Objective To evaluate the efficacy and safety of bile duct stent in the surgical treatment of iatrogenic bile duct injury. Methods From January 2020 to June 2024 in department of general surgery of general or branch hospital of Ruijin Hospital, the clinical data of 7 cases with iatrogenic bile duct injury who underwent surgical treatment were retrospectively analyzed to evaluate the therapeutic effect and complications of bile duct injury. Results For 7 cases with iatrogenic bile duct injury, 2 of which were Strasberg D type, were performed with biliary duct repair and bile duct stenting, 5 of which were Strasberg E1 type, were performed with primary end-to-end anastomosis and bile duct stenting. All the operations were successful, and none of patients had the complications such as biliary leakage, jaundice, acute cholangitis, bile duct calculus, and bile duct stenosis. Conclusions It is safe and effective to replace T tube with bile duct stent in the surgical treatment of iatrogenic bile duct injury of Strasberg D/E1 type.
Breast cancer is the most common malignancy among women worldwide. In recent years, with the rapid development of artificial intelligence (AI) technology, foundation models in pathology have shown great potential in the diagnosis and treatment of breast cancer. This article provided a systematic overview of the current state and future directions of digital pathology and AI-assisted diagnosis for breast cancer from four dimensions: technical architecture, clinical applications, frontier explorations, and ethical challenges. We focused on the latest advances in pathology foundation models such as Virchow, UNI, and CONCH in downstream tasks including histological grading, HER2 scoring, and genotype prediction, discussed breakthroughs of multimodal generative AI systems like PathChat and SlideSeek in promoting interpretable diagnosis, and provided perspectives on emerging directions such as spatial transcriptomics integration and three-dimensional(3D) pathology reconstruction.
Early-stage breast cancer diagnosis and treatment are characterized by long disease course, high heterogeneity, multi-source and heterogeneous data, and dynamic evolving decision-making. The traditional multidisciplinary team (MDT) decision-making model faces challenges such as low efficiency and fragmented whole-cycle management. Large language models (LLMs) provide a new approach to solving these problems by virtue of their advantages in processing unstructured text, integrating multi-source data, and assisting clinical reasoning. This paper elaborated on the application value of LLMs in breast cancer MDT decision-making, focused on analyzing three core methods: personalized treatment recommendation agents, multi-agent collaboration, and clinical decision-making evidence generation and fusion. Furthermore, it proposed future development strategies across four dimensions: dynamic update of clinical knowledge bases, in-depth integration of case databases and models, human-machine collaborative case management, and OpenClaw-style intelligent physician assistant, providing references for promoting whole-cycle precise diagnosis and treatment of breast cancer and optimizing the MDT model.
Objective To assess safety and aesthetic outcomes of single-port breast endoscopy-assisted versus traditional open subpectoral implant placement in stage Ⅰ breast reconstruction for early-stage breast cancer. Methods A retrospective review was performed on clinical data from patients with early-stage breast cancer who underwent breast reconstruction at our hospital between January 1 and December 31, 2024. Patients were divided into two groups according to the surgical approach: the endoscopic surgery group (n=10) and the traditional open surgery group (n=14). Comparisons were made between groups of operation time, intraoperative blood loss, number of sentinel lymph nodes detected, length of hospital stay, wound drainage volume on postoperative day 3, drain removal time, surgeons' assessments of aesthetic outcomes (Ueda score), and patients’ satisfaction with breast reconstruction (BREAST-Q questionnaire). Statistical analyses were conducted. Results The traditional surgery group had a significantly longer postoperative drain removal time compared with the endoscopic surgery group (P<0.05). Postoperative aesthetic outcomes, evaluated by Ueda score and BREAST-Q questionnaire, were significantly superior in the endoscopic surgery group (P<0.05). No significant differences were identified between groups in operation time, intraoperative blood loss, number of sentinel lymph nodes detected, length of hospital stay, or wound drainage volume on postoperative day 3 (P>0.05). Conclusions Single-port endoscopy-assisted prepectoral implant placement in phase Ⅰ breast reconstruction appears to provide safety outcomes comparable to those of traditional open surgery, with the added benefit of improved postoperative aesthetics. Further studies are warranted to confirm its broader applicability under appropriate clinical indications.
Endoscopic tattooing (ET) technology plays a crucial role in the diagnosis and treatment of gastrointestinal diseases. This article provided a systematic review of the development and current status of ET technology. It focused on the characteristics, advantages, and limitations of commonly used dyes such as India ink, Spot®, nanocarbon, indocyanine green, and methylene blue, as well as new types of marking materials. In terms of clinical applications, the article discussed in detail the practical value of this technique in various scenarios, including pre-surgical localization, lymph node tracking, post-endoscopic follow-up examinations, small bowel endoscopy rendezvous, navigation during endoscopic retrograde cholangiopancreatography (ERCP), and marking before neoadjuvant therapy. ET enables precise tracking of lesions and lymphatic drainage, providing essential visual guidance for diagnostic and therapeutic procedures. This thereby significantly enhances the accuracy and safety of treatments.
