[Observation on the efficacy of modified Appleby operation for carcinoma of the body and tail of the pancreas]

OBJECTIVE

To evaluate the security, feasibility and therapeutic efficacy of modified Appleby operation for carcinoma of the body and tail of pancreas.

METHODS

From March 2010 to February 2015 modified Appleby operation was performed in 17 patients with carcinoma of the body and tail of the pancreas. The biochemical indices of fasting plasma blood (FPB), body weight (BW), visual analogue pain intensity scale (VAS score) and the quality of life index were evaluated before and 1 day , 1, 2, 6weeks after surgery. Survival time, tumor recurrence time, hospitalization time and treatment-related complications were analyzed.

RESULTS

There was no hospital mortality in this study. Pancreatic fistula and diarrhea were the major complications. The overall complication rate was 47.1%. The liver function index of ALT and AST were increased on postoperative day 1, and they were restored to normal after one week. Blood glucose has no obvious abnormal increase and abdominal pain was completely relieved. The VAS score decreased after surgery comparing with before (1.9±3.6 vs 83.2±8.5, P<0.05). Life quality assessment was significantly higher. The body weight of patients after surgery has a mean increment of (4.1±1.3)kg than that before surgery (68.1±4.3 vs 64.0±6.7, P<0.05). A significant rise of the overall quality of life index was observed after surgery (93.8±9.7 vs 68.6±6.7, P<0.05). The recurrence rates of 1, 2, 3 and 5 years were 22.9%, 58.9%, 72.6% and 72.6%, respectively. Median recurrence time was (20.0±3.8 m) (95%CI: 12.6-27.4 m). The survival rates of 1, 2, 3 and 5 years were 80.4%, 54.2%, 32.5% and 16.3%, respectively. The median survival time was (26.0±6.0)m (95%CI: 14.2-37.8 m).

CONCLUSIONS

Modified Appleby operation for pancreatic cancer is safe and feasible. It can relieve abdominal pain, improve the quality of life, improve the survival rate and prolong the survival time.

[A method of determine the inspection period of measuring instruments in a hospital]

In this paper we apply the principles of statistics to analyze a measuring instruments of diagnosis and treatment, and then make overall evaluations and quantifications so as to determine the inspection period of a measuring instrument.

[Determination of phospholipid in the peroxisomal membrane of rat liver by high performance liquid chromatography]

A method was employed for the determination of phospholipid in membrane of peroxisomes by high performance liquid chromatography. The separation was performed on a mu-Porasil Si60 column(250 mm x 4.6 mm i.d.) by gradient elution. The phospholipids were detected at 205 nm. The limits of detection for cardiolipin, phosphatidylinositol, phosphatidylserine, phosphatidylethanolamine, phosphatidylcholine and sphingomyelin were 12, 8, 23, 4, 23 and 7 ng respectively and the recoveries were between 84% and 103%. The linear relationship of calibration curves was good (r > 0.91). The phospholipids in peroxisomal membrane of 10 SD rat liver were determined and the results are satisfactory.

[Portazygos disconnection in the treatment of portal hypertension]

Since January 1988 to February 1993, 116 cases of cirrhotic portal hypertension were treated with portazygos disconnection. 37 cases were treated with Hassab's procedure, 36 cases were treated with amplification Hassab's procedure, 33 cases were treated with pericardial devascularization with circular interruption of blood flow of fundus, 10 cases were treated with transthoracic portazygos disconnection. The operative mortality was 6.9%. The hemorrhage rate was 8.6% in one month after the operation. All of 108 patients discharged from the hospital were followed up for 14 months to 75 months. The recurrent hemorrhage rate was 18.5% in the period. The one-year and three-year survival rate after the operation were 94.2% and 81.8%, respectively. The results we have got indicate that amplification Hassab's procedure and transthoracic portazygos disconnection have good effect.

[Anastomotic coarctation in the treatment of serious encephalopathy following splenosystemic shunt]

In this study, 11 cases of serious encephalopathy following splenorenal or splenocaval shunt were treated by anastomotic coarctation, in 4 of the 11 cases, portoazygos disconnection was added. All symptoms and signs disappeared soon after the procedure. The portal hepatopetal blood flow increased. Liver function improved. Blood ammonia concentration decreased. Follow-up of 6 to 48 months found, no recurrent encephalopathy or variceal bleeding. Anastomotic coarctation is effective method to treat serious post-splenosystemic shunt encephalopathy.

[Staged surgery in the treatment of Budd-Chiari's syndrome of mixed type]

9 patients with Budd-Chiari's syndrome of mixed type were operated upon. Among them 3 cases were treated by percutaneous transluminal angioplasty using balloon catheters, and 1 to 2 weeks after followed by Hassab's procedure and Linton's procedure. Two cases were treated by incision and plasty of IVC, and 1 month after followed by Hassab's procedure and Linton's procedure. The remaining 4 were treated by prehepatic cavoatrial shunt, succeeded by Hassab's procedure and Linton's procedure one month after. 6 to 24 months' follow up of the 9 cases revealed satisfactory results.