J Huazhong U Sci Med
-
J Huazhong U Sci Med · Dec 2013
Practice GuidelineExpert consensus on laparoscopic hepatectomy (2013 version).
Laparoscopic hepatectomy has many advantages over open surgery, including minimization of local injury, reduced systemic reactions, and faster postoperative recovery. The aim of this "Consensus" is to provide guidance and reference to surgeons who perform, or are interested in performing laparoscopic liver surgeries. ⋯ The types of hepatectomy, indications and contraindications, preoperative preparation, anesthesia, patient position, insufflation pressure, port position, control of hepatic inflow and outflow, indications for conversion to open surgery, and surgical devices and equipment are reviewed. Techniques and procedures of various laparoscopic hepatectomies are also discussed.
-
J Huazhong U Sci Med · Dec 2013
Tacolimus postconditioning alleviates apoptotic cell death in rats after spinal cord ischemia-reperfusion injury via up-regulating protein-serine-threonine kinases phosphorylation.
The effects of tacrolimus postconditioning on protein-serine-threonine kinases (Akt) phosphorylation and apoptotic cell death in rats after spinal cord ischemia-reperfusion injury were investigated. Ninety male SD rats were randomly divided into sham operation group, ischemia-reperfusion group and tacrolimus postconditioning group. The model of spinal cord ischemia was established by means of catheterization through femoral artery and balloon dilatation. ⋯ The Akt activities reached the peak at 15 min after reperfusion in ischemia-reperfusion group and tacrolimus postconditioning group. The percentage of apoptotic cells and water content in spinal cord tissue were significantly reduced (P<0.01) in tacrolimus postconditioning group as compared with those in ischemia-reperfusion group at 24 h after reperfusion. It is concluded that tacrolimus post-conditioning can increase Akt activity in spinal cord tissue of rats, inhibit apoptosis of neural cells as well as tissue edema, and thereby alleviate spinal cord ischemia-reperfusion injury.
-
J Huazhong U Sci Med · Dec 2013
Retracted PublicationSurgical selection for late pancreatic head carcinoma without gastric outlet obstruction.
The effects of different surgical procedures for late pancreatic head carcinoma without gastric outlet obstruction were explored in order to provide theoretical basis to select a suitable operation for these patients. The clinical data of 441 cases of late pancreatic head carcinoma without gastric outlet obstruction were retrospectively analyzed. All patients were divided into 4 groups based on different surgical procedures: group A (101 cases) subjected to Roux-en-Y cholecystojejunostomy; group B (133 cases) undergoing Roux-en-Y choledochojejunostomy; group C (83 cases) given Roux-en-Y cholecystojejunostomy combined with gastrojejunostomy; group D (124 cases) receiving Roux-en-Y choledochojejunostomy combined with gastrojejunostomy. ⋯ The gastrojejunostomy had no impacts on the mean life span, and there was no statistically significant difference in complications, average hospital stay (days) and median survival among four groups (P>0.05). For the late pancreatic head carcinoma without gastric outlet obstruction, Roux-en-Y choledochojejunostomy is effective for the reduction of icteric index and the incidence of recurrent jaundice, also offers an opportunity for prolonged survival. Combined use of prophylactic Roux-en-Y gastrojejunostomy during surgical biliary drainage is safe for advanced pancreatic carcinoma with obstructive jaundice, which can decrease the incidence of postoperative gastric outlet obstruction, and has important implications for improving outcomes.