Objective:To investigate the postoperative recovery of patients undergoing laparoscopic upper gastrointestinal perforation repair under different pneumoperitoneum pressures.Methods:According to the principle of prospective study, 50 patients with upper gastrointestinal perforation who were admitted to Anqing Hospital Affiliated to Anhui Medical University from June 2019 to June 2021 were selected and randomly divided into two groups: the observation group (24 cases, pneumoperitoneal pressure 8-12 mmHg, i.e. 1.064-1.596 kPa) and the control group (26 cases, pneumoperitoneum pressure 13-15 mmHg, i.e. 1.729-1.996 kPa). The patients in the two groups underwent laparoscopic exploration + ulcer perforation repair. The postoperative recovery process, complications, and the changes of inflammatory indexes (leukocyte count, C-reactive protein and procalcitonin) at one hour before operation and on the first and fourth day after operation were compared between the two groups.Results:Both groups successfully completed the operation, and there was no significant difference in operation time between the two groups. The postoperative anal recovery time, length of hospital stay, and total hospitalization expenses in the observation group were less than those in the control group (t=-3.006, -2.514, -7.012; all P<0.05); the incidence of postoperative complications in the observation group was lower than that in the control group, but the difference was not statistically significant (χ2=2.427, P=0.119). There were no significant differences in inflammatory indexes between the two groups one hour before operation, but the indexes in the control group was significantly higher than those in the observation group on the first and fourth day after operation (all P<0.05).Conclusion:During laparoscopic repair of upper gastrointestinal perforation, controlling the pneumoperitoneum pressure at 8-12 mmHg dose not affect the operation, which can reduce the impact on the recovery of gastrointestinal function and toxin absorption.

目的总结医源性胆管损伤的诊治经验。方法回顾性分析我院诊治的14例医源性胆管损伤的临床资料。结果术中发现9例,其中左右肝管汇合部横断损伤1例,副右肝管损伤2例,胆管侧壁损伤2例,胆总管横断损伤4例;术后发现5例,其中右肝管被缝合狭窄1例,胆总管钛夹夹闭2例,胆总管横断2例。所有病例全部随访,平均随访(5.07±2.65)年。13例痊愈,l例术后出现吻合口狭窄,反复发作胆管炎,7年后死于肝衰竭。结论医源性胆管损伤的治疗重点是把握首次修复的时机及手术方式,关键是争取早期做出诊断。

目的探讨术中应用纤维胆管镜的价值。方法对156例肝胆管结石患者术中应用胆管镜分析,总结评价其效果。结果全组患者156例,术后残石12例,其中10例又通过术后胆镜取净,残石率1.44%(2/139)。结论术中应用纤维胆管镜能明显减少术后残石率,能进一步明确诊断,指导手术方式,减少创伤及缩短患者术后带管时间,减轻患者痛苦。

Objective:To study the diagnosis and treatment of cystic neoplasm in pancreas.Methods:The clinical data of 10 cases with cystic tumors in pancreas,including 8 cases with tumor total resection,one with internal drainage,one with switching operation,were retrospectively analyzed.Results:One patient undergoing cystojejunostomy died of hepatic metastasis after 18 months,one patient died of recurrence after 9 months,one patient left hospital automatically because of extensive metastasis,and seven patients got well.The follow-up lasted 11 months to 8 years.There was no recurrence after the total resection.Conclusions:In order to promoting the diagnosis and treatment of cystic neoplasm in pancreas,surgeons must be familiar with the clinical features and pathologic appearance of this disease.The achievement ratio of resection was higher.The total resection of tumor was a best treatment for this disease.

目的总结纤维胆道镜(纤胆镜)治疗肝胆管结石350例的经验。方法回顾性分析纤胆镜治疗肝胆管结石350例并分为两组。A组术中纤胆镜取石者98例,B组术后经T管窦道治疗者252例。结果A组配合肝段切除结石取净率为93.9%,B组结石取净率85.7%。结论纤胆镜配合手术在肝内胆管结石的治疗中具有重要作用,可提高结石取净率。

Aim To investigate the treatment and clinical diagnosis of right lower-abdominal mass. Methods Retrospectively analysed the clinical data of an 39 cases of right lover-abdominal mass. Results An 39 cases were recepted to surgery. 16 cases diagnosis in pre-operation. Others in post-operation. Conclusion It is important to understant the disease. Early surgery is essential to these not dignosis definitely in preoperation.

目的探讨纤维胆道镜辅助手术治疗胆道结石的临床效果.方法分析1996年10月～2003年1月我院纤维胆道镜诊治的250例胆道结石的临床资料.结果应用纤维胆道镜术中、术后分别发现漏诊结石2例和15例,术中发现残留结石9例,取尽4例;术后残留结石171例,取尽144例,结石总取尽率为84.2%.结论纤维胆道镜辅助外科手术是治疗肝胆管结石的有效措施.