Clinical characteristics of incidental or unsuspected gallbladder cancers diagnosed during or after cholecystectomy: A systematic review and meta-analysis

AIM: To perform a systematic review of incidental or unsuspected gallbladder(GB) cancer diagnosed during or after cholecystectomy. METHODS: Data in Pub Med, EMBASE, and CochraneLibrary were reviewed and 26 publications were included in the meta-analysis. The inclusion criterion for incidental GB cancer was GB cancer diagnosed during or after cholecystectomy that was not suspected at a preoperative stage. Pooled proportions of the incidence, distribution of T stage, and revisional surgery of incidental GB cancer were analyzed.RESULTS: The final pooled population comprised 2145 patients with incidental GB cancers. Incidental GB cancers were found in 0.7% of cholecystectomies p e r f o r m e d f o r b e n i g n g a l l b l a d d e r d i s e a s e s o n preoperative diagnosis(95%CI: 0.004-0.012). Nearly 50% of the incidental GB cancers were stage T2 with a pooled proportion of 47.0%(95%CI: 0.421-0.519). T1 and T3 GB cancers were found at a similar frequency, with pooled proportions of 23.0%(95%CI: 0.178-0.291) and 25.1%(95%CI: 0.195-0.317), respectively. The pooled proportion that completed revisional surgery for curative intent was 40.9%(95%CI: 0.329-0.494). The proportion of patients with unresectable disease upon revisional surgery was 23.0%(95%CI: 0.177-0.294). CONCLUSION: A large proportion of incidental GB cancers were T2 and T3 lesions. Revisional surgery for radical cholecystectomy is warranted in T2 and more advanced cancers.

Formation of spherical alloy microparticles in a porous salt medium

This study describes the development of a one-pot strategy to produce spherical alloy microparticles for advanced near-net-shape manufacturing processes, including additive manufacturing and powder injection molding. The Al Si12 eutectic alloy(ca. 12 wt% Si) system was chosen as the model with which the main experiments were carried out. The proposed process synergistically integrates a few common,low-cost processing techniques including the mixing of Al micrometer size particles with silicon and sodium chloride, heat-treating the mixture at temperatures of 650–810°C, and the dissolution of salt in water to produce spherical Al Si12 alloy particles without the need to rely on costly melting and atomizing techniques. This new process can use laow-cost source Al and Si powders as the raw materials to produce10–200 um-sized spherical particles of Al Si12. The Ansys-CFX computational fluid dynamics software was used to analyze the flow behavior of Al Si12 liquid droplets and particle size refinement in the narrow voids of the sample.