Objective To investigate the prevention and treatment strategy of bile duct injury (BDI) in laparoscopic cholecystectomy (LC). MethodsLatest progress was reviewed based on recent documents and the experience on BDI in LC in our department. ResultsWith the popularity of LC, BDI in LC is increasing. The reasons include illegibility and variability of local anatomy in gallbladder trigone,injury caused by galvanothermy, as well as operator’s overconfidence. In order to prevent BDI, we should apply more blunt dissection, not to use electrocogulation if possible and to study local anatomy and its variance clearly. The common bile duct and common hepatic duct should be clearly identified. Intraoperative cholangiography, laparoscopic ultrasonography and hepatobiliary scintigraphy are selections as necessary.The treatment of BDI depends on the type of BDI and its site and local condition.The treatment includes end to end anastomosis, repairing the defect, choledochoduodenostomy, RouxenY choledochojejunostomy and so on. T tube should be maintained in place for more than half a year after operation.Conclusion The key to improve the prognosis of BDI is prevention and treatment in proper time and in correct way.
ObjectiveTo summarize the research advancement of peroxisome proliferator-activated receptor γ (PPARγ) agonists inhibiting transforming growth factor-β (TGF-β)-induced organ fibrosis. MethodsThe related literatures on PPARγ agonists inhibiting TGF-β-induced organ fibrosis were reviewed. ResultsTGF-β was a major fibrosispromoting cytokine, which could promote a variety of organ fibrosis. PPARγ agonists could effectively block TGFβ signal transduction, and then suppressed organ fibrosis well. ConclusionsThe main antifibrotic mechanism of PPARγ agonists is to inhibit TGF-β signal transduction. The studies on this mechanism will help promoting the clinical application of PPARγ agonists, and provide a new way of the treatment for organ fibrosis.
【摘要】目的 探討成人先天性膽總管囊腫的診斷和治療。方法 對我科收治的7例成人先天性膽總管囊腫患者的資料進行回顧性分析。術前B超診斷正確率為91.9%(34／37)。6例行囊腫切除和肝總管空腸Roux-Y吻合術，1例因癌變行胰十二指腸切除術。結果 共隨訪29例，隨訪率為78.4%，平均隨訪43個月，未發現惡變者。結論 B超應作為先天性膽總管囊腫的首選檢查，囊腫切除和肝總管空腸Roux-Y吻合術應作為首選術式，早期診斷，早期根治性治療，是先天性膽總管囊腫診治的關鍵。