Mucin-producing Bile Duct Tumor of the Caudate Lobe Protruding into the Common Hepatic Duct

Mucin-producing tumor in the bile duct is referred to clinically as mucin-producing bile duct tumor (MPBT). Intraductal papillary neoplasm of the biliary tract that resembles an intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a rare category of MPBT and is not well characterized. We, herein, report a case of MPBT of the caudate lobe of the liver that showed papillary growth and communicated with the bile duct of the caudate lobe and protruded into the common hepatic duct. Histologically, MPBT cells showed papillary overgrowth with abundant mucinous secretions, resembling an IPMN of the pancreas. The MPBT cells showed the same immunostaining pattern as that of cells from IPMN of the pancreas.     

以胆酸为载体的肝靶向疗法

通过肝靶向给药技术将化学治疗药物选择性地投放于肝脏,能够减轻或避免其全身的毒副作用.胆酸是唯一的口服有效的小分子肝靶向载体,以胆酸为载体的肝靶向疗法为肝病及肝脏代谢性疾病提供了新的疗法.如胆酸-一氧化氮供体靶向偶合物能够选择性地将一氧化氮投放于肝脏,产生治疗肝硬化的作用;胆酸-脂肪酸靶向偶合物能够选择性地调节肝脏的脂代谢,具有治疗胆结石、脂肪肝和动脉粥样硬化的作用;胆酸-米非司酮偶合物能够选择性地作用于肝脏,产生特异性的降糖作用,而没有全身副作用.     

肝门部胆管癌的治疗

目的探讨肝门部胆管癌的治疗方法。方法回顾性分析我院1996，2004年间52例肝门部胆管癌患者的临床病例资料。I型癌肿切除率最高，Ⅳ型癌肿切除率最低。结果本组52例肝门部胆管癌中，围手术期死亡2例，均死于肝肾功能衰竭，余50例中31例术后获得随访，失访19例，随访率为62％。结论疑似或诊断肝门部胆管癌应早期积极手术探查，争取行根治性切除术；肝门部胆管癌肿瘤切除疗效明显优于其他治疗方式。     

人胎儿胃液、胆汁及胃粘膜、胆囊组织胃动素水平及其相关性

作者采用特异性胃动素(MTL)抗体,通过放射免疫法,对8例16～40周龄的人胎儿胃液、胆汁及胃粘膜、胆囊组织MTL含量进行探测。结果显示:MTL含量胃液为46.00±12.87pmol/L,胆汁为29.89±15.45Pmol/L;胃粘膜为1.34±0.45pmol/g,胆囊为0.87±0.32pmol/g.胃液、胃粘膜MTL含量分别高于胆汁及胆囊MTL水平(P<0.05)。相关分析显示:胃液与胃粘膜MTL含量,胆汁与胆囊MTL含量均呈显著正相关(N=8,r=0.8933,P<0.01;N=8,r=0.9016,P<0.01)。胃粘膜MTL含量与胎龄增长也呈显著正相关(N=8,r=0.7321,P<0.05)。     

血清TBA评估慢性重型肝炎肝细胞损伤的临床价值

目的　进一步探讨血清总胆汁酸 (TBA)评估慢性重型肝炎患者肝细胞损伤程度及其预后的临床价值。方法　对慢性重型肝炎组 12 2例、慢性肝炎组 98例和正常对照组 4 8人同时测定TBA、总胆红素 (TBIL)及凝血酶原活动度 (PA) ,并分析它们之间的关系。结果　慢性重型肝炎患者血清TBA水平显著高于慢性肝炎组及正常对照组 (P <0 .0 1) ,TBA与TBIL呈正相关 ,与PA呈负相关 (分别为r =0 .712 ,P <0 .0 1;r =- 0 .832 ,P <0 .0 1) ;治愈 +好转组TBA明显低于恶化 +死亡组 (P <0 .0 1)。结论　慢性重型肝炎TBA显著升高 ,肝细胞损伤越严重 ,TBA水平越高。TBA是敏感的肝功能检测指标 ,对慢性重型肝炎的疗效及预后评估有一定的临床价值。     

胆汁中提取胆红素的最佳实验条件探讨

从胆汁中提取胆红素，所得成品，其含量和收率受许多因素的影响。本文通过正交表实验选择，结果表明，最主要因素为醇析酸化ｐＨ值，其次为乙醇浓度、乙醇用量和抗氧剂用量等。     

老年肝外胆管梗阻85例治疗分析

目的：探讨老年性肝外胆管梗阻的治疗。方法：85例老年胆管梗阻中良性疾病引起的梗阻为59例，主要是由于胆管结石嵌顿MIRRIZI‘S综合征；恶性肿瘤引起的梗阻为26例，主要为壶腹部周围癌，肝门区肿瘤等。手术分别采取胆囊切除术、胆总管切开取石＋T管引流术、胰十二指肠切除术、腹部探查＋内外引流术以及ERCP下行置管内支撑术后引流和ENBD等。结果：良性疾病引起的梗阻中仅1例术后死于ARDS，恶性肿瘤 引起的梗阻者中有11例术后死于肝肾综合征、ARDS和DIC等。结论；手术仍是老年肝外胆管梗阻的首选方法。老年患者合并其它脏器病变，病情较重者如先行胆管引流，能有效降低病死率及延长生命。     

Incomplete excision of the gallbladder during laparoscopic cholecystectomy

Dissection and transection of the cystic duct close to the gallbladder has been advocated as a means of avoiding common bile injury during laparoscopic cholecystectomy (LC). We present three cases in which inadequate identification of the gallbladder—cystic duct junction resulted in incomplete cholecystectomy. In two patients an unsecured gallbladder infundibulum presented as cystic duct leaks and one patient developed recurrent symptomatic cholelithiasis. These cases emphasize the need for complete dissection and visualization of the cystic duct at the gallbladder prior its division and secure ligation during LC.     

A STUDY ON DETECTION OF SERUM FASTING TOTAL BILE ACID AND CHOLOYGLYCIN IN NEONATE FOR CHOLESTASIS

ＡＳＴＵＤＹＯＮＤＥＴＥＣＴＩＯＮＯＦＳＥＲＵＭＦＡＳＴＩＮＧＴＯＴＡＬＢＩＬＥＡＣＩＤＡＮＤＣＨＯＬＯＹＧＬＹＣＩＮＩＮＮＥＯＮＡＴＥＦＯＲＣＨＯＬＥＳＴＡＳＩＳＧｕｏＷｅｎ（郭文）；ＷｕＭｉｎｇｃｈａｎｇ（吴明昌）；ＰｅｉＸｕｅｙｉ（裴学义）；Ｇ...