese Journal of Hepatobiliary Surgery.2011;17(10):838-841. doi:10.3760/cma.j.issn.1007-8118.2011.10.014

Objective To investigate the mechanism of pseudomonasaeruginosa mannose sensitive hamemagglutination vaccine (PA-MSHA) in inducing apoptosis in hepatocellular carcinoma (HCC).MethodsA metastatic model of human hepatocellular carcinoma (HCC) was established by orthotopic implantation of histologically intact human HCC tissue into the liver of nude mice.Mice bearing xenografts in liver were randomly divided into three groups:control group,PA-MSHA intraperitoneal administration group,and PA-MSHA subcutaneous administration group.The agent was administered every day after the third day post-tumor implantation.At the end of the sixth week,the mice were killed.Serum levels of TNF-α,IL-4,IL-6 and IFN-γ were measured by ELISA and the activities of caspase 3,caspase 8 and caspase 9 in the tumor samples were tested by spectrophotometric method.Fas/FasL expressions were evaluated by Western blotting.ResultsSerum TNF-α levels in the control group,PA-MSHA subcutaneous administration group and PA-MSHA intraperitoneal administration group were 25.24±3.22 pg/ml,25.50±4.55 pg/ml(P>0.05) and 34.22±2.42 pg/ml (P<0.01),respectively,while there were no significant differences in serum IL-4,IL-6 and IFN-γ among these three groups(P>0.01).Compared with the control group,the activities of caspase 3,caspase 8 and caspase 9 in tumors in the intraperitoneal administration group increased by 4.1,2.3 and 1.9 fold(P<0.01),respectively,and Fas/FasL expressions were significantly elevated in the intraperitoneal administration group and subcutaneous administration group.ConclusionWhen given intraperitoneally,PA-MSHA can induce apoptosis in HCC by promoting the secretion of TNF-α and expression of Fas/FasL,thereby inhibiting HCC growth and metastasis.

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A control study of laparoscopic versus open hepatectomy: the stress reaction of patients

Ping YUE ; Hongzhi ZHAO ; Mingfang QIN

Chinese Journal of Hepatobiliary Surgery.2011;17(10):813-815. doi:10.3760/cma.j.issn.1007-8118.2011.10.006

Objective:To investigate the influence of laparoscopic versus open hepatectomy on the stress reaction of patients.MethodsRetrospectively 30 cases who received operation of laparoscopic and open left lateral lobectomy of liver for stones in bile ducts within left lobes of lives were selected form May 2006 to September 2010.The serum level of neutrocytes (N),adrenaline (AD),cortisol (Cor),blood glucose (BG),white blood cell (WBC),Natural killer cell ( NK cell),interleukin-6 (IL-6),C-reactive protein (CRP) were detected preoperatively as well as 24 h,28 h,72 h postoperatively.ResultsAD,Cor reached their peaks after operation,and N,BG,IL-6,CRP reached their peaks in 24 h postoperatively.There were significant difference between O and L groups (P<0.05).NK cell sank to its lowest level in 24 h postoperatively,and there were no significant difference between the two groups (P<0.05).ConclusionLaparoscopic and open left lateral lobectomy of liver are two methods curing stones in bile ducts within left lobes of lives,the former process can result in less stress reaction of patients than the latter.

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Value of the conventional liver function tests in the assessment of hepatic reserve

Bin LI ; Yao YU ; Yifeng HE ; Jia FAN ; Zhiquan WU ; Jian ZHOU ; Lunxiu QIN ; Qinghai YE ; Huichuan SUN ; Shuangjian QIU

Chinese Journal of Hepatobiliary Surgery.2011;17(10):805-808. doi:10.3760/cma.j.issn.1007-8118.2011.10.004

Objective To study the risk factors of post-hepatectomy hepatic decompensation (PHD) in patients with hepatocellular carcinoma.MethodWe reviewed 562 patients with Child-Pugh A classification,who underwent partial hepatectomy for hepatocellular carcinoma at Zhongshan Hospital,Fudan University between July 1st 2007 to December 31st 2007,to study the risk factors of hepatic decompensation.ResultsPreoperative high total bilirubin (TB) and low prealbumin (PA) were independent risk factors of PHD by logistic multivariate analysis ROC analysis revealed the cut-offs of preoperative PA predicting PHD were 0.14 g/L (sensitivity 41.4%; specificity 83.1%).The incidence of PHD was 16.0% when TB≥20.4 μmol/L and PA<0.14 g/L(OR=7.276,P=0.002).ConclusionThe Child-Pugh A patients recovered well when the preoperative liver function was as follows:TB<20.4 μmol/L and PA≥0.14 g/L.

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Research on etiology and pathophysiology of acute-on-chronic liver failure

Guangxiang GU ; Xiaolei SHI ; Yitao DING

Chinese Journal of Hepatobiliary Surgery.2011;17(10):861-864. doi:10.3760/cma.j.issn.1007-8118.2011.10.026

Acute-on-chronic liver failure is a common form of liver failure characterized by complicated clinical manifestations and high mortality.The pathophysiology of ACLF is still unclear.More efficacious treatments are based mainly on a better understanding of the pathophysiology of ACLF.The advances in the pathophysiology of ACLF have been extremely encouraging in the last few years.In this article,we reviewed the progress of ACLF,its definition,etiology and,pathophysiology.

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Suberoylanilide hydroxamic acid (SAHA) suppresses JAK/STAT1 signal pathway to down-regulate the expression of indoleamine 2, 3-dioxygenuse in gallbladder carcinoma cells

Peng ZHANG ; Guanmin JIANG ; Jian GAO ; Lingling LI ; Jun DU ; Xingyuan JIAO ; Jingsen SHI

Chinese Journal of Hepatobiliary Surgery.2011;17(10):833-837. doi:10.3760/cma.j.issn.1007-8118.2011.10.013

Objective To investigate the mechanism on JAK/STAT1 signal pathway in SAHA down-regulation of indoleamine 2,3-dioxygenase (IDO) in gallbladder carcinoma cells.MethodsWe treated gallbladder carcinoma SGC-996 cells with IFN-γ and SAHA.Western blotting was used to detect the expression of IDO,signal transducer and activator of transcription 1 (STAT1) phosphorylation and interferon regulatory factor genes-1 (IRF-1).Confocal microscopy analysis was used to detect STAT1 translocation.Transient transfections and reporter genes assay was used in detecting the activation of γ-activated sites (GAS) and interferon stimulated response elements (ISRE).ResultsIDO expressed in SGC-996 cells in dose- and time-dependent manners when stimulated with IFN-γ.SAHA down-regulated the expression of IDO induced by IFN-γ in a dose-dependent manner.SAHA blocked the expression of IRF-1 induced by IFN-γ.SAHA inhibited the IFN-γ-induced STAT1 phosphorylation and nuclear translocation.SAHA down-regulated IFN-γ-induced activation of GAS and ISRE.ConclusionsSAHA may down-regulate IDO expression through inhibiting the activation of members in JAK/STAT1 signal pathway.This may provide a new immunotherapeutic strategy to break tumor immune tolerance in gallbladder carcinoma.

Country

China

Publisher

中华医学会

ElectronicLinks

https://zhgdwkzz.yiigle.com

Editor-in-chief

E-mail

zhgdwkzz@vip.163.com

Abbreviation

Chinese Journal of Hepatobiliary Surgery

Vernacular Journal Title

中华肝胆外科杂志

ISSN

1007-8118

EISSN

Year Approved

2007

Current Indexing Status

Currently Indexed

Start Year

1995

Description

历史沿革【现用刊名:中华肝胆外科杂志;曾用刊名:肝胆胰脾外科杂志;创刊时间:1995】,该刊被以下数据库收录【CA 化学文摘(美)(2009);Pж(AJ) 文摘杂志(俄)(2009)】,核心期刊【中文核心期刊(2008)】。

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