| 1 | Surgical treatment for Nevin stage IV and V gallbladder carcinoma: report of 70 cases显示文摘BACKGROUND: The role of aggressive surgery for end-stage gallbladder carcinoma is controversial. This retrospective study was designed to evaluate the outcome of surgical treatment for Nevin stage Ⅳ and Ⅴ gallbladder carcinoma at a single institution. METHODS: A retrospective analysis was made on 70 patients with Nevin stage Ⅳ and Ⅴ gallbladder carcinoma undergoing surgical treatment from January 1993 to June 2004. RESULTS: There were 22 cases of stage Ⅳ and 48 of stage V. Cholecystectomy was performed in 37 cases with a resection rate of 53%,9 cases received radical resection, 13 extended radical resection, and 15 palliative resection. The curative resection rate was 31% and the morbidity rate was 36%. Postoperative 1-, 3-, 5-year survival rates of curative and palliative resection were 69%, 33%, 8% and 27%, 13%, 0, respectⅣely (P <0.01). The 1- and 3-year survival rates of patients undergoing exploratory laparotomy only were 3% and 0, respectively. CONCLUSIONS: Nevin stage Ⅳ and Ⅴ gallbladder carcinoma should be treated by aggressive surgery. Curative resection is promising in the improvement of long-term survⅣal rate. | Wei-Dong Xiao,Cheng-Hong Peng,Guang-Wen Zhou,Wei-Ding Wu, Bo-Yong Shen, Ji-Qi Yan,Wei-Ping Yang and Hong-Wei Li Department of Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China First author’s present address: Deparment of General Surgery, the First Affiliated Hospital, Nanchang University, Nanchang 330006, China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，4： | 5 |
| 2 | Pancreatic fistula after central pancreatectomy: case series and review of the literature显示文摘BACKGROUND: Postoperative pancreatic fistula is one of the most common complications after pancreatectomy. This study aimed to assess the occurrence and severity of pancreatic fistula after central pancreatectomy.METHODS: The medical records of 13 patients who had undergone central pancreatectomy were retrospectively studied together with a literature review of studies including at least five cases of central pancreatectomy. Pancreatic fistula was defined and graded according to the recommendations of the International Study Group on Pancreatic Fistula (ISGPF).RESULTS: No death was observed in the 13 patients. Pancreatic fistula developed in 7 patients and was successfully treated nonoperatively. None of these patients required re-operation. A total of 40 studies involving 867 patients who underwent central pancreatectomy were reviewed. The overall pancreatic fistula rate of the patients was 33.4% (0-100%). Of 279 patients, 250(89.6%) had grade A or B fistulae of ISGPF and were treated nonoperatively, and the remaining 29 (10.4%) had grade C fistulae of ISGPF. In 194 patients, 15 (7.7%) were re-operated upon. Only one patient with grade C fistula of ISGPF died from multiple organ failure after re-operation.CONCLUSION: Despite the relatively high occurrence, most pancreatic fistulae after central pancreatectomy are recognized a grade A or B fistula of ISGPF, which can be treated conservatively or by mini-invasive approaches. | Yan-Ming Zhou Xiao-Feng Zhang Lu-Peng Wu Xu Su Bin Li Le-Hua Shi | 2014 | Hepatobiliary & Pancreatic Diseases International2014，13，2： | 3 |
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