Quality of life after pancreatic surgery

BACKGROUND Pancreatic surgery is challenging owing to the anatomical characteristics of the pancreas.Increasing attention has been paid to changes in quality of life(QOL)after pancreatic surgery.AIM To summarize and analyze current research results on QOL after pancreatic surgery.METHODS A systematic search of the literature available on PubMed and EMBASE was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Relevant studies were identified by screening the references of retrieved articles.Studies on patients’QOL after pancreatic surgery published after January 1,2012,were included.These included prospective and retrospective studies on patients'QOL after several types of pancreatic surgeries.The results of these primary studies were summarized inductively.RESULTS A total of 45 articles were included in the study,of which 13 were related to pancreaticoduodenectomy(PD),seven to duodenum-preserving pancreatic head resection(DPPHR),nine to distal pancreatectomy(DP),two to central pancre-atectomy(CP),and 14 to total pancreatectomy(TP).Some studies showed that 3-6 months were needed for QOL recovery after PD,whereas others showed that 6-12 months was more accurate.Although TP and PD had similar influences on QOL,patients needed longer to recover to preoperative or baseline levels after TP.The QOL was better after DPPHR than PD.However,the superiority of the QOL between patients who underwent CP and PD remains controversial.The decrease in exocrine and endocrine functions postoperatively was the main factor affecting the QOL.Minimally invasive surgery could improve patients’QOL in the early Core Tip:This review summarizes and analyzes current research results on quality of life(QOL)after pancreatic surgery.The article covers the discussion and analysis of the QOL of various pancreatic surgeries.Which kind of surgical procedure has better QOL is controversial.The long-term benefits on QOL of minimally invasive surgery over open surgery are contro-INTRODUCTION The pancreas,located in the retroperitoneum,is a glandular organ with endocrine and exocrine functions.It can be divided into four main parts:Head,neck,body,and tail.Pancreatic surgery can be divided into pancreaticoduoden-ectomy(PD),duodenum-preserving pancreatic head resection(DPPHR),distal pancreatectomy(DP),central pancre-atectomy(CP),and total pancreatectomy(TP).Pancreatic surgery is challenging due to the organ’s complex anatomical structure,peripheral vascularity,and intractable postoperative complications.Following the standardization of surgical steps and improvements in relevant medical techniques and surgical instruments,the safety of pancreatic surgery has significantly improved.Perioperative morbidity,mortality,and other related indicators have become more acceptable.However,owing to the organ’s essential role in digestion,absorption,and blood glucose regulation,changes in the quality of life(QOL)of patients after pancreatic surgery have attracted the attention of surgeons.More patients with non-malignant pancreatic diseases are willing to undergo surgical treatment because of the acceptable safety.In this case,from the perspective of the patient postoperatively,the significance of rehabilitation reflects the traditional perioperative outcome and QOL[1].The QOL is a new concept that extends beyond health.Although there is no consensus on its conception[2],we can consider it a multi-dimensional architecture that incorporates objective and individual subjective views of aspects of one’s physical,psychological,and social well-being[3-5].It includes evaluating physical health,and many subscales,such as emotion,job,culture,family,sociability,economy,cognition,happiness,sex,and some symptoms[6].Since people have realized the importance of QOL,many QOL scales have emerged,including the European Organization for Research and Treatment of Cancer QLQ-C30,European Quality of Life 5-dimension,36-item Short,etc.However,it is challenging to follow up on patients’QOL once they are discharged from the hospital.Consequently,most relevant studies had small sample sizes or lacked long-term follow-up results.Moreover,a summary of studies on QOL after pancreatic surgery is lacking.This study assessed the QOL in patients who underwent PD,DPPHR,DP,CP and TP.We conducted this study to describe the existing findings on the QOL after pancreatic surgery to make it easier for surgeons and patients to decide on a surgical approach.In addition,we attempted to identify controversial results to encourage further targeted research.

Formation,evolution,reconstruction of black shales and their influence on shale oil and gas resource

Black shales are important products of material cycling and energy exchange among the lithosphere,atmosphere,hydrosphere,and biosphere.They are widely distributed throughout geological history and provide essential energy and mineral resources for the development of human society.They also record the evolution process of the earth and improve the understanding of the earth.This review focuses on the diagenesis and formation mechanisms of black shales sedimentation,composition,evolution,and reconstruction,which have had a significant impact on the formation and enrichment of shale oil and gas.In terms of sedimentary environment,black shales can be classified into three types:Marine,terrestrial,and marine-terrestrial transitional facies.The formation processes include mechanisms such as eolian input,hypopycnal flow,gravity-driven and offshore bottom currents.From a geological perspective,the formation of black shales is often closely related to global or regional major geological events.The enrichment of organic matter is generally the result of the interaction and coupling of several factors such as primary productivity,water redox condition,and sedimentation rate.In terms of evolution,black shales have undergone diagenetic evolution of inorganic minerals,thermal evolution of organic matter and hydrocarbon generation,interactions between organic matter and inorganic minerals,and pore evolution.In terms of reconstruction,the effects of fold deformation,uplift and erosion,and fracturing have changed the stress state of black shale reservoirs,thereby having a significant impact on the pore structure.Fluid activity promotes the formation of veins,and have changed the material composition,stress structure,and reservoir properties of black shales.Regarding resource effects,the deposition of black shales is fundamental for shale oil and gas resources,the evolution of black shales promotes the shale oil and gas formation and storage,and the reconstruction of black shales would have caused the heterogeneous distribution of oil and gas in shales.Exploring the formation mechanisms and interactions of black shales at different scales is a key to in-depth research on shale formation and evolution,as well as the key to revealing the mechanism controlling shale oil and gas accumulation.The present records can reveal how these processes worked in geological history,and improve our understanding of the coupling mechanisms among regional geological events,black shales evolution,and shale oil and gas formation and enrichment.

Geological conditions and reservoir characteristics of various shales in major shalehosted regions of China

China is home to shales of three facies:Marine shale,continental shale,and marine-continental transitional shale.Different types of shale gas are associated with significantly different formation conditions and major controlling factors.This study compared the geological characteristics of various shales and analyzed the influences of different parameters on the formation and accumulation of shale gas.In general,shales in China’s several regions exhibit high total organic carbon(TOC)contents,which lays a sound material basis for shale gas generation.Marine strata generally show high degrees of thermal evolution.In contrast,continental shales manifest low degrees of thermal evolution,necessitating focusing on areas with relatively high degrees of thermal evolution in the process of shale gas surveys for these shales.The shales of the Wufeng and Silurian formations constitute the most favorable shale gas reservoirs since they exhibit the highest porosity among the three types of shales.These shales are followed by those in the Niutitang and Longtan formations.In contrast,the shales of the Doushantuo,Yanchang,and Qingshankou formations manifest low porosities.Furthermore,the shales of the Wufeng and Longmaxi formations exhibit high brittle mineral contents.Despite a low siliceous mineral content,the shales of the Doushantuo Formation feature a high carbonate mineral content,which can increase the shales’brittleness to some extent.For marine-continental transitional shales,where thin interbeds of tight sandstone with unequal thicknesses are generally found,it is recommended that fracturing combined with drainage of multiple sets of lithologic strata should be employed to enhance their shale gas production.

Tectonic evolution and accumulation characteristics of Carboniferous shale gas in Yadu-Ziyun-Luodian aulacogen, Guizhou Province, South China

The Yadu-Ziyun-Luodian aulacogen(YZLA) developed into being NW-trending in the Late Paleozoic,and was considered as an important passive continental margin aulacogen in Guizhou Province, South China. This tectonic zone is considered a large intracontinental thrust-slip tectonic unit, which has undergone a long period of development. It was ultimately determined in the Yanshanian, where the typical Upper Paleozoic marine shales were deposited. In 2021, Well QSD-1 was deployed in the Liupanshui area at the northwest margin of the aulacogen, and obtained a daily shale gas flow of 11011 m3in the Carboniferous Dawuba Formation. It thus achieved a breakthrough in the invesgation of shale gas in the Lower Carboniferous in South China, revealing relatively good gas-bearing properties and broad exploration prospects of the aulacogen. Being different from the Lower Paleozoic strata in the Sichuan Basin and the Yichang area of the Middle Yangtze, the development of the Carboniferous Dawuba Formation in the aulacogen exhibits the following characteristics:(1) The Lower Carboniferous shale is thick and widely distributed, with interbedded shale and marlstone of virous thickness;(2) The total organic carbon(TOC) content of the shale in the Dawuba Formation ranges from 1% to 5%, with an average of 2%, and the thermal maturity of organic matter(Ro) varies from 1% to 4%, with an average of2.5%, indicating good hydrocarbon generation capacity;(3) The main shale in the aulacogen was formed during the fault subsidence stage from the Middle Devonian to the Early Permian. Although the strong compression and deformation during the late Indosinian-Himalayan played a certain role in destroying the formed shale gas reservoirs, comparative analysis suggests that the area covered by the current Triassic strata has a low degree of destruction. It therefore provides good conditions for shale gas preservation,which can be regarded as a favorable area for the next exploration.

Distribution characteristics, exploration and development, geological theories research progress and exploration directions of shale gas in China

The shale gas resources in China have great potential and the geological resources of shale gas is over 100×10^(12)m^(3),which includes about 20×10^(12)m^(3) of recoverable resources.Organic-rich shales can be divided into three types according to their sedimentary environments,namely marine,marine-continental transitional,and continental shales,which are distributed in 13 stratigraphic systems from the Mesoproterozoic to the Cenozoic.The Sichuan Basin and its surrounding areas have the highest geological resources of shale gas,and the commercial development of shale gas has been achieved in the Upper Ordovician Wufeng Formation-Lower Silurian Longmaxi Formation in these areas,with a shale gas production of up to 20×10^(9)m^(3) in 2020.China has seen rapid shale gas exploration and development over the last five years,successively achieving breakthroughs and important findings in many areas and strata.The details are as follows.(1)Large-scale development of middle-shallow shale gas(burial depth:less than 3500 m)has been realized,with the productivity having rapidly increased;(2)breakthroughs have been constantly made in the development of deep shale gas(burial depth:3500-4500 m),and the ultradeep shale gas(burial depth:greater than 4500 m)is under testing;(3)breakthroughs have been made in the development of normal-pressure shale gas,and the assessment of the shale gas in complex tectonic areas is being accelerated;(4)shale gas has been frequently discovered in new areas and new strata,exhibiting a great prospect.Based on the exploration and development practice,three aspects of consensus have been gradually reached on the research progress in the geological theories of shale gas achieved in China.(1)in terms of deep-water fine-grained sediments,organic-rich shales are the base for the formation of shale gas;(2)in terms of high-quality reservoirs,the development of micro-nano organic matter-hosted pores serves as the core of shale gas accumulation;(3)in terms of preservation conditions,weak structural transformation,a moderate degree of thermal evolution,and a high pressure coefficient are the key to shale gas enrichment.As a type of important low-carbon fossil energy,shale gas will play an increasingly important role in achieving the strategic goals of peak carbon dioxide emissions and carbon neutrality.Based on the in-depth study of shale gas geological conditions and current exploration progress,three important directions for shale gas exploration in China in the next five years are put forward.

Discovery of shale gas from Wufeng-Longmaxi Formation in Xianfeng area, Hubei Province, China

1.Objective The Xianfeng area in Hubei Province is located in the central anticlinorium of the fold belt in western Hunan-Hubei,with a stable tectonic structure.It was in a deep-water shelf sedimentary environment from Wufeng period of Late Ordovician to Longmaxi period of Early Silurian,contributing to the formation of organic-rich shale in this area(Li B et al.,2016;Zhang H et al.,2019;Wu X et al.,2019).The well E Feng Di 1(Well EFD1)was drilled in Xianfeng area in the south of the central anticlinorium by preliminary geological survey and favorable shale gas areas optimization.During the drilling,shale gas was discovered from Upper Ordovician Wufeng Formation to Lower Silurian Longmaxi Formation(Wufeng-Longmaxi Formation).The geological conditions for shale gas enrichment were further defined through the analysis of the data obtained from the well drilling,well logging,and sample testing.The discovery will provide an important basis for further exploration and development of shale gas in this area.

Geochemical characteristics and sedimentary environment of the Middle Devonian organic-rich shales in the Northwest of Guizhong Depression, Southwest China

In order to figure out the redox conditions and paleo-sedimentary environment of the Middle Devonian shales in the northwest of Guizhong Depression,the trace element analysis was conducted on the Middle Devonian cores(320.35–938.50 m)of the typical shale gas investigation well(GY-1)at a 1.50 m sampling interval through X-ray fluorescence spectroscopy(XRF)and inductively coupled plasma mass spectrometry(ICP-MS).According to the test result,the average values of V/(V+Ni),V/Cr and Ni/Co in Nabiao formation(Fm.)are larger than 0.67,4.65 and 7.71 respectively,and Nabiao Fm.is rich in biological assemblages such as tabasheer,ammonite,etc.These evidences indicate the rising sea level rose relatively in the sedimentation period of Nabiao Fm.and a deepwater shelf environment,which was favorable for the preservation of organic matters.The V/(V+Ni),V/Cr and Ni/Co in Luofu Fm.and Tangting Fm.are 0.38–0.65,0.73–4.10 and 3.70–6.72 respectively,indicating that the sea level dropped relatively in their sedimentation period,during which the water bodies became shallow,and the sedimentary environment was a weak oxidizing shallow water shelf environment.In addition,the variation of TOC has a high correlation with the enrichment degree of Ba element,indicating the favorable conditions for the enrichment and preservation of organic matters under an oxygen-deficient environment.Moreover,according to the identification of trace element indexes,the northwest of Guizhong Depression experienced the sedimentary cycle of relative rise to relative fall of sea level from bottom to top in the Middle Devonian sedimentation period.The relative sea level rose to the highest in the sedimentation period of Nabiao Fm.,in which the organic-rich shales with stable thickness and high organic content were deposited.Hence,the Nabiao Fm.could be regarded as the favorable exploration target interval in this area.

Discovery of Hesigewula Sag on the western margin of Da Hinggan Mountains in China and its significance in petroleum geology

With Songliao Basin in northeast China entering the middle-late stage of the exploration and development of oil and gas resources,it is urgent to open up new areas for oil and gas exploration on the periphery of the basin.Five sedimentary sags have been discovered in the western margin of the Da Hinggan Mountains through high-precision gravity,magnetic,and electrical prospecting engineering.According to the conditions of the 5 sags such as buried depth,area,and the scale of source rock,Hesigewula Sag was preferentially selected to deploy two-dimensional seismic prospecting and drilling.As a result,the stratigraphic distribution and structure of Hesigewula Sag were preliminarily ascertained,the main sedimentary facies developed in Aershan Formation-Tengger Formation of the Lower Cretaceous was summarized,and the assessment parameters of source rock of Hesigewula Sag were obtained.According to the research results,the Hesigewula Sag can be divided into 3 second-order tectonic units including the western bulge,the central sag,and the eastern bulge respectively,and the sag was formed mainly subject to the west fractures.Three sedimentary facies including fan delta facies,braided river delta facies,and lacustrine facies have been identified in the Aershan Formation-Tengger Formation of the sag.The source rock in the first member and second member of Tengger Formation in the sag features high abundance of organic matter,meeting the standards of good source rocks.The kerogen of the source rock is mainly of type Ⅱ1-Ⅱ2.The organic matter in the source rock is characterized by low maturity and it entered the evolution stage of low maturity from the second member of Tengger Formation.Furthermore,Hesigewula Sag bears a strong similarity to other petroliferous sags in Erlian Basin in structure,sedimentation,source rock,and other characteristics.Therefore,it can be preliminarily determined that Hesigewula Sag boasts great potential for oil and gas resources.

Central cell:the key to determine persistent pollen tube attraction or termination

Most eukaryotic species depend on sexual reproduction,characterized by fertilization,to produce a new individual.This process requires the transfer of sperm(male gamete),containing half of the genetic information,from the male to the egg cell(female gamete),which holds half of the maternal genome,within the female reproductive organs.Various strategies have been evolved to ensure fertilization success in plants.