Objective To investigate the application value of the binding pancreaticogastrostomy in pancreatico-duodenectomy. Methods The clinical data of 13 patients that performed pancreaticoduodenectomy with binding pancr-eaticogastrostomy from Jan. 2010 to Mar. 2013 in our hospital were retrospectively analyzed. The incidence of postoper-ative complications were counted. Results There was 1 patient with pancreatic stump bleeding after operation， and then recovered after conservative treatment. There was no patient with pancreatic fistula， bile fistula， delayed gastric empt-ying， and other complications after operation in whole group. Peritoneal fluid and amylase level in peritoneal fluid were gradually reduced or degraded after operation. The gastrointestinal function was recovered better. All patients were compl-etely cured. Conclusion The binding pancreaticogastrostomy in pancreaticoduodenectomy has its own unique advantage.It could be reduce the incidence of pancreatic fistula in postoperative patients by using binding pancreaticogastrostomy reasonably.
Objective To investigate the effect of CO2 pneumoperitoneum on the tumor cell port site implantation in laparoscopic surgery. Methods Male SpraqueDawley rats were intraperitoneally injected with gastric cancer cells (cell line SGC-7901). Continuous CO2 pneumo of 15 mm Hg or 30 mm Hg were established for 5 mins, 60 mins, 120 mins and 180 mins with the injection of different concentrations of tumor cells (104/ml, 106/ml respectively). Several samples of peritoneal washing served as positive control. All collecting dishes were incubated at 37℃ with 5% CO2 concentration for one week and then examined for the presence of tumor cell under microscope. Results After one week of incubation, some of the dishes with continuous flow of CO2 gas (5 L/min) at pneumo 30 mm Hg for 60 mins or longer demonstrated tumor growth, and all peritoneal washing samples showed tumor growth, while other dishes showed negative. Conclusion The research suggests that gastric cancer cells can cause port site implantation and the concentration of tumor cells, pneumoperitoneum pressure and duration may affect the occurrence of port site implantation. It may help to find a suitable way to prevent the port site implantation in operations.
ObjectiveTo further understand function of circular RNA (circRNA) and explore its relationship with occurrence and development of gastric cancer and its value in diagnosis and prognosis of gastric cancer.MethodThe published literatures on the circRNA function and its relationship with gastric cancer were reviewed and summarized.ResultsThe closed loop structure of circRNA made it was enzymatically stable. At present, it was clear that the circRNA acted as a microRNA (miRNA) sponge and regulated the gene transcription by binding with the corresponding sites, even could be as a translation template to participate in the protein translation. Further the circRNA could act on the target gene regulated by the miRNA through the miRNA sponge. The biosignal pathway involved in the development of gastric cancer regulated by the growth of gastric cancer cells. The circRNA was differentially expressed in the gastric cancer tissue and its adjacent tissue as well as in the serums of patient and healthy human, which had the close relationships with the clinical features (pathological staging, lymph node metastasis, distant metastasis, CEA, CA19-9, etc.) and the poor prognosis and shorter postoperative survival time of patients with gastric cancer.ConclusionsDue to structural characteristics of circRNA closed loop, it has an enzyme stability and can play a variety of biological functions based on miRNA sponge. Differential expression of circRNA in gastric cancer is expected to play an important role in diagnosis and prognosis evaluation of gastric cancer.
To investigate the influence of biliary surgery on gastrointestinal motility, electrogastrography (EGG) and gastrointestinal manometry were performed in a series of 17 patients who underwent biliary operation. EGG was done in all the patients in preoperative day, the operative day and the first, second and third postoperative day for at least one hour. Gastrointestinal manometry was done in eight patients in the operative day and the first, second and third postoperative day for 4－5 hours. Recording and analysis of EGG and gastrointestinal manometry were done by computer. Results: as compared with the preoperative day, the percentage of EGG normal wave in the operative day was obviously lower (Ｐ＜0.001)，and percentage of EGG bradygastria and tachygastria was remarkable higher (Ｐ＜0.01). From the first postoperative day, EGG frequency became normal. The EGG power was obviously low after operation till the third postoperative day. After operation, MMC in upper jejunum was rarely recorded, and in the third part of duodenum was most often recorded. Duration of phase Ⅲ of MMC ranged from 4－7 min. Contractive power and area of phase Ⅲ of MMC in the third part of duodenum changed obviously (Ｐ＜0.01),and the other had no changes. Conclusion: there were good correspondence between EGG and gastric manometry. Postoperative gastrointestinal dysfunction of stomach may be mainly caused by its fast wave. There were obvious changes of gastroduodenojejunal MMC after surgery which suggested that postoperative gastrointestinal dysfuntion might be caused by abnormal MMC. Improving the recovery of MMC may shorten the duration of postoperative gastrointestinal dysfunction.
目的探讨老年胃癌患者合并糖尿病的围手术期处理。方法对我院1990年1月至2004年2月期间收治的297例老年胃癌中41例合并糖尿病患者的临床资料进行回顾性分析。结果术后并发感染率、吻合口漏、死亡率及住院时间，血糖正常者分别为19.9%（51/256）、0.4%（1/256）、0.8%（2/256）和（19.1±4.3） d，糖尿病患者分别为34.1%（14/41）、7.3%（3/41）、7.3%（3/41）和（24.3±5.1） d，后者均明显高于前者（P均＜0.05）。结论老年胃癌患者合并糖尿病术后并发症及病死率较高，其围手术期处理至关重要，应引起外科医生的高度重视。
Objective To evaluate the accuracy of preoperative 64 multidetector spiral computed tomography (MDCT) in the diagnosis of stage Ⅳ gastric cancer. Methods The data of patients with stage Ⅳ gastric cancer between July 2007 and April 2008 were collected. Twenty-nine patients underwent preoperative 64 MDCT were retrospectively analyzed. All computed tomography scans were prospectly analyzed by 2 abdominal radiologists separately. Pathological tumor stage was based on TNM stage according to the revised Japanese Classification of Gastric Carcinoma from the Japanese Gastric Cancer Association. All CT results were compared with clinical, surgical and histopathologic results. Results The 65.2% (15/23), 47.8% (11/23) and 70.8% (17/24) of the stage Ⅳ patients were accurately predicted of T, N and M stage, respectively. Moreover, 58.6% (17/29) of the stage Ⅳ patients were accurately predicted of TNM stage. But 6/9 cases with peritoneal metastases were not detected by preoperative 64 MDCT. Conclusion The 64 MDCT is a promising technique for detection and preoperative staging of stage Ⅳ gastric cancer. It was difficult to detect peritoneal metastases, but it may not increase the rate of exploratory laparotomy.
Objective To investigate the expression of growth hormone receptor (GHR) in human gastric cancer tissue. Methods The GHR was detected in samples of the human gastric cancer (57 cases) and the distal normal tissues (57 cases) by immunohistochemistry technique. Results The GHR expression positive rate was 80.7%(46/57) in the human gastric cancer tissues and 70.2%(40/57) in the distal normal tissues. There was no statistic difference between the human gastric cancer tissues and the distal normal tissues (Pgt;0.05). There were also no statistic differences among the gastric cancer tissues of different differentiation, different tissue type, different gender and different age ranges (Pgt;0.05). Conclusion It is similar that the expression of GHR between the human gastric cancer tissues and the distal normal tissues.