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The effect of abdominal drains on difficult cholecystectomy

Journal of Clinical Surgery.2001;9(3):163-164.

Objective　To evaluate the effect of abdominal drains on difficult cholecystectomy.Method　894 cases of difficult cholecystectomy from Jan. 1988 to Jun. 1999 were retrospectively analysed.Results　The incidences of complication, reoperation and death in drain group were 6.81%,1.16% and 0.33%，respectively while those in non-drain group were 33.56%,9.59% and 4.11% respectively.There was significant difference between the two groups.Conclusion　Abdominal drains should be laid routinely in difficult cholecystectomy.

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The diagnosis and treatment of retroperitoneal fibrosis

Jiuhua LIU ; Shuangguan CHENG ; Lixin HUA

Journal of Clinical Surgery.2001;9(3):146-147.

Objective　To explore the cause, diagnosis and treatment of retroperitoneal fibrosis.Methods　5 cases of retroperitoneal fibrosis were respectively treated by moving ureter into abdomen cavity, encapsulating with pediculate omenta and ilel ureter.Results　Following-up of 5 cases for 1 to 3 years, all cases had normal renal functions and hydronephrosis were much decreased.Conclusions　Intravenous urogenous(IVU),retrograde pyelography(RGP) and computed tomography (CT) are important methods to diagnose the disease. And the treatment method chosen depends on the range, location of ureterostenosis, and whether the ureter is open or not.

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Surgical application of thoracolumbar vertebrae by atlas fixation system

Jianmin ZHANG ; Xizhong XIE ; Huijian XIE

Journal of Clinical Surgery.2001;0(04):-.

Objective To verify the significance the Atlas Fixation (AF) for thoracolumbar vertebrae.Methods 61 patients with fracture of thoracolumbar spine were operated by AF internal fixation. And to evaluate the effectiveness of the AF by X ray and CT scans. Results The patients of Frankel's B～D were improved by 1～2 scroe after operation. There were no iatrogenic nerve root injury and broken screws. There no earlier period infection. 2 had peri-screws abscess after 6 months by operation. Conclusion Compared with other spinal posterior internal fixation, AF has better results in effectiveness and simplification.

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Thoracic spinal cord injury without radiographic abnormality

Yanbo FENG ; Yonglong CHI ; Huazhi XU

Journal of Clinical Surgery.2001;0(04):-.

Objective 7 cases of thoracic spinal cord injury without radiographic abnormality (SCIWORA) were analyzed to elevate the level of diagnosis and treatment.Methods The type of spinal cord injury were classified into complete injury in 2 and incomplete injury in 5 according to Frankel. 5 cases had MRI examination. Conservative therapy was adopted in 5, and operation was programmed in 2.Results 4 cases recovered completely , 2 cases recovered partly , and 1 case had no recovery.Conclusion MRI provides reliable foundation for diagnosis and treatment to thoracic SCIWORA. The result is satisfactory in those incomplete injury.

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Clinical use of intramedullary interlocking nail in treatment of femoral, tibial fractures

Yufei WANG ; Kemin YANG ; Xiaotao LU

Journal of Clinical Surgery.2001;0(04):-.

Objective To study the clinical use of intramedullary interlocking nail in treatment of femoral and tibial fractures. Methods104 cases of femoral or tibial fractures were treated with intramedullary interlocking nails.Results The close and open reduction fractures had healed 6 10 and 8 12 weeks after surgery, and the fixation nails were taken out after 48 weeks. No broken nail, no delayed or nonunion, no infection, no fat embolism, no stiff joint occurred, All cases were followed up and the average following was 20 months without fracture.Conclusion The intramedullary interlocking nail had obvious advantage of reliable fixation, rotation and separation prevention, no need of external fixation support, high rate of fracture healing and allowance of early walk without support.

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Incision of the intrarenal sinus supplemented by a postrenal pole segmental incision removal of huge calculus

Jie ZHANG ; Wujun CAO ; Yi YIN

Journal of Clinical Surgery.2001;0(04):-.

Objective To evaluate the surgical treatment of huge staghorn stones. Method The clinic dates of 184 cases treated with an incision of the infrarenal sinus supplemented by a postrenal low pole segmental incision were studied. Result 184 cases were all successful.Conclusion We conclude that this method, need no interruption of renal blood flow had advantages of simple procedure less bleeding, completely removing calculi, protecting renal function.

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Cardiac operations in patients aged 70 years and over

Jianmin YAO ; Qirun CHENG ; Qingren JIA

Journal of Clinical Surgery.2001;0(04):-.

Objective To summarize the surgical treatment of heart disease in patients aged 70 years and over. Methods From May 1995 to July 2000, 23 patients aged 70 years and over underwent cardiac operation at our department. Thirteen cases underwent isolated coronary bypass grafting, 5 had isolated valve operations , 3 had combined valve operation and coronary bypass grafting, 1 had excision of left atrial myxomas, 1 had combined pericardiectomy and coronary bypass grafting .Results Postoperative complications occurred in 5 cases (21.7%). The hospital mortality rate was 4.3% (1 case) . All of the 22 cases survived showed improvements in cardiac function and quality of life during a follow up of 1 month to 5 years.Conclusions Cardiac operations can be performed in patient saged 70 yeas and over with a satisfactory outcome,earlier referral and intervention is mandatory to improve results in this patients.

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Clinical study of acute pancreatitis by Ulinastatin

Xudong HUO ; Chen CHAI ; Yumin LI

Journal of Clinical Surgery.2001;0(04):-.

Objective In order to evaluate the curative effects and mechanism of Ulinastatin on acute pancreatitis(AP). Methods 40 patients with AP were enrolled in this prospective study. They were comparable in dispearing time of symptoms and physical signs and laboratory data. Results The symptoms and physical signs of patients were significantly relieved in Ulinastatin group,and the labrotory data,such as the blood amylase and urine amylase recovered normal after five days with Ulinaststin. Conclution Ulinaststin has good clinical value in AP.

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The operation on hepatocellular carcinoma with obstructive jaundice as primary symptom

Jinbo WANG ; Zhenping HE ; Yan WANG

Journal of Clinical Surgery.2001;0(04):-.

Objective To study the clinical features and treatment on hepatocellular carcinoma(HCC) with obstructive jaundice as primary symptom. Method We collected 39 cases of patients of HCC with obstructive jaundice as primary symptom in our hospital,the clinical features and treatments were studyed.Results The incidence of such patients was 6.3% in all HCC patients and all patients were operaed;the positive diagnostic rate of B ultrasonud and T was 88.2% and 80% respectively ,it was 48.7% in cases with intraportal thrombi.Conclutions Preperative correct diagnosis depends on image test,hepatectomy with biliary duct drainage is the mainstay for treatment .

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The effect of early enteral nutrition support for the patients with severe acute pancreatitis

Zhangqing CHEN ; Shengquan ZOU

Journal of Clinical Surgery.2001;0(04):-.

Objective To elucidate the effect of early enteral nutrition support(ENS) for the patients with severe acute pancreatitis(SAP).Methods Fifty patients with SAP were at random divided into two groups: enteral nutrition group(EN group, 25 cases), parenteral nutrition group(PN group, 25cases). PN group was given total parenteral nutrition(TPN),125 kJ/(kg?d) of energy, nitrogen intake:0.20g/(kg?d). In EN group, the naso intestinal tube was placed posterior to ligament Treitz. Since the 1st day nutrilion was infused.Results On the first?4th day, the serum RBP?PA levels were obviously decreased (P

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