Timing of early laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography

Objective:This study was performed to compare the effect of different time intervals between endoscopic retrograde cholangiopancreatography(ERCP)and early laparoscopic cholecystectomy(LC)on the operation duration,postoperative hospitalization,and postoperative complications.Materials and methods:We retrospectively reviewed data for 105 patients with cholecystocholedocholithiasis who underwent ERCP and LC from January 2016 to May 2019.The patients were divided into three groups.In Group A,the interval from ERCP to LC was3 days;in Group B,the interval was 4e6 days;and in Group C,the interval was>6 days.We compared operation duration,blood loss volume,postoperative hospitalization,and rate of biliary complications among the three groups and analyzed the risk factors for postoperative complications.Results:Operation duration differed significantly between Groups A and B(47.5 min vs.60.0 min,p?0.033)and between Groups B and C(60.0 min vs.47.5 min,p?0.033).The median blood loss volume was significantly less in Group A than in Group B(8 ml vs.10 ml,p?0.041),and the postoperative hospitalization and rate of postoperative complications did not differ significantly.Conclusion:The best time for patients with cholecystocholedocholithiasis to undergo LC is 0e3 days after ERCP.If the operation cannot be performed within 3 days,we recommend 6 days after ERCP.

Utility of the Surgical Apgar Score in pancreatic cancer and modification

Objectives:The Surgical Apgar Score(SAS)can predict the incidence of complications in different surgical fields.However,it is rarely studied in pancreatic cancer.The aim of the present study was to assess the predictive value of the SAS in pancreatic ductal adenocarcinoma(PDAC),and then propose a modified SAS which was more suitable for pancreatic cancer patients.Materials and methods:A prospective cohort study of 160 PDAC patients was concluded.The primary endpoint was 30-day major complications.The SAS was calculated as described.The overall discriminatory power of the score was analyzed using receiver operating characteristic curves and the area under the curve(AUC)with respect to major complications or death.Results:It showed a significant predictive value of SAS in major complications or death in PDAC(p=0.020,AUC=0.606),especially in complication of pneumonia(p=0.022)and pleural effusion(p=0.023).In addition,the SAS exert significant predictive value in distal pancreatectomy group,but it has a weak predictive value for pancreaticoduodenectomy group.On multivariable analyses,occurrence of major postoperative complications was associated with lowest mean arterial pressure,estimated blood loss and operative time.Interestingly,as a characteristic of SAS,lowest heart rate was not involved.The modified SAS we proposed including lowest mean arterial pressure,estimated blood loss and operative time increased AUC from 0.606 to 0.743.Conclusions:The SAS can be a simple,rapid scoring system that effectively predicts major postoperative complications.Besides,the modified SAS we proposed in this study,which included lowest mean arterial pressure,estimated blood loss and operative time,exert a better predictive value in PDAC patients.

Research on Deformation Reconstruction Based on Structural Curvature of CFRP Propeller With Fiber Bragg Grating Sensor Network

The deformation and reconstruction of the composite propeller under the static load in the laboratory is studied so as to provide the basic research for the deformation and reconstruction of the underwater deformed propeller.The fiber Bragg grating(FBG)sensor is proposed to be used for strain monitoring and deformation reconstruction of the carbon fiber reinforced polymer(CFRP)propeller,and a reconstruction algorithm of structural curvature deformation of the CFRP propeller based on strain information is presented.The reconstruction algorithm is verified by using variable-thickness CFRP laminates in the finite element software.The results show that the relative error of the reconstruction algorithm is within 8%.Then,an experimental system of strain monitoring and deformation reconstruction for the CFRP propeller based on the FBG sensor network is built.The propeller blade is loaded in the form of the cantilever beam,and the blade deformation is reconstructed by the strain measured by the FBG sensor network.Compared with the blade deformation measured by three coordinate scanners,the reconstruction relative error is within 15%.