Objective:To evaluate the safety and feasibility of double-port laparoscopic cholecystectomy (LC) combined with transcystic common bile duct (CBD) exploration using ultrafine choledochoscopy on patients with gallbladder stones and common bile duct stones.Methods:Clinical data of 35 patients undergoing double-port LC combined with transcystic CBD exploration using ultrafine choledochoscopy in Anhui No.2 Provincial People’s Hospital from December 2021 to June 2024 were retrospectively analyzed, including 8 males and 27 females, aged (45.8±18.1) years. In all patients, the diameter of the gallbladder duct was greater than 3 mm, the maximum diameter of the stones was less than 10 mm, and the number of stones was less than 5, and the gallbladder ducts were normal. Magnetic resonance cholangiopancreatography (MRCP) was used to measure the diameter of CBD, the number and the maximum diameter of stones. The operative time, intraoperative blood loss, postoperative anal exhaust time, postoperative hospital stay and complications (including abdominal infection, biliary tract infection, bile leakage, bleeding, etc.) of all patients were analyzed. The incidence of bile duct stenosis, residual stone or stone recurrence were followed up by telephone or outpatient review.Results:MRCP measurement indicated that the common bile duct diameter of patients was (8.1±1.3) mm. Single CBD stone occurred in 27 cases (77.1%, 27/35), and the mean maximum diameter of CBD stones was (3.9±1.3) mm. All patients successfully underwent the procedure. The operative time was (80.1±10.9) min, the intraoperative blood loss was (25.5±10.2) ml, the recovery time of postoperative anal exhaust was (17.3±4.7) h, and the postoperative hospital stay was (2.5±0.6) d. There were no complications such as abdominal and biliary tract infection, bile leakage and bleeding. All patients were followed up for 1-30 months, with a median follow-up time of 12 months. No biliary stricture, residual stones or recurrence occured during the follow-ups.Conclusion:In selected cases, double-port LC combined with transcystic CBD exploration using ultrafine choledochoscopy could be safe and feasible, with less trauma, quick recovery and short operative time.

Objective:To evaluate the safety and feasibility of double-port laparoscopic cholecystectomy (LC) combined with transcystic common bile duct (CBD) exploration using ultrafine choledochoscopy on patients with gallbladder stones and common bile duct stones.Methods:Clinical data of 35 patients undergoing double-port LC combined with transcystic CBD exploration using ultrafine choledochoscopy in Anhui No.2 Provincial People’s Hospital from December 2021 to June 2024 were retrospectively analyzed, including 8 males and 27 females, aged (45.8±18.1) years. In all patients, the diameter of the gallbladder duct was greater than 3 mm, the maximum diameter of the stones was less than 10 mm, and the number of stones was less than 5, and the gallbladder ducts were normal. Magnetic resonance cholangiopancreatography (MRCP) was used to measure the diameter of CBD, the number and the maximum diameter of stones. The operative time, intraoperative blood loss, postoperative anal exhaust time, postoperative hospital stay and complications (including abdominal infection, biliary tract infection, bile leakage, bleeding, etc.) of all patients were analyzed. The incidence of bile duct stenosis, residual stone or stone recurrence were followed up by telephone or outpatient review.Results:MRCP measurement indicated that the common bile duct diameter of patients was (8.1±1.3) mm. Single CBD stone occurred in 27 cases (77.1%, 27/35), and the mean maximum diameter of CBD stones was (3.9±1.3) mm. All patients successfully underwent the procedure. The operative time was (80.1±10.9) min, the intraoperative blood loss was (25.5±10.2) ml, the recovery time of postoperative anal exhaust was (17.3±4.7) h, and the postoperative hospital stay was (2.5±0.6) d. There were no complications such as abdominal and biliary tract infection, bile leakage and bleeding. All patients were followed up for 1-30 months, with a median follow-up time of 12 months. No biliary stricture, residual stones or recurrence occured during the follow-ups.Conclusion:In selected cases, double-port LC combined with transcystic CBD exploration using ultrafine choledochoscopy could be safe and feasible, with less trauma, quick recovery and short operative time.

Objective:To explore the safety of laparoscopic antegrade modular pancreatosplenectomy (L-RAMPS) through vascular axis approach in the treatment of pancreatic body and tail adenocarcinoma.Methods:The clinical data of 12 patients with pancreatic body and tail adenocarcinoma undergoing L-RAMPS in Department of Hepatobiliary Pancreatic Surgery, Anhui No.2 Provincial People's Hospital from April 2021 to December 2022 were retrospectively analyzed, including eight males and four females, aged (65.8±11.6) years. Data regarding operative time, intraoperative blood loss, anal exhaust time, postoperative hospital stay, lymph node dissection, pathology, and postoperative complications, and survival were analyzed.Results:The procedures were successfully completed in all 12 patients. Eight patients underwent anterior L-RAMPS, four underwent posterior L-RAMPS. In one patient laparoscopic procedure was almost completed, but eventually conversed to open surgery due to vascular invasion. The operative time was (221.5±21.7) min, the intraoperative blood loss was (224.1±125.3) ml, the anal exhaust time was (3.5±1.0) d, and the postoperative hospital stay was (10.0±3.9) d. All patients underwent R 0 resection, and (15.1±3.7) lymph nodes were dissected. Positive lymph nodes were confirmed in four patients. Six patients had postoperative pancreatic fistula. The patients had been followed up for a median time of 9.5 (3.2-15.0) months, and three patients died. Conclusion:The vascular axis approach could optimize the L-RAMPS surgical approach and improve surgical safety.

Objective: To explore the efficacy of 125I particle bile duct intraluminal and intratumoral implantation for treatment of unresectable pancreatic head carcinoma (PHC). Methods: Clinical data of 72 patients with unresectable PHC were analyzed retrospectively. Among them 37 patients were treated with 125I particle bile duct intraluminal and intratumoral implantation (125I group), and 35 cases underwent laparoscopic palliative surgery (PS group). The postoperative liver function, complications, medial survival time and survival rate at the end of follow-up were compared between the two groups. Results: The levels of serum total bilirubin, alanine aminotransferase and aspartate aminotransferase significantly decreased compared with those of preoperation, the level of serum albumin significantly decreased at 1, 3 and 6 months of postoperation in both groups, especially in 125I group at 3 and 6 months of postoperation (all P<0.05). The incidence of postoperative complications was 28.57% (10/35) in PS group and 21.62% (8/37) in 125I group, and there was no significant difference between the two groups (P=0.496). The medial survival time was 9 months in PS group and 11 months in 125I group (P=0.041). Conclusion: 125I particle bile duct intraluminal and intratumoral implantation can effectively alleviate symptoms of bile duct obstruction and prolong survival time of PHC patients.

Objective:To investigate the effects of paeonol on aortic nuclear factor-kappaB ( NF-κB) activity and blood lipid levels in the rats with atherosclerosis ( AS) . Methods:The AS rat model was established by administration of high-fat diet and vitamin D3 ( i. p. ). The rats were divided into 5 groups (n=8) randomly, namely the normal group, model group, positive control group(simvasta-tin, 10 mg·kg-1 ) and paeonol groups with the dose of 20 and 10 mg·kg-1 , respectively. After the 4-week treatment, the serum of rats was collected to determine the lipid levels. The aortic pathologic changes of AS rats were observed under a microscope, and then graded, and aortic NF-κB activity was detected by an immunohistochemistry method. Results:Administration of paeonol improved the severity of aortic pathology in AS rats. The pathologic grade in the paeonol group (20 mg·kg-1 ) showed a significant difference com-pared with that in the model group (P<0. 05). Paeonol (20 and 10 mg·kg-1) markedly decreased the TG, TC and LDL-C levels in the serum of AS rats (P<0. 05 or P<0. 01). Meanwhile, paeonol significantly inhibited the aortic NF-κB activity(IOD value) with (1. 96 ± 0. 55) and (2. 50 ± 0. 80) in 20 and 10 mg·kg-1 group, respectively, which showed significant differences compared with that in the model group (P<0. 05 or P<0. 01). Conclusion:Paeonol shows certain therapeutic effect in AS rats, and the mechanisms may be related with the regulation of lipid mobilization and the inhibition of aortic NF-κB activity.