ObjectiveTo investigate the feasibility and safety of endoscopic retrograde cholangiopancreatography （ERCP） combined with oral cholangiopancreatography in the treatment of major duodenal papilla gallbladder polyps. MethodsA retrospective analysis was performed for the clinical data of eight patients with choledocholithiasis and gallbladder polyps who underwent ERCP and combined with oral cholangiopancreatography for major duodenal papilla cholecystectomy in Center of Digestive Endoscopy， Jilin People’s Hospital， from May 2022 to June 2024， and related data were collected， including the success rate of surgery， the technical success rate of gallbladder polyp removal， the superselective method of cystic duct， the time of operation， the time of gallbladder polyp removal， and surgical complications. ResultsBoth the success rate of surgery and the technical success rate of gallbladder polyp removal reached 100%， and of all eight patients， three patients used guide wire to enter the gallbladder under direct view， while five patients received oral cholangiopancreatography to directly enter the gallbladder. The time of operation was 51.88±12.34 minutes， and the time of gallbladder polyp removal was 23.13±10.94 minutes. The diameter of gallbladder polyp was 2‍ ‍—‍ ‍8 mm， and pathological examination showed inflammatory polyps in three patients， adenomatous polyps in one patient， and cholesterol polyps in four patients. There were no complications during or after surgery. The patients were followed up for 2‍ ‍—‍ ‍27 months after surgery， and no recurrence of gallbladder polyp was observed. ConclusionOral cholangiopancreatography is technically safe and feasible in endoscopic major duodenal papilla cholecystectomy.

Objective:To evaluate the feasibility and safety of endoscopic retrograde cholangiopancreatography (ERCP) combined with peroral cholangioscopy in the treatment of gallbladder stones with common bile duct stones.Methods:Clinical data of 19 patients with gallbladder stones and common bile duct stones admitted to the Digestive Endoscopy Center, Jilin People’s Hospital from July 2019 to November 2024 were retrospectively analyzed, including 13 males and 6 females, aged (68.2±14.2) years. All patients underwent ERCP combined with peroral cholangioscopy. Perioperative data, including the long diameter of the common bile duct stone, the long diameter of the gallbladder stone, the number of stones, ERCP operative time, gallbladder stone extraction time, stone clearance status, hospitalization duration, and complications, were recorded. Postoperative follow-up was conducted through outpatient visits or telephone consultations to monitor recurrence.Results:The long diameter of the common bile duct stones was (9.55±2.86) mm, and the long diameter of the gallbladder stones was 4.0(3.0, 5.5) mm. Among the 19 patients, 5 had single gallbladder stones, and 14 had multiple stones. The ERCP operative time was (49.0±18.4) min, and the gallbladder stone extraction time was (25.0±11.7) min. The methods used for handling the gallbladder neck were as follows: two cases involved stone removal after 6 mm balloon dilation; six cases involved stone removal after metal stent placement; three cases involved the placement of a plastic stent in the gallbladder for three months, followed by stone extraction using ERCP combined with peroral cholangioscopy; eight cases were treated directly for stone removal without specific procedures. Among the 19 patients, 11 completed stone removal within one treatment, while eight required a second treatment. All patients had complete clearance of both common bile duct and gallbladder stones under direct peroral cholangioscopy. No severe complications occurred postoperatively, although two cases developed post-ERCP pancreatitis. The postoperative hospitalization time was 8.0 (6.0, 10.0) d. The follow-up duration for the 19 patients was 14.0 (8.5, 20.0) months. One patient had a recurrence of gallbladder stones 12 months postoperatively, while no other patients had recurrence at the final follow-up.Conclusion:ERCP combined with peroral cholangioscopy is a safe and feasible approach for treating gallbladder stones with common bile duct stones.

On the 110th anniversary of the founding of the Chinese Medical Association, I would like to extend my warmest congratulations and high respect. During the past 110 years, the Chinese Medical Association has protected the health of the people in the years of war, and promoted the vigorous development of the medical cause in the new era. The Chinese Medical Association has always been brave in building the tide of medical development, prospering academia and benefiting the people. On this occasion, the author summarized the development process, practice and achievements of the Chinese College of Intraoperative Ultrasound in Hepatobiliary Surgery. Since its establishment, the Chinese College of Intraoperative Ultrasound in Hepatobiliary Surgery has always been committed to promoting the precise and intelligent development of hepatobiliary surgery. It has been constantly deepening its efforts in academic research, technological innovation, personnel training and other aspects, and injecting continuous power into the vigorous deve-lopment of hepatobiliary surgery in China.

Objective To investigate the diagnostic and therapeutic value of single-use mother-baby choledochoscope-assisted endoscopic retrograde appendicitis therapy in the treatment of acute uncomplicated appendicitis.Methods A retrospective analysis was conducted on the clinical data of 39 patients with acute uncomplicated appendicitis who underwent single-use mother-baby choledochoscope-assisted endoscopic retrograde appendicitis treatment at the Endoscopy center of the hospital from September 2022 to September 2024.Observe the endoscopic manifestations,the rate of maternal and child basket stone removal,the rate of appendiceal stent implantation,the technical success rate,the clinical success rate,the operation time,the hospital stay,the incidence of complications,the visual analogue scale(VAS)score 6 hours after the operation,and the inflammatory indicators 24 hours after the operation.Results In 28 cases(71.8%),congestion and edema could be seen at the opening of the appendix under colonoscopy.In 10 cases(25.6%),pus could be seen flowing out of the opening of the appendix under colonoscopy.In 32 cases(82.1%),a large amount of pus could be seen in the lumen of the appendix under subscopy.In 20 cases(51.3%),appendiceal fecalith could be seen in the lumen of the appendix under subscopy.The technical success rate of single-use mother-baby choledochoscope-assisted endoscopic retrograde appendicitis treatment was 100.0%(39/39).The operation time was(21.08±7.49)min;Hospital stay:(3.97±2.08)days;Eight cases(20.5%)of patients underwent endoscopic maternal basket stone removal.Appendiceal stent implantation was performed in 14 cases(35.9%)of patients.The clinical success rate is 97.4%(38/39).One patient's clinical symptoms and inflammatory indicators did not improve after the operation,and was transferred to the surgery department for appendectomy.The VAS score of 38 patients was less than 3 points 6 hours after the operation,and the abdominal pain symptoms were significantly relieved.The white blood cell count and the percentage of neutrophils 24 hours after the operation decreased significantly compared with those before the operation,and the differences were statistically significant(P<0.05).None of the 39 patients had complications.The postoperative follow-up was(5.94±4.03)months,and recurrence occurred in 3 cases(7.7%).Conclusion single-use mother-baby choledocoscope-assisted endoscopic retrograde appendicitis therapy is safe and effective in the diagnosis and treatment of acute uncomplicated appendicitis,which is worthy of further promotion and popularization in clinical practice.

Objective:To evaluate the feasibility and safety of endoscopic retrograde cholangiopancreatography (ERCP) combined with peroral cholangioscopy in the treatment of gallbladder stones with common bile duct stones.Methods:Clinical data of 19 patients with gallbladder stones and common bile duct stones admitted to the Digestive Endoscopy Center, Jilin People’s Hospital from July 2019 to November 2024 were retrospectively analyzed, including 13 males and 6 females, aged (68.2±14.2) years. All patients underwent ERCP combined with peroral cholangioscopy. Perioperative data, including the long diameter of the common bile duct stone, the long diameter of the gallbladder stone, the number of stones, ERCP operative time, gallbladder stone extraction time, stone clearance status, hospitalization duration, and complications, were recorded. Postoperative follow-up was conducted through outpatient visits or telephone consultations to monitor recurrence.Results:The long diameter of the common bile duct stones was (9.55±2.86) mm, and the long diameter of the gallbladder stones was 4.0(3.0, 5.5) mm. Among the 19 patients, 5 had single gallbladder stones, and 14 had multiple stones. The ERCP operative time was (49.0±18.4) min, and the gallbladder stone extraction time was (25.0±11.7) min. The methods used for handling the gallbladder neck were as follows: two cases involved stone removal after 6 mm balloon dilation; six cases involved stone removal after metal stent placement; three cases involved the placement of a plastic stent in the gallbladder for three months, followed by stone extraction using ERCP combined with peroral cholangioscopy; eight cases were treated directly for stone removal without specific procedures. Among the 19 patients, 11 completed stone removal within one treatment, while eight required a second treatment. All patients had complete clearance of both common bile duct and gallbladder stones under direct peroral cholangioscopy. No severe complications occurred postoperatively, although two cases developed post-ERCP pancreatitis. The postoperative hospitalization time was 8.0 (6.0, 10.0) d. The follow-up duration for the 19 patients was 14.0 (8.5, 20.0) months. One patient had a recurrence of gallbladder stones 12 months postoperatively, while no other patients had recurrence at the final follow-up.Conclusion:ERCP combined with peroral cholangioscopy is a safe and feasible approach for treating gallbladder stones with common bile duct stones.

On the 110th anniversary of the founding of the Chinese Medical Association, I would like to extend my warmest congratulations and high respect. During the past 110 years, the Chinese Medical Association has protected the health of the people in the years of war, and promoted the vigorous development of the medical cause in the new era. The Chinese Medical Association has always been brave in building the tide of medical development, prospering academia and benefiting the people. On this occasion, the author summarized the development process, practice and achievements of the Chinese College of Intraoperative Ultrasound in Hepatobiliary Surgery. Since its establishment, the Chinese College of Intraoperative Ultrasound in Hepatobiliary Surgery has always been committed to promoting the precise and intelligent development of hepatobiliary surgery. It has been constantly deepening its efforts in academic research, technological innovation, personnel training and other aspects, and injecting continuous power into the vigorous deve-lopment of hepatobiliary surgery in China.

Objective To investigate the diagnostic and therapeutic value of single-use mother-baby choledochoscope-assisted endoscopic retrograde appendicitis therapy in the treatment of acute uncomplicated appendicitis.Methods A retrospective analysis was conducted on the clinical data of 39 patients with acute uncomplicated appendicitis who underwent single-use mother-baby choledochoscope-assisted endoscopic retrograde appendicitis treatment at the Endoscopy center of the hospital from September 2022 to September 2024.Observe the endoscopic manifestations,the rate of maternal and child basket stone removal,the rate of appendiceal stent implantation,the technical success rate,the clinical success rate,the operation time,the hospital stay,the incidence of complications,the visual analogue scale(VAS)score 6 hours after the operation,and the inflammatory indicators 24 hours after the operation.Results In 28 cases(71.8%),congestion and edema could be seen at the opening of the appendix under colonoscopy.In 10 cases(25.6%),pus could be seen flowing out of the opening of the appendix under colonoscopy.In 32 cases(82.1%),a large amount of pus could be seen in the lumen of the appendix under subscopy.In 20 cases(51.3%),appendiceal fecalith could be seen in the lumen of the appendix under subscopy.The technical success rate of single-use mother-baby choledochoscope-assisted endoscopic retrograde appendicitis treatment was 100.0%(39/39).The operation time was(21.08±7.49)min;Hospital stay:(3.97±2.08)days;Eight cases(20.5%)of patients underwent endoscopic maternal basket stone removal.Appendiceal stent implantation was performed in 14 cases(35.9%)of patients.The clinical success rate is 97.4%(38/39).One patient's clinical symptoms and inflammatory indicators did not improve after the operation,and was transferred to the surgery department for appendectomy.The VAS score of 38 patients was less than 3 points 6 hours after the operation,and the abdominal pain symptoms were significantly relieved.The white blood cell count and the percentage of neutrophils 24 hours after the operation decreased significantly compared with those before the operation,and the differences were statistically significant(P<0.05).None of the 39 patients had complications.The postoperative follow-up was(5.94±4.03)months,and recurrence occurred in 3 cases(7.7%).Conclusion single-use mother-baby choledocoscope-assisted endoscopic retrograde appendicitis therapy is safe and effective in the diagnosis and treatment of acute uncomplicated appendicitis,which is worthy of further promotion and popularization in clinical practice.

ObjectiveTo discuss the effects of Cistanches Herba phenylethanoid glycosides （CHPhGs） on the intestinal mucosal barrier and gut microbiota in alcoholic liver disease （ALD） mice were discussed. MethodThe 36 C57BL/6N female mice were randomly divided normal group， normal group of CHPhGs， model group， and low， medium， and high-dose groups （175， 350， 700 mg·kg^-1） of CHPhGs， with six mice in each group. The ALD mouse model was built using Lieber-Decarli alcohol liquid feed. The normal group and low， medium， and high-dose groups of CHPhGs were given CHPhGs by gavage daily. Serum aspartate aminotransferase aminotransferase （ALT）， alanine aminotransferase （AST）， triglycerides （TG）， and total cholesterol （TC） levels were detected by an automatic biochemical analyzer. Serum tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， lipopolysaccharide （LPS）， lipopolysaccharide-binding protein （LBP）， D-lactic acid （D-LA）， diamine oxidase （DAO）， and LBP of liver were detected by enzyme-linked immunosorbent assay （ELISA）. The levels of TG and TC in the liver were detected by colorimetry. Liver tissue was treated by oil red O and hematoxylin-eosin （HE） staining. The microstructure of jejunum epithelial cells was observed by electron microscope. Jejunum and colon were treated by HE staining and alcian blue-periodate-scheff (AB-PAS) staining staining， and mucin 2 （Muc2） was treated by immunohistochemistry. The intestinal contents of the normal group， normal group of CHPhGs， model group， and high-dose group of CHPhGs were collected and sequenced. ResultThe ALD model was established successfully. Compared with the normal group， the levels of serum ALT， AST， and TG， as well as the levels of liver TG and TC in the model group were significantly increased （P<0.05）. Histopathology showed that compared with the normal group， the liver cells in the model group showed obvious steatosis. Compared with the model group， the levels of serum TG and liver TG and TC in the low， medium， and high-dose groups of CHPhGs decreased significantly （P<0.05）. The serum ALT， AST， TNF-α， IL-1β， LPS， and LBP in the high-dose group of CHPhGs were also significantly decreased （P<0.05）. The number of liver cells with steatosis in the high-dose group of CHPhGs was significantly reduced， and the microvilli structure of jejunum epithelial cells was basically intact. The expression of Muc2 was reduced in the colon， and the gut microbiota of the high-dose group of CHPhGs changed significantly （P<0.05）. Compared with the normal group， the Allobaculum was significantly up-regulated in the model group （P<0.05）. Compared with the model group， the abundance of Akkermansia in the high-dose group of CHPhGs was significantly increased （P<0.01）. The abundance of Akkermansia was negatively correlated with that of Allobaculum （r=-0.701， P<0.01）. ConclusionCHPhGs can reduce the intestinal barrier injury caused by ALD， which may play a protective role by regulating the abundance and structure of Akkermansia and Allobaculum and affecting the homeostasis of intestinal mucus.

ObjectiveTo investigate the safety and efficacy of endoscopic retrograde cholangiopancreatography （ERCP） combined with electrohydraulic lithotripsy under the direct view of eyeMax biliary-pancreatic imaging system in the treatment of difficult choledocholithiasis. MethodsA retrospective analysis was performed for the clinical data of 12 patients with difficult choledocholithiasis who underwent ERCP and electrohydraulic lithotripsy under the direct view of eyeMax biliary-pancreatic imaging system in Department of Gastroenterology， Jilin People’s Hospital， from May to November 2022. The clinical effect of lithotripsy and lithotomy was observed， and postoperative complications and time of surgical operation were assessed. ResultsAmong the 12 patients， 11 （91.67%） were successfully treated by electrohydraulic lithotripsy under direct view， 9 （75.00%） achieved first-attempt success in lithotripsy， and 11 （91.67%） had complete removal of calculi； 1 patient was found to have stenosis of the bile ducts caused by multiple biliary tract surgeries， and grade Ⅱ intrahepatic bile duct stones above the sites of stenosis were removed under direct view， but there were still residues of grade Ⅲ intrahepatic bile duct stones， which led to the fact that complete calculus removal was not achieved. The mean time of ERCP operation was 91.3±26.2 minutes， including a time of 41.8±22.2 minutes for energy lithotripsy. There were 2 cases of postoperative biliary tract infection which were improved after anti-infective therapy， 2 cases of hyperamylasemia which were not given special treatment， and 3 cases of mild pancreatitis which were improved after symptomatic medication， and there were no complications such as bleeding and perforation. ConclusionERCP combined with electrohydraulic lithotripsy under the direct view of eyeMax biliary-pancreatic imaging system is safe， effective， and feasible in the treatment of difficult choledocholithiasis.

Objective:To investigate the clinical value of colonoscopy combined with mother-baby endoscopy in the diagnosis and treatment of simple appendicitis, and to summarize the technical points of non-guidewire-assisted appendiceal intubation.Methods:From January to October in 2023, the clinical data of 156 patients with simple appendicitis treated by colonoscopy combined with mother-baby endoscopy at Jilin People′s Hospital were retrospectively collected. The technical success rate, clinical success rate and the occurrence of adverse events of colonoscopy combined with mother-baby endoscopy were analyzed. Descriptive method was used for statistical analysis.Results:Among the 156 patients, 149 cases (95.5%) were treated with non-guidewire-assisted catheterization and 7 cases (4.5%) with guidewire-assisted catheterization. Under the 'baby’ endoscope, 126 cases (80.8%) showed congestion and edema in appendiceal cavity, 83 cases (53.2%) with fecal stones, 31 cases (19.9%) with purulent attachment, 3 cases (1.9%) with stenosis, and 1 case (0.6%) with appendiceal haemorrhage. All the 156 patients successfully completed the treatment of appendicitis with colonoscopy combined with mother-baby endoscopy, with a technical success rate of 98.7% (154/156) and a clinical success rate of 99.4% (155/156). There was no case changed to surgical treatment during the procedure, and 1 patient had an additional surgical procedure due to severe appendicitis and no obvious relief of abdominal pain. No complications (bleeding or perforation) occurred. The length of hospital stay was (3.77±1.89) d.Conclusion:Colonoscopy combined with mother-baby endoscopy is safe and feasible in the treatment of simple appendicitis.