Background: s/Aims: Pancreaticoduodenectomy (PD) is the only radical treatment for periampullary malignancies. Superior mesenteric artery (SMA) first approach combined with total meso-pancreas (MP) excision was conducted to improve the oncological results.There has not been any previous research of a technique that combines the SMA first approach and total MP excision with a detailed description of the MP macroscopical shape. Methods: We prospectively assessed 77 patients with periampullary malignancies between October 2020 and March 2022 (18 months). All patients had undergone PD with SMA first approach combined total MP excision. The perioperative indications, clinical data, intra-operative index, R0 resection rate of postoperative pathological specimens (especially mesopancreatic margin), postoperative complications, and follow-up results were evaluated. Results: The median operative time was 289.6 min (178−540 min), the median intraoperative blood loss was 209 mL (30−1,600 mL).Microscopically, there were 19 (24.7%) cases with metastatic MP, and five cases (6.5%) with R1-resection of the MP. The number of lymph nodes (LNs) harvested and metastatic LNs were 27.2 (maximum was 74) and 1.8 (maximum was 16), respectively. Some (46.8%) patients had pancreatic fistula, but mostly in grade A, with 7 patients (9.1%) who required re-operations. Some 18.2% of cases developed postoperative refractory diarrhea. The rate of in-hospital mortality was 1.3%. Conclusions The PD with SMA first approach combined TMpE for periampullary malignancies was effective in achieving superior oncological statistics (rate of MP R0-resection and number of total resected LNs) with non-inferior short-term outcomes. It is necessary to evaluate survival outcomes with long-term follow-up.

Background: s/Aims: Parenchymal-sparing anatomical hepatectomy (Ps–AH) based on portal ramification of the right anterior section (RAS) is a new technique to avoid unnecessarily transecting too much liver parenchyma, especially in cases of major anatomical hepatectomy. Methods: We prospectively assessed 26 patients with primary hepatic malignancies having undergone major Ps–AH based on portal ramification of the RAS from August 2018 to August 2022 (48 months). The perioperative indications, clinical data, intra-operative index, pathological postoperative specimens, postoperative complications, and follow-up results were retrospectively evaluated. Results: Among the 26 patients analyzed, there was just one case that had intrahepatic cholangiocarcinoma The preoperative level of α– Fetoprotein was 25.2 ng/mL. All cases (100%) had Child–Pugh A liver function preoperatively. The ventral/dorsal RAS was preserved in 19 and 7 patients, respectively. The mean surgical margin was 6.2 mm. The mean surgical time was 228.5 minutes, while the mean blood loss was 255 mL. In pathology, 5 cases (19.2%) had microvascular invasion, and in the group of HCC patients, 92% of all cases had moderate or poor tumor differentiation. Six cases (23.1%) of postoperative complications were graded over III according to the Clavien–Dindo system, including in three patients resistant ascites or intra-abdominal abscess that required intervention. Conclusions Parenchymal-sparing anatomical hepatectomy based on portal ramification of the RAS to achieve R0-resection was safe and effective, with favorable short-term outcomes. This technique can be used widely in clinical practice.

Background: According to WHO, there are 5 million deaths from kinds of injury a year in the world, of which 875000 deaths occur in children under 18 years old. Injury leads to 40000 deaths which account for 10.7% deaths due to all other causes a year in VietNam. Objective: To show conclusions of the situation of child injury, recommendations for prevention of child injury and methods in order to enhance emergency activity in Vietnam. Subjects and method: The authors collected information about all patients who had emergencies due to injury at Viet Duc hospital, from March 26th 2006 to Octorber 26th 2006. However, supervised cases were the patients under 18 years old who were examined and treated at the Department of Emergency. Results: During the period of study, 2536 patients under 18 years old were examined for injury, of which death and coming back home for death were 83 cases (3.27%). 974 children had emergency resulted from injury: male was more than female: 697 verus 227. The leading causes of child injury were fall and traffic accident, respetively 34% and 60%. The most common traumas were traumatic brain injury (45%), limbs injury (41%). Although most of cases had first aid at the hospitals in district or province level, the rate of non-first aid cases was high (34%). Conclusion: Child injury is a leading cause of child death in hospitals. Methods for prevention of child injury should focus on educating and propagandizing to minimize injuries caused by traffic accident and fall.
Wounds and Injuries ; Child

Over the years many approaches have been used in communication for behavioral changes in nutrition. The overall aim of this study was to provide practical insights into how participatory, audience-centered communication activities can be effectively used for imparting information and for behavioral change promotion on the topic of dietary diversity and micronutrient nutrition, among reproductive-age women in Vietnam. The communication initiatives for improving nutrition knowledge and practices of the women in two selected communes (Dongky and Donglac) in Bacgiang province were carried out from January, 2003 to December, 2005. The Dongky commune was selected as the intervention commune, while the Donglac commune served as the control. In the intervention commune of Dongky the problems and strategies of nutrition communication and education were defined, IEC materials and some seeds of iron-rich vegetables and fruits were provided. Besides that, a contest on nutrition knowledge at a primary school and a competition between nutrition collaborators were held. The results of the study showed that food consumption of the women in both communes improved compared to levels at the baseline survey, especially in the intervention commune. The total knowledge scores and the nutrition practices of the women in the Dongky commune significantly improved compared to the data at baseline and were higher compared to that of the control commune.
commune ; Nutritional status ; Human Females ; Communication ; seconds

Retrospective study 34,590 trauma patients at Emergency department in Viet Duc Hospital in 2004 with traffic accident: 20,184, occupational accident 2536 and other accident: 11,870 cases. Result: Patient needs emergency operation - (scheduled operations and minor operations were excluded): 6469 cases (12%), trauma: 4299 case (66%), pathology: 2170 cases (34%). Among 4299 cases with emergency operation, traffic accident is cause of 2586 cases (transfer back home: 870, death: 243; 60%); life accident: 1086 cases (transfer back home: 86, death: 30; 25 %), occupational accident: 627 (transfer back home: 75, death: 27;15%). Emergency operation rate due to pathology is 4 time less than traffic accident. Operation on gastro abdomen :1105 case (51%), liver 479 (22%,) and followed by disease of urinary, cardiology and chest, brain and less on disease on muscle, born thrititis: 3%.
Surgery ; Emergencies ; Epidemiology

A retrospective study on 14 patients with diagnosis and treatment of peritonitis in Viet Duc hospital from January /2000 to December/2004. Results: Most of them have unpredictable reason of intestinal perforation. There are three groups of reason after operation: break of small intestinal cancer (leiomyosarcoma, maglinant lymphoma), tuberculosis and inflammation without specific cause. Most cases were treated appropriately with peritonitis: stitches the holes, cut the intestinal section in abdomen...however cultivate bacterium for antibiogram and it doesn’t carry out systematic, the diseases after operation due to tuberculosis haven’t treated as the standard outline. The fatality rate: 2/14 is acceptable due to both 2 patients with small intestinal cancer in weakened situation.
Peritonitis ; Intestinal Perforation ; Diagnosis ; Therapeutics

Study on 4 cases of malignant tumor of Vater’s ampulla operated at Viet-Duc Hospital and 1 case treated at University of Medicine and Pharmacy at Ho Chi Minh City between August 2003 and December 2004. Results: clinical sign is biliary obstruction jaundice. Gastroduodenoscopy with flexible tube found that papilla of Vater with the diameter lower than 3cm (histological finding: carcinomas), without metastasis to adjacent duodenum. Tumor invasion into head of pancreas and the lower of choledochous duct was determined by pancreatic and liver ultrasound, CT scanner or MRI examinations, in combination with intraoperative balance, immediate biopsy of lymph nodes in group 14 and group 8, sections of bile duct, pancreatic duct and duodenum in order to ensure the elimination of surgery. Initial outcomes showed that there wasn’t post-operative complication or death.
Ampulla of Vater ; Duodenum ; Therapeutics ; Surgery

A retrospective study was performed on 13 patients with spontaneous bacterial peritonitis at Viet Duc Hospital between Jan 2000 and Dec 2004. Results: Most patients with spontaneous bacterial peritonitis were diagnosed as appendix peritonitis. The rate of spontaneous bacterial peritonitis in cirrhosis patients were highest (53.8%); unknown cause 30.8%, lupus erythematosus 7.7%; 3/13 cases did not have intraoperative bacteria culture , among 7 cases had the culture results positive with gastrointestinal bacteria, E.Coli accounted for 6/7. Postoperative results: mortality rate was high (46.1%), especially in cirrhosis patients.
Peritonitis ; Diagnosis ; Therapeutics

The prospective study was conducted in 5 cases (4 males, 1 female; aged from 8 months to 76 years old) with peritonitis induced by surgery perforation of Meckel’s diverticulum at Viet Duc Hospital from January 2000 to December 2004. Clinical symptoms included abdominal pain, fever, vomiting, infection syndrome, peritoneal induction, abdominal cramp. Preoperative diagnosis: appendicitis’ peritonitis in 3 patients; appendicitis’ peritonitis induced by perforation of stomach 1 patient; peritonitis due to left bubonocele 1 patient. Results: there were 3 patients had Meckel’s diverticulum removed; 2 patients had appendix removed plus; 3 patients with anatopathology tests. There was no patients had events during surgery and postoperative complication, all 5 patients completely recovered and discharged.
Peritonitis ; Diagnosis ; Therapeutics

12 patients with internal or surgery hemorrhoids at level 3, level 4 underwent Longo surgery at Viet Duc Hospital and Health Center of Dong Anh district from July to October 2005. The author reviewed indication, technique and primary results of Longo surgery on hemorrhoids treatment. Indication of Longo surgery: almost cases of internal and surgery hemorrhoids at level 3 or 4 underwent scheduled surgery, some cases underwent emergency surgery due to haemorrhoids prolapsed, thrombosis. It maybe difficult to place sonde to enlarge the anus; or combined operation can be done together with Longo surgery. The primarily results of the treatment were good; the patients had low pain, shorten hospitalization, without bleeding or incontinence diarrhea
Hemorrhoids ; Therapeutics ; Surgery