Objective To investigate the efficacy and safety of continuous local anesthetic wound infiltration following open abdominal partial hepatectomy. Methods We performed a prospective, non-randomized, concurrent and con...Objective To investigate the efficacy and safety of continuous local anesthetic wound infiltration following open abdominal partial hepatectomy. Methods We performed a prospective, non-randomized, concurrent and controlled study. Patients undergoing open abdominal partial hepatectomy, according to their willingness, accepted one of the following managements for the postoperative pain： continuous wound catheter （CWC） infiltration, patient-controlled epidural analgesia （PCEA）, patient-controlled intravenous analgesia of morphine （PCIAM）, and patient-controlled intravenous analgesia of sufentanil （PCIAS）. The primary outcome was postoperative visual analogue scale （VAS） scores at rest and on movement. Secondary outcomes included consumption of rescue medication, side effects, and complications associated with postoperative pain management. Results From August 2013 to December 2013, 80 patients were allocated to receive CWC （n=10）, PCEA （n=22）, PCIAM （n=29）, or PCIAS （n=19）. After adjusting for age, sex, body mass index, percentage of resected liver, operation time, and Amsterdam Preoperative Anxiety and Information Scale, there was no significant difference in the VAS scores at rest or on movement between Group CWC and the other groups, namely PCEA, PCIAM, and PCIAS, at 4, 12, 48, and 72 hours postoperatively （all P〉0.05）. The need for rescue medication was not significantly different between Group CWC and the other three groups at 48 and 72 hours postoperatively （all P〉0.05）. There was no significant difference in the incidence of postoperative nausea and vomiting or anal exsufflation time between group CWC and the other three groups （all P〉0.05）. No severe adverse effects associated with continuous wound infiltration were observed during the study period. Conclusions CWC has a comparable analgesic effect compared with traditional analgesia methods at most time points postoperatively. CWC is a safe alternative for the postoperative analgesic management of open liver surgery.展开更多
AIM： To compare the results and complications of early pre-cutting technique with standard technique. METHODS： From January 2003 to December 2004, a total of 426 consecutive therapeutic biliary ERCP procedures were ...AIM： To compare the results and complications of early pre-cutting technique with standard technique. METHODS： From January 2003 to December 2004, a total of 426 consecutive therapeutic biliary ERCP procedures were performed by one endoscopist （T.A.）. Data were retrospectively collected according to procedure indication and results. Of these, 293 procedures （70.4%） were done with standard technique （group A） and 223 procedures （29.6%） with early pre-cutting technique in case of difficult cannulation （group B）. The results and complications of ERCP were compared. RESULTS： Success rate of first attempt cannulation was 98.0% in group A and 87.8% in group 13. The overall incidence of post-ERCP pancreatitis, hemorrhage, perforation and cholangitis was 0%, 0.2%, 0.5% and 0.5%, respectively. Morbidity rate was not significantly different. No procedure-related mortality was occurred. CONCLUSION： For an experienced hand, the early pre-cutting technique for biliary cannulation is safe and effective as standard technique.展开更多
We report a rare case of a patient who survived for 5 years after undergoing a medial pancreatectomy for invasive ductal carcinoma originating from the body of the pancreas. A 63-year-old woman was diagnosed as a smal...We report a rare case of a patient who survived for 5 years after undergoing a medial pancreatectomy for invasive ductal carcinoma originating from the body of the pancreas. A 63-year-old woman was diagnosed as a small cancer of the pancreatic body, and surgery was performed. Even though the tumor was a carcinoma, its small size prompted us to perform a medial pancreatectomy with regional lymph nodes dissection. Additional chemoradiation was performed and, five years after surgery, the patient is well with no signs of recurrence. Medial pancreatectomy for invasive ductal carcinoma has not ever been reported. Furthermore, long-term survival after a lumpectomy for invasive ductal carcinoma has never been reported in the literatures. The current case suggests that long-term survival in patients with invasive ductal carcinoma of the pancreas may be associated with the pathological or biological features of pancreatic carcinoma.展开更多
Eighty-two patients with supraventricular tachycardia undergoing radiofrequency catheter ablation (RFCA) were studied to observe the inhibition effect of aspirin and ticlopidine on platelet aggregability (PAG) and thr...Eighty-two patients with supraventricular tachycardia undergoing radiofrequency catheter ablation (RFCA) were studied to observe the inhibition effect of aspirin and ticlopidine on platelet aggregability (PAG) and thromboxane B 2(TXB 2) of the blood samples. Patients were divided into aspirin group A, ticlopidine group B, aspirin+ticlopidine group C and control group D. PAG and TXB 2 were increased clearly after RFCA in all groups (P<0.001). Treatment with aspirin or ticlopidine before operation could reduce the platelet aggregability caused by RFCA and the joint effect of two drugs(change rate of group A:52.51±12.51%; group B:54.78±11.27%;group C: 30.51±10.59%;group D:91.75±21.43%; P<0.05)was studied. The much decreased platelet aggregability after antiplatelet therapy was evidence of the potential benefit of the treatment in preventing thromboembolism after ablation. Pretreatment with aspirin and ticlopidine together is a good way to decrease palatelet aggregability after RFCA.展开更多
文摘Objective To investigate the efficacy and safety of continuous local anesthetic wound infiltration following open abdominal partial hepatectomy. Methods We performed a prospective, non-randomized, concurrent and controlled study. Patients undergoing open abdominal partial hepatectomy, according to their willingness, accepted one of the following managements for the postoperative pain： continuous wound catheter （CWC） infiltration, patient-controlled epidural analgesia （PCEA）, patient-controlled intravenous analgesia of morphine （PCIAM）, and patient-controlled intravenous analgesia of sufentanil （PCIAS）. The primary outcome was postoperative visual analogue scale （VAS） scores at rest and on movement. Secondary outcomes included consumption of rescue medication, side effects, and complications associated with postoperative pain management. Results From August 2013 to December 2013, 80 patients were allocated to receive CWC （n=10）, PCEA （n=22）, PCIAM （n=29）, or PCIAS （n=19）. After adjusting for age, sex, body mass index, percentage of resected liver, operation time, and Amsterdam Preoperative Anxiety and Information Scale, there was no significant difference in the VAS scores at rest or on movement between Group CWC and the other groups, namely PCEA, PCIAM, and PCIAS, at 4, 12, 48, and 72 hours postoperatively （all P〉0.05）. The need for rescue medication was not significantly different between Group CWC and the other three groups at 48 and 72 hours postoperatively （all P〉0.05）. There was no significant difference in the incidence of postoperative nausea and vomiting or anal exsufflation time between group CWC and the other three groups （all P〉0.05）. No severe adverse effects associated with continuous wound infiltration were observed during the study period. Conclusions CWC has a comparable analgesic effect compared with traditional analgesia methods at most time points postoperatively. CWC is a safe alternative for the postoperative analgesic management of open liver surgery.
文摘AIM： To compare the results and complications of early pre-cutting technique with standard technique. METHODS： From January 2003 to December 2004, a total of 426 consecutive therapeutic biliary ERCP procedures were performed by one endoscopist （T.A.）. Data were retrospectively collected according to procedure indication and results. Of these, 293 procedures （70.4%） were done with standard technique （group A） and 223 procedures （29.6%） with early pre-cutting technique in case of difficult cannulation （group B）. The results and complications of ERCP were compared. RESULTS： Success rate of first attempt cannulation was 98.0% in group A and 87.8% in group 13. The overall incidence of post-ERCP pancreatitis, hemorrhage, perforation and cholangitis was 0%, 0.2%, 0.5% and 0.5%, respectively. Morbidity rate was not significantly different. No procedure-related mortality was occurred. CONCLUSION： For an experienced hand, the early pre-cutting technique for biliary cannulation is safe and effective as standard technique.
文摘We report a rare case of a patient who survived for 5 years after undergoing a medial pancreatectomy for invasive ductal carcinoma originating from the body of the pancreas. A 63-year-old woman was diagnosed as a small cancer of the pancreatic body, and surgery was performed. Even though the tumor was a carcinoma, its small size prompted us to perform a medial pancreatectomy with regional lymph nodes dissection. Additional chemoradiation was performed and, five years after surgery, the patient is well with no signs of recurrence. Medial pancreatectomy for invasive ductal carcinoma has not ever been reported. Furthermore, long-term survival after a lumpectomy for invasive ductal carcinoma has never been reported in the literatures. The current case suggests that long-term survival in patients with invasive ductal carcinoma of the pancreas may be associated with the pathological or biological features of pancreatic carcinoma.
文摘Eighty-two patients with supraventricular tachycardia undergoing radiofrequency catheter ablation (RFCA) were studied to observe the inhibition effect of aspirin and ticlopidine on platelet aggregability (PAG) and thromboxane B 2(TXB 2) of the blood samples. Patients were divided into aspirin group A, ticlopidine group B, aspirin+ticlopidine group C and control group D. PAG and TXB 2 were increased clearly after RFCA in all groups (P<0.001). Treatment with aspirin or ticlopidine before operation could reduce the platelet aggregability caused by RFCA and the joint effect of two drugs(change rate of group A:52.51±12.51%; group B:54.78±11.27%;group C: 30.51±10.59%;group D:91.75±21.43%; P<0.05)was studied. The much decreased platelet aggregability after antiplatelet therapy was evidence of the potential benefit of the treatment in preventing thromboembolism after ablation. Pretreatment with aspirin and ticlopidine together is a good way to decrease palatelet aggregability after RFCA.
