To study the risk factors for early complications after pancreaticoduodenectomy （PD）. Methods： Two hundred patients undergoing PD at our hospital between December 1996 and September 2002 were reviewed retrospective...To study the risk factors for early complications after pancreaticoduodenectomy （PD）. Methods： Two hundred patients undergoing PD at our hospital between December 1996 and September 2002 were reviewed retrospectively. Standard PD was performed on 176 cases, standard PD with extended lymphadenectomy on 24 patients, whereas pylorus-preserving PD was not used. An end-toside combined with mucosa-to-mucosa pancreaticojejunostomy was performed on the patients with a hard pancreas and a dilated pancreatic duct, and a traditional end-to-end invagination pancreaticojejunostomy on the patients with a soft pancreas and a non-dilated duct. The risk factors with the potential to affect the incidence of complications were analyzed with SAS 8.12 software. Logistic regression was then used to determine the effect of multiple factors on early complications. Results： The overall rate of the major com- plications was 21% （42/200）, with the failure of pancreaticojejunal anastomosis being the most frequently encountered. Age （odds ratio [OR] 2.162）, diabetes mellitus （OR 4.086）, total serum bilirubin level （OR 7.556）, end-to-end pancreaticojejunostomy （OR 2.616）, T tube through the choledochojejunostomy （OR 0.100）, and blood transfusion over 1000 mL （OR 2.410） were the significant risk factors for the morbidity. Conclusion： The results from published series concerning morbidity after pancreaticoduodenectomy are not comparable because of lack of homogeneity between them. The knowledge of the complications rate in each particular department turns out essentially to provide the patient with tailored information about risks before surgery. Additionally, management of postoperative complications is essential for improving the results of this operation.展开更多
A 10-year-old Chinese boy who had a history of congenital thrombocytopathy presented with severe iron deficiency anemia secondary to chronic gastric inflammation and duodenal ulcerations. Subtle oculocutaneous albinis...A 10-year-old Chinese boy who had a history of congenital thrombocytopathy presented with severe iron deficiency anemia secondary to chronic gastric inflammation and duodenal ulcerations. Subtle oculocutaneous albinism led to the finding of diminished dense bodies in the platelets under electron microscopy, hence the diagnosis of Hermansky-Pudlak syndrome (HPS). Biopsies from the stomach and duodenum revealed a lymphocytic infiltration in the submucosa, but H pylori infection was absent. The gastroduodenitis responded to the treatment with omeprazole while iron deficiency anemia was corrected by oral iron therapy. HPS is a rare cause of congenital bleeding disorder with multisystemic manifestations. Upper gastrointestinal involvement is rare and should be distinguished from a mere manifestation of the bleeding diathesis.展开更多
AIM: To reduce the possibility of gastroduodenal complications. The purpose of this retrospective study was to survey the literature and compare and discuss the incidence of post-transarterial embolization (TAE)gastro...AIM: To reduce the possibility of gastroduodenal complications. The purpose of this retrospective study was to survey the literature and compare and discuss the incidence of post-transarterial embolization (TAE)gastroduodenal complications.METHODS: We found reports describing 280 cases of hepatocellular carcinoma with TAE procedures done during the past 4 years and selected all of them for our study.Amongst these cases, 86 were suspected of suffering gastroduodenal complications within one month of postTAE treatment. Fifteen of these cases were proved by pan-endoscopy to have gastroduodenal erosions or ulcerations. We reviewed the angiographic pictures in patient records to evaluate the possibility that anatomic and technical skill factors could explain the complications.RESULTS: Amongst the 15 cases, 9 were primary lesions of the antrum and prepylorus; 4 had duodenal ulcer or erosions; 2 had mid-body lesions; none showed a lesion at the fundus or cardia region. Three cases had not received TAEs using our ideal method, and may be associated with possible regurgitation of gel-foam pieces into the right or left gastric arteries. Two cases involved sub-selective embolization at a distal point on the hepatic artery; one case was found by angiography to have complete occlusion of the celiac trunk.CONCLUSION: Comparing our results with past cases of post-TAE gastroduodenal complications, we surmise that our relatively low incidence (5.3%) of gastric complications might be explained by our concerted efforts to improve our technical skills in multi-sequential, selective and superselective approaches to the embolization of tumor vessels.展开更多
Foreign-body ingestion is a relatively common presentation at emergency departments,but long metallic spoon swallowing is an infrequent occurrence.Unlike most cases of foreign-body ingestion,there have been no reporte...Foreign-body ingestion is a relatively common presentation at emergency departments,but long metallic spoon swallowing is an infrequent occurrence.Unlike most cases of foreign-body ingestion,there have been no reported cases of long foreign bodies reaching the jejunum.We report a rare case of a coffee spoon that was swallowed accidentally and passed through the pylorus and duodenal loop and reached the jejunum,with no complications.展开更多
The major papilla of Vater is usually located in the second portion of the duodenum, to the posterior medial wall. Sometimes the mouth of the biliary duct is located in other areas. Drainage of the common bile duct in...The major papilla of Vater is usually located in the second portion of the duodenum, to the posterior medial wall. Sometimes the mouth of the biliary duct is located in other areas. Drainage of the common bile duct into the pylorus is extremely rare. A 73-year old man, with a history of duodenal ulcer, was admitted to hospital with the diagnosis of cholangitis. Dilatation of the extrahepatic biliary duct was observed by abdominal ultrasonography, and endoscopic retrograde cholangiopancreatography （ERCP） was performed. No area suggesting the presence of the papilla of Vater was found within the second duodenal portion. Finally the major papilla was located in the theoretical pyloric duct. Cholangiography was performed and choledocholithiasis was found in the biliary tree. The patient underwent dilatation of the papilla with a balloon tyre and removal of a 7 mm stone using a Dormia basket, which solved the problem without further complications. This anomaly increased the difficulty of performing therapeutic interventions during ERCR This alteration in anatomy may increase the risk of complications during papillotomy, with a theoretically higher risk of perforation. Dilatation using a balloon was the chosen therapeutic technique both in our case and in the literature, due to its low rate of complications.展开更多
Small bowel metastases from primary carcinoma of the lung are very uncommon and occur usually in patients with terminal stage disease. These metastases are usually asymptomatic, but may present as perforation, obstruc...Small bowel metastases from primary carcinoma of the lung are very uncommon and occur usually in patients with terminal stage disease. These metastases are usually asymptomatic, but may present as perforation, obstruction, malabsorption, or hemorrhage. Hemorrhage as a first presentation of small bowel metastases is extremely rare and is related to very poor patient survival. We describe a case of a 61- year old patient with primary adenocarcinoma of the lung, presenting with melena as the first manifestation of small bowel metastasis. Both primary tumor and metastatic lesions were diagnosed almost simultaneously. Upper gastrointestinal endoscopy performed with a colonoscope revealed active bleeding from a metastatic tumor involving the duodenum and the proximal jejunum. Histological examination and immunohistochemical staining of the biopsy specimen strongly supported the diagnosis of metastatic lung adenocarcinoma, suggesting that small bowel metastases from primary carcinoma of the lung occur usually in patients with terminal disease and rarely produce symptoms. Gastrointestinal bleeding from metastatic small intestinal lesions should be included in the differential diagnosis of gastrointestinal blood loss in a patient with a known bronchogenic tumor.展开更多
MM： To investigate how to reduce the incidence of biliary complications in rat orthotopic liver transplantation. METHODS： A total of 165 male Wistar rats were ran- domly divided into three groups： Group A, orthotro...MM： To investigate how to reduce the incidence of biliary complications in rat orthotopic liver transplantation. METHODS： A total of 165 male Wistar rats were ran- domly divided into three groups： Group A, orthotropic liver transplantation with modified ＂two-cuff＂ technique; Group B, bile duct was cut and reconstructed without transplantation; and Group C, only laparotomy was performed. Based on the approaches used for biliary reconstruction, Group A was divided into two sub-groups： A1 （n = 30）, duct-duct reconstruction, and A2 （n = 30）, duct-duodenum reconstruction. To study the influence of artery reconstruction on bile duct complication, Group B was divided into four sub-groups： B1 （n = 10）, duct-duct reconstruction with hepatic artery ligation, B2 （n = 10）, duct-duct reconstruction without hepatic artery ligation, B3 （n = 10）, duct-duodenum reconstruction with hepatic artery ligation, and B4 （n = 10）, duct-duodenum recon- struction without hepatic artery ligation. The samples were harvested 14 d after operation or at the time when significant biliary complication was found. RESULTS： In Group A, the anhepatic phase was 13.7 ＋ 1.06 min, and cold ischemia time was 50.5 ＋ 8.6 min. There was no significant difference between A1 and A2 in the operation duration. The time for biliary reconstruction was almost the same among all groups. The success rate for transplantation was 98.3% （59/60）. Significant differ- ences were found in the incidence of biliary complications in Groups A （41.7%）, B （27.5%） and C （0%）. A2 was more likely to have biliary complications than A1 （50% vs 33.3%）. B3 had the highest incidence of biliary complica- tions in Group B. CONCLUSION： Biliary complications are almost in- evitable using the classical ＂two cuff＂ techniques, and duct-duodenum reconstruction is not an ideal option in rat orthotopic liver transplantation.展开更多
Our intent is to examine the predictive role of Charlson comorbidity index （CCI） on mortality of patients with type 2 diabetic nephropathy （DN）. Based on the CCI score, the severity of comorbidity was categorized ...Our intent is to examine the predictive role of Charlson comorbidity index （CCI） on mortality of patients with type 2 diabetic nephropathy （DN）. Based on the CCI score, the severity of comorbidity was categorized into three grades： mild, with CCI scores of 1-2; moderate, with CCI scores of 3-4; and severe, with CCI scores 〉5. Factors influencing mortality and differences between groups stratified by CCI were determined by logistical regression analysis and one-way analysis of variance （ANOVA）. The impact of CCI on mortality was assessed by the Kaplan- Meier analysis. A total of 533 patients with type 2 DN were enrolled in this study, all of them had comorbidity （CCI score 〉1）, and 44.7% （238/533） died. The mortality increased with CCI scores： 21.0% （50/238） patients with CCI scores of 1-2, 56.7% （135/238） patients with CCI scores of 3-4, and 22.3% （53/238） patients with CCI scores 〉5. Logistical regression analysis showed that CCI scores, hemoglobin, and serum albumin were the potential predictors of mortality （P〈0.05）. One-way ANOVA analysis showed that DN patients with higher CCI scores had lower levels of hemoglobulin, higher levels of serum creatinine, and higher mortality rates than those with lower CCI scores. The Kaplan-Meier curves showed that survival time decreased when the CCI scores and mortality rates went up. In con- clusion, CCI provides a simple, readily applicable, and valid method for classifying comorbidities and predicting the mortality of type 2 DN. An increased awareness of the potential comorbidities in type 2 DN patients may provide insights into this complicated disease and improve the outcomes by identifying and treating patients earlier and more effectively.展开更多
Objective： To observe the clinical effects in the treatment of post-stroke dysfunction of lower limb by puncturing Weizhong （BL 40）. Methods： One hundred and twenty patients were randomly divided into two groups,...Objective： To observe the clinical effects in the treatment of post-stroke dysfunction of lower limb by puncturing Weizhong （BL 40）. Methods： One hundred and twenty patients were randomly divided into two groups, 60 cases in each group. Both groups were treated by puncturing Weizhong （BL 40） plus functional rehabilitation training, once every day. Those in the observation group were treated by Shi Xue-min＇s needling technique, while others in the control group were treated with routine needling technique. The therapeutic effects were assessed by the scores of lower limb functions of Lovett scale of grading muscle strength （LSGMS） and short-form FugI-Meyer assessment （SFFMA）. Results： The instant and post-treatment effective rates in the observation group were 83.3% and 93.3%, versus 6.7% and 53.3% in the control group, indicating that the therapeutic effect was better in the observation group （P〈0.01）. The instant and post-treatment scores of Lovett muscle strength grading scale were better in the observation group than that in the control group （P〈0.05）. SFFMA score of lower limbs function was better in the observation group than that in the control group （P〈0.0s）. Conclusion： Different needling methods at Weizhong （BL 40） can produce different therapeutic effects in treating post-stroke dysfunction of lower limb, and Shi＇s needling technique has obvious instant effect and therapeutic function.展开更多
Objective: To find out the optimal approach to decompress externally the severe injured brain and to avoid possible complications caused by external decompression. Methods: 68 patients who underwent external decompres...Objective: To find out the optimal approach to decompress externally the severe injured brain and to avoid possible complications caused by external decompression. Methods: 68 patients who underwent external decompression after traumatic brain injury were admitted into Tianjin Medical University General Hospital for cranioplasty from 1995 to 2001. Complications were retrospectively investigated and analyzed in all patients. The findings were compared between the patients who accepted the decompressive craniectomy in our hospital and in local hospitals. χ 2-test was employed for statistical analysis and complication evaluation. Results: Large craniectomy definitely caused some side effects to patients. Among various complications, several of them showed significantly high incidence (P< 0.05) in patients who underwent the decompressive operation in local hospitals such as shunt-dependent hydrocephalous, subdural fluid collection, and CSF leakage from scalp incision. The rest of the complications had no remarkable difference (P> 0.05) between the two groups including dilation or/and migration of lateral ventricle underlying the cranial defect, skin flap concavity, encephalomalacia of the decompressive area, seizure and infection. Conclusions: To reduce the incidence of iatrogenic side effects, surgical craniectomy should be performed according to the strict indication and standard and any abuse should be avoided.展开更多
文摘To study the risk factors for early complications after pancreaticoduodenectomy （PD）. Methods： Two hundred patients undergoing PD at our hospital between December 1996 and September 2002 were reviewed retrospectively. Standard PD was performed on 176 cases, standard PD with extended lymphadenectomy on 24 patients, whereas pylorus-preserving PD was not used. An end-toside combined with mucosa-to-mucosa pancreaticojejunostomy was performed on the patients with a hard pancreas and a dilated pancreatic duct, and a traditional end-to-end invagination pancreaticojejunostomy on the patients with a soft pancreas and a non-dilated duct. The risk factors with the potential to affect the incidence of complications were analyzed with SAS 8.12 software. Logistic regression was then used to determine the effect of multiple factors on early complications. Results： The overall rate of the major com- plications was 21% （42/200）, with the failure of pancreaticojejunal anastomosis being the most frequently encountered. Age （odds ratio [OR] 2.162）, diabetes mellitus （OR 4.086）, total serum bilirubin level （OR 7.556）, end-to-end pancreaticojejunostomy （OR 2.616）, T tube through the choledochojejunostomy （OR 0.100）, and blood transfusion over 1000 mL （OR 2.410） were the significant risk factors for the morbidity. Conclusion： The results from published series concerning morbidity after pancreaticoduodenectomy are not comparable because of lack of homogeneity between them. The knowledge of the complications rate in each particular department turns out essentially to provide the patient with tailored information about risks before surgery. Additionally, management of postoperative complications is essential for improving the results of this operation.
文摘A 10-year-old Chinese boy who had a history of congenital thrombocytopathy presented with severe iron deficiency anemia secondary to chronic gastric inflammation and duodenal ulcerations. Subtle oculocutaneous albinism led to the finding of diminished dense bodies in the platelets under electron microscopy, hence the diagnosis of Hermansky-Pudlak syndrome (HPS). Biopsies from the stomach and duodenum revealed a lymphocytic infiltration in the submucosa, but H pylori infection was absent. The gastroduodenitis responded to the treatment with omeprazole while iron deficiency anemia was corrected by oral iron therapy. HPS is a rare cause of congenital bleeding disorder with multisystemic manifestations. Upper gastrointestinal involvement is rare and should be distinguished from a mere manifestation of the bleeding diathesis.
文摘AIM: To reduce the possibility of gastroduodenal complications. The purpose of this retrospective study was to survey the literature and compare and discuss the incidence of post-transarterial embolization (TAE)gastroduodenal complications.METHODS: We found reports describing 280 cases of hepatocellular carcinoma with TAE procedures done during the past 4 years and selected all of them for our study.Amongst these cases, 86 were suspected of suffering gastroduodenal complications within one month of postTAE treatment. Fifteen of these cases were proved by pan-endoscopy to have gastroduodenal erosions or ulcerations. We reviewed the angiographic pictures in patient records to evaluate the possibility that anatomic and technical skill factors could explain the complications.RESULTS: Amongst the 15 cases, 9 were primary lesions of the antrum and prepylorus; 4 had duodenal ulcer or erosions; 2 had mid-body lesions; none showed a lesion at the fundus or cardia region. Three cases had not received TAEs using our ideal method, and may be associated with possible regurgitation of gel-foam pieces into the right or left gastric arteries. Two cases involved sub-selective embolization at a distal point on the hepatic artery; one case was found by angiography to have complete occlusion of the celiac trunk.CONCLUSION: Comparing our results with past cases of post-TAE gastroduodenal complications, we surmise that our relatively low incidence (5.3%) of gastric complications might be explained by our concerted efforts to improve our technical skills in multi-sequential, selective and superselective approaches to the embolization of tumor vessels.
文摘Foreign-body ingestion is a relatively common presentation at emergency departments,but long metallic spoon swallowing is an infrequent occurrence.Unlike most cases of foreign-body ingestion,there have been no reported cases of long foreign bodies reaching the jejunum.We report a rare case of a coffee spoon that was swallowed accidentally and passed through the pylorus and duodenal loop and reached the jejunum,with no complications.
文摘The major papilla of Vater is usually located in the second portion of the duodenum, to the posterior medial wall. Sometimes the mouth of the biliary duct is located in other areas. Drainage of the common bile duct into the pylorus is extremely rare. A 73-year old man, with a history of duodenal ulcer, was admitted to hospital with the diagnosis of cholangitis. Dilatation of the extrahepatic biliary duct was observed by abdominal ultrasonography, and endoscopic retrograde cholangiopancreatography （ERCP） was performed. No area suggesting the presence of the papilla of Vater was found within the second duodenal portion. Finally the major papilla was located in the theoretical pyloric duct. Cholangiography was performed and choledocholithiasis was found in the biliary tree. The patient underwent dilatation of the papilla with a balloon tyre and removal of a 7 mm stone using a Dormia basket, which solved the problem without further complications. This anomaly increased the difficulty of performing therapeutic interventions during ERCR This alteration in anatomy may increase the risk of complications during papillotomy, with a theoretically higher risk of perforation. Dilatation using a balloon was the chosen therapeutic technique both in our case and in the literature, due to its low rate of complications.
文摘Small bowel metastases from primary carcinoma of the lung are very uncommon and occur usually in patients with terminal stage disease. These metastases are usually asymptomatic, but may present as perforation, obstruction, malabsorption, or hemorrhage. Hemorrhage as a first presentation of small bowel metastases is extremely rare and is related to very poor patient survival. We describe a case of a 61- year old patient with primary adenocarcinoma of the lung, presenting with melena as the first manifestation of small bowel metastasis. Both primary tumor and metastatic lesions were diagnosed almost simultaneously. Upper gastrointestinal endoscopy performed with a colonoscope revealed active bleeding from a metastatic tumor involving the duodenum and the proximal jejunum. Histological examination and immunohistochemical staining of the biopsy specimen strongly supported the diagnosis of metastatic lung adenocarcinoma, suggesting that small bowel metastases from primary carcinoma of the lung occur usually in patients with terminal disease and rarely produce symptoms. Gastrointestinal bleeding from metastatic small intestinal lesions should be included in the differential diagnosis of gastrointestinal blood loss in a patient with a known bronchogenic tumor.
基金Supported by National Natural Science Foundation of China,No.30671987
文摘MM： To investigate how to reduce the incidence of biliary complications in rat orthotopic liver transplantation. METHODS： A total of 165 male Wistar rats were ran- domly divided into three groups： Group A, orthotropic liver transplantation with modified ＂two-cuff＂ technique; Group B, bile duct was cut and reconstructed without transplantation; and Group C, only laparotomy was performed. Based on the approaches used for biliary reconstruction, Group A was divided into two sub-groups： A1 （n = 30）, duct-duct reconstruction, and A2 （n = 30）, duct-duodenum reconstruction. To study the influence of artery reconstruction on bile duct complication, Group B was divided into four sub-groups： B1 （n = 10）, duct-duct reconstruction with hepatic artery ligation, B2 （n = 10）, duct-duct reconstruction without hepatic artery ligation, B3 （n = 10）, duct-duodenum reconstruction with hepatic artery ligation, and B4 （n = 10）, duct-duodenum recon- struction without hepatic artery ligation. The samples were harvested 14 d after operation or at the time when significant biliary complication was found. RESULTS： In Group A, the anhepatic phase was 13.7 ＋ 1.06 min, and cold ischemia time was 50.5 ＋ 8.6 min. There was no significant difference between A1 and A2 in the operation duration. The time for biliary reconstruction was almost the same among all groups. The success rate for transplantation was 98.3% （59/60）. Significant differ- ences were found in the incidence of biliary complications in Groups A （41.7%）, B （27.5%） and C （0%）. A2 was more likely to have biliary complications than A1 （50% vs 33.3%）. B3 had the highest incidence of biliary complica- tions in Group B. CONCLUSION： Biliary complications are almost in- evitable using the classical ＂two cuff＂ techniques, and duct-duodenum reconstruction is not an ideal option in rat orthotopic liver transplantation.
基金Project supported by the Science and Technology Research Projects of Sichuan Province(No.2011SZ0215),China
文摘Our intent is to examine the predictive role of Charlson comorbidity index （CCI） on mortality of patients with type 2 diabetic nephropathy （DN）. Based on the CCI score, the severity of comorbidity was categorized into three grades： mild, with CCI scores of 1-2; moderate, with CCI scores of 3-4; and severe, with CCI scores 〉5. Factors influencing mortality and differences between groups stratified by CCI were determined by logistical regression analysis and one-way analysis of variance （ANOVA）. The impact of CCI on mortality was assessed by the Kaplan- Meier analysis. A total of 533 patients with type 2 DN were enrolled in this study, all of them had comorbidity （CCI score 〉1）, and 44.7% （238/533） died. The mortality increased with CCI scores： 21.0% （50/238） patients with CCI scores of 1-2, 56.7% （135/238） patients with CCI scores of 3-4, and 22.3% （53/238） patients with CCI scores 〉5. Logistical regression analysis showed that CCI scores, hemoglobin, and serum albumin were the potential predictors of mortality （P〈0.05）. One-way ANOVA analysis showed that DN patients with higher CCI scores had lower levels of hemoglobulin, higher levels of serum creatinine, and higher mortality rates than those with lower CCI scores. The Kaplan-Meier curves showed that survival time decreased when the CCI scores and mortality rates went up. In con- clusion, CCI provides a simple, readily applicable, and valid method for classifying comorbidities and predicting the mortality of type 2 DN. An increased awareness of the potential comorbidities in type 2 DN patients may provide insights into this complicated disease and improve the outcomes by identifying and treating patients earlier and more effectively.
基金supported by National Basic Research Program of China(973 Program,2006CB504504)Major Scientific and Technological Project of Tianjin Scientific and Technological Target Program(05YFGDSF02300)
文摘Objective： To observe the clinical effects in the treatment of post-stroke dysfunction of lower limb by puncturing Weizhong （BL 40）. Methods： One hundred and twenty patients were randomly divided into two groups, 60 cases in each group. Both groups were treated by puncturing Weizhong （BL 40） plus functional rehabilitation training, once every day. Those in the observation group were treated by Shi Xue-min＇s needling technique, while others in the control group were treated with routine needling technique. The therapeutic effects were assessed by the scores of lower limb functions of Lovett scale of grading muscle strength （LSGMS） and short-form FugI-Meyer assessment （SFFMA）. Results： The instant and post-treatment effective rates in the observation group were 83.3% and 93.3%, versus 6.7% and 53.3% in the control group, indicating that the therapeutic effect was better in the observation group （P〈0.01）. The instant and post-treatment scores of Lovett muscle strength grading scale were better in the observation group than that in the control group （P〈0.05）. SFFMA score of lower limbs function was better in the observation group than that in the control group （P〈0.0s）. Conclusion： Different needling methods at Weizhong （BL 40） can produce different therapeutic effects in treating post-stroke dysfunction of lower limb, and Shi＇s needling technique has obvious instant effect and therapeutic function.
文摘Objective: To find out the optimal approach to decompress externally the severe injured brain and to avoid possible complications caused by external decompression. Methods: 68 patients who underwent external decompression after traumatic brain injury were admitted into Tianjin Medical University General Hospital for cranioplasty from 1995 to 2001. Complications were retrospectively investigated and analyzed in all patients. The findings were compared between the patients who accepted the decompressive craniectomy in our hospital and in local hospitals. χ 2-test was employed for statistical analysis and complication evaluation. Results: Large craniectomy definitely caused some side effects to patients. Among various complications, several of them showed significantly high incidence (P< 0.05) in patients who underwent the decompressive operation in local hospitals such as shunt-dependent hydrocephalous, subdural fluid collection, and CSF leakage from scalp incision. The rest of the complications had no remarkable difference (P> 0.05) between the two groups including dilation or/and migration of lateral ventricle underlying the cranial defect, skin flap concavity, encephalomalacia of the decompressive area, seizure and infection. Conclusions: To reduce the incidence of iatrogenic side effects, surgical craniectomy should be performed according to the strict indication and standard and any abuse should be avoided.
