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Clinical research on laparascopic management for patients with both gallbladder and common bile duct stones

Yangde ZHANG ; Xiaolin LU ; Xiaoping WAN ; Nianfeng LI ; Liansheng GONG ; Weidong LIU

China Journal of Endoscopy.2005;11(2):113-115,118.

[Objective] To investigate the therapeutic status of laparoscopic management for gallbladder stones and common bile duct stones. [Methods] A Retropective study were adopted to analysize the therapeutic scheme,effect for patients with gallbladder stones and common bile duct stones who were treated from January 1996 to September 2004. [Results] 68 cases were diagnosed, and most of them underwent single stage laparoscopic cholecystectomy (LC) and common bile duct exploration (LC BDE). A few of them were treated through endoscopic procedure in combination with LC, or open surgery when the minimal invasive surgery failed. [Conclusions] Both them indicated that patients by LC+LCBDE have shorter hospital stay, easier recovery and less complications. LC+LCBDE has obvious advantage over the other methods with appropriate operative time and high success rate. For choledochlithiasis patients, the single laparoscopic management should be a better, major option.

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RADICAL OPERATION ON HIRSCHSPRUNG’S DISEASE IN LAPAROSCOPE：ANALYSIS OF 8 CASES

Weicheng LIANG ; Cunchugn WANG

China Journal of Endoscopy.2001;7(1):55,57-.

Objective:To investigate the use of laparoscopy in Hirschsprung's disease.Methods:Eight patients with Hirschsprung's disease had been done by laparoscopy.Results:All casses were successfully done,and take fluids on the second postoperative day.The average length of postoperative stay were 7.2 days.No patient required conversion to open laparotomy.There was no anastomotic leak nor mortality.The results were satisfactory.Conclusions:Laparoscopic radical operation on Hirschsprung's disease for Hirschsprang's disease can be carried out safely and effectively with decreased postoperative pain and rapid recovery.

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NASAL SEPTAL PERFORATION REPAIR WITH ENDOSCOPIC SURGERY

Xianan LIU ; Wei CHEN ; Qijun LI ; Jianming LIU

China Journal of Endoscopy.2001;7(1):50,52-.

Objective:To investigate the new method of nasal septal perforation repair.Methods:Through labiogingival groove,6 patient's nasal septal perforations were repaired with mucoperichondrial flap or mucoperiosteal flap rotated from the septum nasia and basis cavum nasi under nasal endoscopy.Results:Five patients had completed clusure,Another reduced in size to pinpoint hole.Conclusions:The method is a simple and effective technique for treatment of nasal septal perforation.

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COMBINED LAPAROSCOPY AND HYSTEROSCOPY IN THE DIAGNOSIS AND THERAPY OF THE FEMALE INFERTITY： CLINICAL ANALYSIS OF 71 CASES

Minfang WANG ; Li LI ; Yongpeng SHI

China Journal of Endoscopy.2001;7(1):39,41-.

Objective:Combined laparoscopy and hysteroscopy in the diagnosis and therapy of the female infertity is and advanced means in the gynecologcial field.We analysed the causes and the treatments of the 71 infertile patients.Pelvic adhesions,endometrosis and salpingtis were the main causes of infertity in our 71 cases.Of 71 cases,29 cases were primary infertity,in whichc endometriosis,PCOS and anatomic uterine defect were the main causes,and 42 cases were secondary infertity,in which 35 cases (83%) had previous intrauterine operations.All the patients were treated for the causes.We concluded that combined laparoscopy and hysteroscopy can diagnose the causes of infertity and can observe the tubal patency by hysteroscopic tubal cathertetization and hydrotubation,which will direct the treatments and estimate the results of the therapy.Methods:Infertity;Combined Laparoscopy and Hysteroscopy.

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DIAGNOSTIC VALUES ON THE UPPER DIGESTIVE TRACT STAININGED BY THE ENDOSCOPY

Yan ZHOU ; Rong ZHU ; Yuling LONG ; Yunzheng DING

China Journal of Endoscopy.2001;7(1):14,16-.

Objective:Discuss the diagnosis values on the upper digestive tract staininged by the endoscopy.Methods:After spraying straining on the 72 cases below parts using stomach endoscopy,who are suffering from esophagus,stomach disease,and duodenal,observe the staining struction and take some samples.Results:Take samples from Lugol's iodine unstaininged but areas on the 18 esophagus disease,the pathobology shows that 9 suffering f from esophagus carcinomas,3 Barrett's esophagus,6 chroinc esophgitis.Taking the staining areas as samples from 29 diseases (it is 80.55% among 36 disease suffering from methylene blue staining stomach),it appears that 5 are suffering from stomach cancer,21 are intestinal metaplosia and gastric dysplasia.Among 18 staining on bulbs of duodenal ulcer,11 unstaininged are checked gastric metaplasia (61.11%).Conclusions:The endoscopy staining possesses the ability of enlarging the endoscopy diagnosis.The method is simple and safe,it is worthy of clinical application and extending.

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EXPERIENCE WITH THE TREATMENT OF BILATERAL SYNCHRONOUS MULTIPLE PRIMARY LUNG CANCERS

Gang LIN ; Tonglin LIU ; Hongyi CHEN

China Journal of Endoscopy.2001;7(1):30-32.

Objective:Evaluate the role of video-assisted thoracic surgery (VATS) in the treatment of bilateral synchronous multiple primary lung cancers.Methods and Results:Two paitents diagnosised as bilateral synchronous multiple primary lung cancers received one-stage treatment combined conventional thoracotomy with video-assisted thoracic surgery,performing open lobectomy to remove the larger tumor,performing wedge resection using thoracoscopy to excise the smaller one.The surgery time is short.Patients all recover smoothly without complications.To date,these two patients all alive without any sign of recurrence or metastasis of tumor,median follow-up time is 5 months (2 months+8 months).Conclusions:It is feasible to carry out one-stage treatment combined conventional thoracotomy with video-assisted thoracic surgery on patients with bilateral synchronous multiple prima-ry lung cancers,when one of the tumors of bilateral synchronous multiple primary lung cancers is classificated as T1N0M0.

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ENDOSCOPIC LIGATION FOR CARCINOMA AND POIYP OF STOMACH

Feng XU ; Yanjiai LI ; Yunong CHENG

China Journal of Endoscopy.2001;7(1):25-26.

Objective:To study the effect of endoscopic ligation for early stage carcinoma and benign polyp of stomach.Methods:The early stage cancer in situ and polyp (d＜1.0cm) of stomach were sucked and resected with the endoscopic ligation advice which is used in esophgeal varice ligation.The remained tissue were observed histopathologically whether there had any malignant cell in it and follow-up of 3～6 months was mode by endoscopy.Results:Form 1996 to 1999,56 patients received endscopic ligation.Of these patients,8 cases had gastric early carcinoma (2 cases superficial flat type,4 cases superficial elevated type,2 cases carcinoma in situ),48 cases had gastric benign polyps (38 cases infammatory polpy,10 cases polpypous adeoma).After the endscopic ligation,no malignnant cell was found in remained tissues and no polyp recured within the follow-up period.So this method was demonstrated to be safe,cheap and good effective method for early stage carcinoma,minicarcinoma,carcinoma in situ and benign polyp (d＜1.5cm) of stomach.It deserves being widespread.

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THE EFFECT OF ENDOSCOPE ON THE TREATMENT OF HEPATOCELLULLAR CARCINOMA COMBINED WITH BILLIARY TRACT OBSTRUCTION

Ping XUE ; De CHEN ; Yezi HU ; Hiwu LU ; Duan ZHAN ; Qiaoqun YIN

China Journal of Endoscopy.2001;7(1):22-23.

Objective:To study the effect of endoscope on the treatment of Hepatocellular Carcinoma (HCC) combined with biliary tract obstrucition (BTO).Methods:We have analyzed retrospectively the results of twelve patients suffering from HCC combined with BTO from 5,1990 to 5,2000.Among these cases,various reasons were found.5 of them were intrabilitary cancer embolus,7 were billary calculus.7 of them were treated with endoscope and following surgical resection,1 was treated with endoscope、TAE and resection,the 3 rest of them were solely treated with endoscope.Results:Of all the 12 cases,1 died of resection,2 failed to follow the survey,these 3 cases above took 25%;among the rest of 9 cases,2 of them survived for 3 to 6 months,3 for half to 1 year,3 for 1 to 2 year,1 for at least 2 years.Those cases suviving for more than 1 year were received surgical resection.Conclusions:We should have no fixed way but to deal with each patient of HCC combined with BTO on his/her merits.As our recognition towards them began accumulating,we found that,in the early stage of obstruction,active endoscopic treatment would prove to be preferable.If combined with other therapy such as surgical resection and TAE,Endoscopy would improve the curative effect of HCC combined with BTO substantially.

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THE INVESTIGATION OF THE ANESTHETIZATION OF FOREIGN BODY EXTRACTION IN RESPIRATORY TRACT OF INFANTS

Zhenghua HE ; Shuwen ZHOU ; Xiying ZHANG

China Journal of Endoscopy.2001;7(1):20-21.

Objective:To investigate the methods of the anesthetization of the foreign body extraction in respiratory tract of infants.Methods:This clinical study compared two anesthetic methods in foreign body extraction of respiratory tract of infants:Ketamine+Sodium r-hydroxybutyrate intravenous (group A) and Ketamine+propofol intravenous (group B) and analyzed the advantages and disadvantages of both methods.Results:Compared with group B,the extent of the changes of heart rate and blood oxygen saturation in patients of group A is littler,and the incidence rate of breath holding and asphyxiation is littler too.Conclusions:The anesthetic effect of Ketamine+Sodium r-hydroxybutyrate intravenous in better than that of Ketmaine+propcfol intravenous.

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THE EXPRESSION OF CYCLIND1 AND P21WAF1 IN COLORECTAL CARCINOMA

Xiaohong LU ; Zhixiang SENN ; Jieping YU

China Journal of Endoscopy.2001;7(1):15-16.

Objective:To investigate expression of cyclinD1 and p21WAF1 and their relationship with multistage process of colon carcinogenesis.Methods:Immunohistochemical staining was performed with SP assay on archival materials from 40 colorectal carcinomas,28 colorectal adenomas,and 14 normal mucosa,cyclinD1 and p21WAF1 expression were compared.Results:The positive staining rate for cyclinD1 in colorectal adenomas and carcinomas is 92.9% and 67.5% respectively,which are both higher than that in the normal mucosa (35.7%) (Padenoma＜0.01，Pcarcinoma＜0.05) and the expression of cyclinD1 is not correlate with differentiation and lymph node metastasis of colorectal carcinoma.The positive stainimg rate for p21WAF1 in normal mucosa (92.9%) is higher than that in colorectal carcinoma(37.5%) (P＜0.01) and the expression of p21WAF1 is correlate with differentiation and lymph node metastasis of colorectal carcinonma.Conclusions:The aberrant expression of cyclinD1 and p21WAF1 is a common event during multistage process of colon carcinogenesis.

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