BACKGROUND Laparoscopic cholecystectomy(LC)and laparoscopic common bile duct exploration(LCBDE)has been widely used for management of gallbladder and common bile duct(CBD)stones.Post-operative clip migration is a rare...BACKGROUND Laparoscopic cholecystectomy(LC)and laparoscopic common bile duct exploration(LCBDE)has been widely used for management of gallbladder and common bile duct(CBD)stones.Post-operative clip migration is a rare complication of laparoscopic biliary surgery,which can serve as a nidus for stone formation and cause recurrent cholangitis.CASE SUMMARY A 59-year-old female was admitted to hospital because of fever and acute right upper abdominal pain.She has a history of LC and had a LCBDE surgery 2 mo ago.Physical examination revealed tenderness in the upper quadrant of right abdomen.Computed tomography scan demonstrated a high-density shadow at the distal CBD,which was considered as migrated clips.The speculation was confirmed by endoscopic retrograde cholangiopancreatography examination,and two displaced Hem-o-lok clips were removed with a stone basket.No fever or abdominal pain presented after the operation.In addition to the case report,literature regarding surgical clip migration after laparoscopic biliary surgery was reviewed and discussed.CONCLUSION Incidence of postoperative clip migration may be reduced by using clips properly and correctly;however,new methods should be explored to occlude cystic duct and vessels.If a patient with a past history of LC or LCBDE presents with features of sepsis and recurrent upper quadrant pain,clip migration must be considered as one of the differential diagnosis.展开更多
A graph is said to be symmetric if its automorphism group acts transitively on its arcs. In this paper, a complete classification of connected pentavalent symmetric graphs of order 16p is given for each prime p. It fo...A graph is said to be symmetric if its automorphism group acts transitively on its arcs. In this paper, a complete classification of connected pentavalent symmetric graphs of order 16p is given for each prime p. It follows from this result that a connected pentavalent symmetric graph of order 16p exists if and only if p = 2 or 31, and that up to isomorphism, there are three such graphs.展开更多
基金Medical and Health Technology Plan of Zhejiang Province,No.2019RC179.
文摘BACKGROUND Laparoscopic cholecystectomy(LC)and laparoscopic common bile duct exploration(LCBDE)has been widely used for management of gallbladder and common bile duct(CBD)stones.Post-operative clip migration is a rare complication of laparoscopic biliary surgery,which can serve as a nidus for stone formation and cause recurrent cholangitis.CASE SUMMARY A 59-year-old female was admitted to hospital because of fever and acute right upper abdominal pain.She has a history of LC and had a LCBDE surgery 2 mo ago.Physical examination revealed tenderness in the upper quadrant of right abdomen.Computed tomography scan demonstrated a high-density shadow at the distal CBD,which was considered as migrated clips.The speculation was confirmed by endoscopic retrograde cholangiopancreatography examination,and two displaced Hem-o-lok clips were removed with a stone basket.No fever or abdominal pain presented after the operation.In addition to the case report,literature regarding surgical clip migration after laparoscopic biliary surgery was reviewed and discussed.CONCLUSION Incidence of postoperative clip migration may be reduced by using clips properly and correctly;however,new methods should be explored to occlude cystic duct and vessels.If a patient with a past history of LC or LCBDE presents with features of sepsis and recurrent upper quadrant pain,clip migration must be considered as one of the differential diagnosis.
基金Supported by the National Natural Science Foundation of China(No.11301154,11301151,11201401,11271012)the Key Project of Education Department of Henan Province Scientific and Technological Research(No.13A110249)the Scientific Research Foundation for Doctoral Scholars of HAUST(No.09001707)
文摘A graph is said to be symmetric if its automorphism group acts transitively on its arcs. In this paper, a complete classification of connected pentavalent symmetric graphs of order 16p is given for each prime p. It follows from this result that a connected pentavalent symmetric graph of order 16p exists if and only if p = 2 or 31, and that up to isomorphism, there are three such graphs.