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| 1 | An analysis of 680 cases of cholangiocarcinoma from 8 hospitals显示文摘BACKGROUND: The outcome of patients with cholangio-carcinoma is poor. To evaluate the experience in the diagnosis and surgical treatment of cholangiocarcinoma, we investigated the status quo of diagnosis and treatment of cholangiocarcinoma in China. METHOD: The clinical data of 680 patients with cholangiocarcinoma treated at 8 hospitals from 1995 to 2001 were retrospectively analyzed with SPSS software package. RESULTS: The incidence of the tumor was the highest in the age group of 60-65 years. Meanwhile,the incidence was higher in aged men than in aged women, with a male to female ratio of 1.39:1. Proximal cholangiocarcinoma was the commonest ( 41.6% ) and distant cholangiocarcinoma the second(28.7% ) in the 680 patients. B-mode ultrasonogra-phy for cholangiocarcinoma was performed in 80.3% of the patients. Non-traumatic examinations such as computed tomography (CT), magnetic resonance image (MRI) and magnetic resonance cholangiopancreatography ( MRCP ) were more widely used than that of traumatic examinations such as percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography ( ER-CP). The low- and middle-differentiation cancer of the proximal bile duct accounted for about 50%. Most of the patients suffered from late-stage cholangiocarcinoma. The resection rate of the tumor was low, and the rate of radical operation was only 21.6% (147/680). CONCLUSIONS: Cholangiocarcinoma is common in the aged men. Its diagnosis and treatment have been improved, but little. Most patients are diagnosed as having late-stage cholangiocarcinoma at the time of outpatient clinic, and the rate of radical operation is low. Thereforce, it is necessary to reinforce the early diagnosis and treatment of cholangiocarcinoma to improve the outcome after operation. | Xiao-Fang Liu, Xian-Ting Zhou and Sheng-Quan Zou Department of Hepatobiliary Surgery, Affiliated Yantai Yuhuangding Hospital, Qingdao University Medical College, Yantai 264000, China and Department of General Surgery, Tongji Medical Hospital, Wuhan 430000, China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，4： | 12 |
| 2 | Prevention and management of pleural effusion following hepatectomy in primary liver cancer显示文摘Postoperative pleural effusion occurs frequently after hepatectomy. The risk factors, prevention and management of postoperative pleural effusion in patients with primary liver cancer (PLC) who have undergone hepatectomy and the value of the argon beam coagulator (ABC) for the prevention of pleural effusion are studied. METHODS:A total of 523 patients with PLC at our institution who had had right hepatectomy from July 2000 to June 2004 were studied retrospectively. Comparative analysis was made to identify the factors contributing to postoperative pleural effusion and the efficacy of various managements. RESULTS:Of the 523 patients whose livers were dissociated using argon beam cutting and/or coagulation, 20(3.8%) developed pleural effusions;whereas in the other 467 patients underwent hepatectomy with suture ligation of the diaphragmatic secondary wound surface during the same period, 49(10.5%) had pleural effusion (P<0.01). The factors contributing to postoperative pleural effusion included subphrenic collection, postoperative hepatic insufficiency with ascites, duration of hepatic occlusion and underlying cirrhosis. CONCLUSIONS: Dissociation of the liver by argon beam cutting and/or coagulation can save suture ligation of the diaphragmatic secondary wound surface and may also prevent postoperative pleural effusion. Pleural drainage using an indwelling central-venous-catheter (CVC) in the pleural cavity is safe and efficacious. | Jian-Jun Yan, Xiang-Hua Zhang, Kai-Jian Chu, Liang Huang, Fei-Guo Zhou and Yi-Qun Yan Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，3： | 5 |
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