Purpose:To determine the effect of aspirin on hepatocellular carcinoma (HCC) recurrence and survival after thermal ablation. Methods:A retrospective analysis was performed to evaluate the efficacy and safety of aspirin in combination with thermal ablation. The clinical data were collected for the enrolled patients. Progression-free survival (PFS), overall survival (OS), and adverse events were analyzed. Results:A total of 174 patients with HCC were enrolled. The median PFS was 11.1 (95% confidence interval [CI]: 8.1-14.0) months for patients who took aspirin and 8.6 (95% CI: 5.5-11.8) months for patients who did not take aspirin. The median OS of patients in the aspirin group was 76.7 (95% CI: 58.1-95.3) months and that in the non-aspirin group was 53.5 (95% CI: 42.7-64.3) months. In patients with non-viral HCC, OS was significantly better for the aspirin group (P = 0.03) after ablation. The PFS of patients who underwent ablation alone in the aspirin group was obviously superior to that of patients in the non-aspirin group (P = 0.002). Stratified Cox regression analysis demonstrated that aspirin use after ablation might be a protective factor in specific HCC patient subgroups. The incidence of major adverse events did not significantly differ between the two groups. Conclusion:Low-dose aspirin use was associated with better OS in patients with non-viral HCC after thermal ablation. In patients who received thermal ablation alone, the administration of low-dose aspirin could improve PFS. Aspirin use might be a protective factor in some patients after ablation.
Purpose:Tumor capsule is an independent prognostic factor for patients with hepatocellular carcinoma (HCC) and used increasingly to guide clinical decision-making. Considering the genetic complexity for capsule formation and its potential association with hypoxia, the significance of the polymorphisms of hypoxia-related genes in capsule formation and HCC prognosis remains to be elucidated.Patients and Methods:Peripheral blood samples from HCC patients were collected in this study. Single nucleotide polymorphism (SNP) genotyping was conducted by the iPLEX chemistry on a matrix-assisted laser desorption/ionization time-of-flight mass spectrometer (Sequenom, Inc.). The demographic and clinical data for the patients were obtained through medical chart review and/or consultation with the treating physicians. SPSS 25.0, R 4.1.1, and PLINK toolset were used to perform statistical analysis.Results:A total of 183 patients were enrolled, including 88 patients assigned to the capsule group and 95 to the non-capsule group. SLC2A1 rs841858 T allele, SLC2A1 rs2297977 T allele, STAT1 rs1547550 C allele, and STAT1 rs34997637 G allele were associated with significantly increased risk of capsule formation. The genotypes of SLC2A1 rs841858, SLC2A1 rs2297977, STAT1 rs34997637, and STAT1 rs1914408 were significantly associated with the formation of HCC capsule. The polymorphisms of STAT1 rs2066802, STAT1 rs12693591, and HIF1A rs2057482 showed close relationship with the prognosis of HCC patients in the capsule group, while the genotype distributions of CTNNB1 rs4135385, IFNG rs1861494, and SERPINE1 rs2227631 were closely related to the survival of patients in the non-capsule group. Further haplotype analysis suggested that SLC2A1 block 1 and STAT1 block 2 were related to the susceptibility of HCC capsule.Conclusion:The polymorphisms of the hypoxia-related genes (HIF1A, SERPINE1, IFNG, STAT1, CTNNB1, and SLC2A1) were correlated with the formation of HCC capsule. Several SNPs in these genes also showed association with HCC prognosis except SLC2A1. Further functional studies are warranted to explore the underlying mechanisms.
BACKGROUND:D-dimer exhibits a certain prognostic value in hepatocellular carcinoma (HCC) patients who underwent hepatectomy and microwave ablation, while its value in estimating the clinical benefit of drug-eluting beads transarterial chemoembolization (DEB-TACE) remains unclear. Hence, this study aimed to investigate the correlation of D-dimer with tumor features, response and survival to DEB-TACE in HCC patients. METHODS:Fifty-one HCC patients treated with DEB-TACE were recruited. Their serum samples at baseline and after DEB-TACE were collected and proposed for D-dimer detection by the immunoturbidimetry method. RESULTS:Elevated D-dimer levels were related to a higher Child‒Pugh stage (P = 0.013), tumor nodule number (P = 0.031), largest tumor size (P = 0.004), and portal vein invasion (P = 0.050) in HCC patients. Then, patients were classified by the median value of D-dimer, and it was observed that patients with D-dimer >0.7 mg/L achieved a lower complete response rate (12.0% vs. 46.2%, P = 0.007) but a similar objective response rate (84.0% vs. 84.6%, P = 1.000) compared to those with D-dimer ≤0.7 mg/L. The Kaplan‒Meier curve showed that D-dimer >0.7 mg/L (vs. ≤0.7 mg/L) was related to shorter overall survival (OS) (P = 0.013). Further univariate Cox regression analyses showed that D-dimer >0.7 mg/L (vs. ≤0.7 mg/L) was related to unfavorable OS [hazard ratio (HR): 5.524, 95% confidence interval (CI): 1.209-25.229, P = 0.027], but it failed to independently estimate OS (HR: 10.303, 95%CI: 0.640-165.831, P = 0.100) in multivariate Cox regression analyses. Moreover, D-dimer was elevated during DEB-TACE therapy (P<0.001). CONCLUSION:D-dimer may be helpful for monitoring prognosis to DEB-TACE therapy in HCC, while further large-scale-study validation is warranted.
This study aimed to compare the treatment efficacy and tolerance between drug-eluting beads transarterial chemoembolization (DEB-TACE) and conventional transarterial chemoembolization (cTACE) in hepatocellular carcinoma (HCC) patients with arterioportal fistula (APF). A total of 44 HCC patients with APF scheduled for DEB-TACE (N = 24, as DEB-TACE group) or cTACE (N = 20, as cTACE group) were recruited. Treatment response, hepatic function, and adverse events were assessed or recorded. Besides, progression-free survival (PFS) and overall survival (OS) were calculated. Total treatment response was better in the DEB-TACE group compared with the cTACE group (P = .012). Meanwhile, the objective response rate (87.5% versus 60.0%) was higher (P = .013), while the disease control rate (95.8% versus 85.0%) was similar in the DEB-TACE group compared to the cTACE group (P = .213). Besides, PFS (mean value: 12.2 (95%CI: 9.9-14.6) months versus 7.8 (95%CI: 5.6-10.0) months) (P = .037), but not OS (mean value: 20.0 (95%CI: 18.1-21.9) months versus. 18.6 (95%CI: 15.4-21.8) months) (P = .341) was prolonged in DEB-TACE group compared with cTACE group. Regarding the safety, Child-Pugh stage, albumin level, and bilirubin level after treatment were all similar between the DEB-TACE group and cTACE group (all P > .05); moreover, no difference was found in the occurrence of adverse events during or after treatment between the two groups (all P > .05). Moreover, subsequent analyses found that embolic materials for APF (microspheres) in the DEB-TACE group did not affect the treatment efficacy (all P > .05). DEB-TACE promotes treatment response and PFS compared with cTACE and shows good safety in HCC patients with APF.
Background: We prospectively evaluated the security and efficiency of percutaneous microwave ablation (MWA) using combined computed tomography (CT) and ultrasound (US)-guided imaging in patients with BCLC-A1-3 hepatocellular carcinoma (HCC) given that they have shortcomings when used alone.Methods: We included 88 consecutive patients with single HCC who were treated with transcatheter hepatic arterial chemoembolization (TACE). The patients were divided into 3 groups at random by using draw lots 1 week after TACE. The combination group (34 patients) received MWA under the guidance of CT and US, while the single group (CT group, 30 patients; US group, 24 patients) received MWA under the guidance of CT or US alone. Contrast-enhanced MRI or CT scans were performed in all patients 1, 3, 6 and 12 months after the procedure. The study endpoints included the treatment time, puncture time, local recurrence rate, and adverse events.Results: The median diameter of the lesions was 3.1 (1.5-4.2) cm. The median treatment time was 38.6 (30-45) min and 36.7 (30-47) min in the combination group and US group, respectively. The median puncture number was 1.2 (1-2) times and 1.1 (1-2) times, respectively. Both were significantly less than in the CT group (45.8 min and 4.2 times). The local recurrence rate was 5.9% in the combination group, which was significantly inferior to that in the US group (16.7%). The grade C complication rate in the combination group was 5.9%, while it was 13.3% and 8.3% in the CT group and US group, respectively. There was a statistically significant difference between the combination group and CT group.Conclusions: Using CT- and US-guided microwave ablation in patients with BCLC-A1-3 hepatocellular carcinoma appeared to be much better in terms of security and efficiency than the use of microwave ablation under the guidance of CT or US alone.
This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12885-021-08923-0
Objective To summarize and analyze the imaging features and outcomes of patients with ruptured hepatocellular carcinoma (HCC) following transcatheter arterial chemoembolization (TACE). Methods We investigated all consecutive patients with HCC who received standardized TACE based on our hospital database. Ruptured HCCs were divided into three types according to their relationship with the liver capsule, determined by computed tomography or magnetic resonance imaging scans: Type I, portion of tumor cambered outwards ≤30%; Type II, portion of tumor cambered outwards >30% and <50%; and Type III, portion of tumor cambered outwards ≥50%. Results There were 54, 40, and 26 patients with Type I, II, and III HCCs, respectively. Among these, eight patients developed ruptured tumors within 2 weeks after TACE, including one, two, and five patients with type I, II, and III ruptured HCCs, respectively. Patients with type III HCCs had a shorter median survival time than patients with type I–II HCCs. Conclusions Patients with type III HCCs might have a higher re-rupture rate and benefit less from emergency arterial embolization procedures than patients with type I–II HCCs.
Aim: To preliminarily evaluate the effect of microwave ablation (MWA) alone on platelet (PLT) and coagulation function in patients with BCLC-A hepatocellular carcinoma (B-A-HCC) using a retrospective method. Materials and Methods: A total of 36 patients with 48 B-A-HCCs were radically treated with MWA alone under the guidance of ultrasound between April and October 2018. PLT coagulation indexes were measured before and after MWA at 1 day, 3 days, 1 week, and 2 weeks, and blood samples (after morning fasting) were collected from cubital veins. Coagulation indexes included prothrombin time (PT), prothrombin activity (PTA), thrombin time (TT), Activated Partial Thromboplastin Time (APTT), international standardized ratio (INR), plasma fibrinogen (FIB), plasma antithrombin III (AT-III), and D dimer (DD). Overall survival (OS), recurrence-free survival (RFS), local tumor progression (LTP), and adverse reactions were also recorded. Results: All patients were radically treated with MWA alone. The median size of the lesion was 2.6 (1.5–7.0) cm3. On the first day after MWA, the level of PLT decreased significantly compared with the values before MWA and gradually returned to preoperative levels one week after MWA. One day after MWA, the levels of PT, INR, and AT-III increased markedly and the level of PTA decreased significantly, all of them gradually returned to baseline after 3 days to a week of time. 1, 3, and 7 days after MWA, the levels of FIB, and DD increased significantly, and the level of TT decreased significantly; all of them gradually returned to baseline at 2 weeks. At 6 months posttreatment, the OS and RFS rates were 100% and 91.7%, the LTP rates was 5.6%, no significant adverse reactions. Conclusion: PLT and coagulation indexes were abnormal in patients with B-A-HCC who were radically treated with MWA alone after treatment; without specific treatment, they all gradually returned to baseline within a week or two.
Background Abundant evidence has manifested that long noncoding RNAs (lncRNAs) are closely implicated in human cancers, including hepatocellular carcinoma (HCC). Remarkably, lncRNA FAM83H antisense RNA 1 (FAM83H-AS1) has been reported to be a tumor-propeller in multiple cancers. However, its effect on HCC progression remains unknown. Methods FAM83H-AS1 expression was analyzed by RT-qPCR. Colony formation, EdU, and flow cytometry as well as transwell assays were implemented to analyze the biological functions of FAM83H-AS1 on HCC progression. Luciferase reporter, RIP and RNA pull-down assays were implemented to detect the interaction among FAM83H-AS1, microRNA-485-5p (miR-485-5p), and myocyte enhancer factor 2D (MEF2D) in HCC cells. Results FAM83H-AS1 expression in HCC cells was markedly elevated. FAM83H-AS1 accelerated cell proliferation, migration and invasion whereas inhibiting cell apoptosis in HCC. Besides, we confirmed that FAM83H-AS1 acts as a miR-485-5p sponge in HCC cells. Additionally, MEF2D was verified to be a direct target of miR-485-5p. FAM83H-AS1 could upregulate MEF2D expression via sponging miR-485-5p. Further, rescue experiments testified that MEF2D upregulation or miR-485-5p downregulation offset the repressive effect of FAM83H-AS1 depletion on HCC cell progression. Conclusions FAM83H-AS1 facilitates HCC malignant progression via targeting miR-485-5p/MEF2D axis, suggesting that FAM83H-AS1 may be a promising biomarker for HCC treatment in the future.
OBJECTIVE:To evaluate the use of transarterial chemoembolisation (TACE) combined with microwave ablation (MWA) to treat patients with hepatocellular carcinoma (HCC) and type Ⅱ-Ⅲ portal vein tumour thrombosis (PVTT) intolerant to targeted drug (TG) therapy.METHODS:A total of 18 patients with HCC and type Ⅱ-Ⅲ PVTT intolerant to TG were enrolled between June 2015 and December 2019, who were treated with TACE + MWA (MWA group). 24 patients were treated with TACE + TG (TG group; control cohort). Time to progression and overall survival (OS) were analysed along with the incidence of adverse events.RESULTS:The median follow-up time was 19.0 months (9.0-32.0 months). The median OS was 17.0 months (8.3-29.3 months; MWA group) and 13.5 months (5.5-22.5 months; TG group) and was not significantly different. The 1- and 2 year OS was also comparable (MWA group: 66.7%, 44.4% vs Target group: 41.7%, 29.2%). Time to progression showed no distinct differences (MWA group: 11.5 months; TG group: 9.0 months) between the two groups. Moreover, the incidence of major Grade 3-4 adverse events in the MWA group (5.6%) was similar to those in the TG group (8.3%).CONCLUSION:TACE + MWA and TACE + TG were comparable in their safety and efficacy in patients with HCC, type Ⅱ-Ⅲ PVTT, and intolerance to TG.ADVANCES IN KNOWLEDGE:TACE + MWA can be used as a palliative treatment alternative for TACE + TG in patients with HCC, type Ⅱ-Ⅲ PVTT, and intolerance to TG.
The present study aimed to compare the efficacy and safety of drug-eluting beads-transarterial chemoembolization (DEB-TACE) plus microwave ablation (MWA) versus (vs.) surgery in treating patients with hepatocellular carcinoma (HCC) adjacent to gallbladder. Totally 54 patients with HCC adjacent to gallbladder were included and divided into two groups: DEB-TACE plus MWA group (n = 24) and surgery group (n = 30). Treatment response, relapse-free survival (RFS), progression-free survival (PFS), overall survival (OS) and adverse events were assessed and documented. For DEB-TACE plus MWA group, complete response rate, objective response rate and disease control rate were 79.2%, 95.8% and 100.0% after one-month post treatment, respectively. In terms of survival profiles, DEB-TACE plus MWA group presented similar RFS (28.2 (95% CI: 12.5-43.9) months vs. 26.6 (95% CI: 19.2-34.1) months) (P = 0.930), PFS (21.2 (95% CI: 1.6-40.8) months vs. 26.6 (95% CI: 19.2-34.1) months) (P = 0.541), and OS (41.4 (95% CI: 35.0-47.9) months vs. 59.7 (95% CI: 51.7-67.7) months) (P = 0.138) compared with surgery group, and further multivariate Cox's regression analysis validated that, after adjustment of confounding factors, DEB-TACE plus MWA group exhibited no difference of RPS, PFS or OS compared with surgery group. Regarding safety, the intraoperative adverse event incidence was higher in DEB-TACE plus MWA group compared with surgery group (P = 0.008), while two groups exhibited no difference of postoperative adverse event incidence (P = 0.618). In conclusion, DEB-TACE plus MWA presents to be an optional treatment strategy in patients with HCC adjacent to gallbladder.
Background : To evaluate prospectively security and efficiency of percutaneous microwave ablation (MWA) by combining computer tomography (CT)- with ultrasound (US)-guided of in patients with BCLC-A1-3 hepatocellular carcinoma (HCC ). Methods : We studied 88 consecutive patients with single HCC who were treated with transcather hepatic arterial chemoembolization (TACE), patients were divided into 3 groups at random by using draw lots 1 week after TACE, combination group (34 cases) received MWA under the guidance of CT and US, while single group (CT group 30 cases, US group 24 cases) received MWA under the guidance of CT or US alone.1 month,3 months,6months and12 months after the procedure, contrast-enhanced MRI scan were performed in all cases. Study endpoints included treatment time, puncture time, local recurrence rate and adverse events. Results : A total of 88 lesions were radically treated with MWA after TACE. The median diameter of the lesion was 3.1(1.5-4.2) cm. The mean treatment time, puncture time were 38.6 (30-45) min, 36.7 (30-47) min, and 1.2 (1-2), 1.1 (1-2) in the combination group and US group, which were significantly inferior to CT group (45.8 minutes and 4.2); Local recurrence rate was 5.9% in the combination group, which was significantly inferior to US group (16.7%).Grade C complication rates occurred in the combination group was 5.9%, while it was 13.3% and 8.3% in CT group and US group, there was statistically significant between combination group and CT group ( P <0.05). Conclusions : Using CT- and US-guided microwave ablation in patients with BCLC-A1-3 hepatocellular carcinoma appeared to be much better in security and efficiency than that under the guidance of CT or US alone.
Background. - This study aimed to investigate the potential of drug-eluting bead transarterial chemoembolization (DEB-TACE) as downstaging therapy for subsequent radical treatment in patients with hepatocellular carcinoma (HCC). Methods. - Totally, 32 patients with unresectable HCC were enrolled, then they received DEBTACE for down-staging therapy followed by radical treatments (surgery, radiofrequency ablation or microwave ablation). The rate of successful down-staging, treatment response (after DEBTACE and radical therapy), alpha-fetoprotein (AFP), progression-free survival (PFS) and overall survival (OS) were assessed. Results. - After down-staging therapy with DEB-TACE, successful down-staging rate was 59.4%. With the followed radical treatment, the complete response was 81.3%. Subsequent analysis indicated that CNLC stage (IIb vs. IIa) was an independent risk factor for successful down staging. Furthermore, AFP level presented a declined trend throughout the time points (beforeDEB-TACE, after DEB-TACE, and after radical treatment). Additionally, 1-year, 2-year and 3-year accumulating PFS were 68.8%, 40.6% and 31.3%, respectively; 1-year, 2-year and 3-year accumulating OS were 84.4%, 71.9% and 53.1%, respectively. Kaplan-Meier curves exhibited that successful down-staging was correlated with longer PFS and OS, then further Cox's regression analysis verified that successful down-staging was an independent factor for predicting increased OS but not PFS. Besides, child-Pugh stage (B vs. A), CNLC stage (IIb vs. IIa) and AFP abnormal after radical treatment were independent factors for decreased PFS or OS. Conclusions. - DEB-TACE has potential as an additionally effective down-staging therapy for radical treatments, and successful down-staging treatment by DEB-TACE associates with favorable survival profiles in patients with unresectable HCC. (c) 2020 Les Auteurs. Publi & acute;e par Elsevier Masson SAS. Cet article est publi & acute;e en Open Access sous licence CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/).
目的 探讨3.0 T TX磁共振成像(MRI)对7,12-二甲基苯并蒽(DMBA)诱导的大鼠胰腺病损的诊断价值.方法 将DMBA 2 mg/100 g植入60只雄性SD大鼠胰腺,术后2、4、6个月对存活的55只行腹部MRI(3.0 T TX)冠状位、横断位平扫及增强扫描,并与术前10只正常大鼠的MRI比较,随后取胰腺组织行病理检查.结果术后2个月,MRI显示大鼠均出现胰腺形态不规则、腹水、肠管扩张现象;19只行病理检查呈现急、慢性胰腺炎改变.术后4个月,MRI显示33.3%(6/18)的大鼠出现胰腺囊肿,病理检查为胰腺假性囊肿,直径0.3~1.0 cm.术后6个月,38.9%(7/18)的大鼠出现胰腺假性囊肿,MRI表现为较长T1、长T2信号,结节中心低信号,增强扫描后不明显.1只可见胰腺部位肿瘤,直径约0.3 cm;MRI特点为稍长T1、长T2信号,病变信号不均匀,中心呈更长T1信号,增强扫描后病变边缘可见较明显强化,病变内部无明显强化;病理及免疫组化诊断为胰腺平滑肌肉瘤.结论使用3.0 T TX MRI可发现DMBA诱导的大鼠胰腺病损,可分辨直径≤0.5 cm的胰腺部囊肿及肿瘤.
Objective To evaluate the efficacy of endovascular radiofrequency ablation with Habib TM VesOpen catheter combined with covered-stent placement in biopsy and treating portal vein tumor thrombus (PVTT). Methods 13 patients with PVTT were treated from June 2014 to December 2015. After confirming the location and extent of PVTT , biopsy was performed on 3 patients using 5F biopsy forceps under fluoroscopy. Radiofrequency ablation of the tumor thrombi was then performed using 5F HabibTM VesOpencatheter with the power of 10W for 3 minutes followed by insertion of covered-stent at the location of PVTT. The patients were followed up for 3-18 months by clinical observation, biochemical examination, color Doppler ultrasound, CT, and MRI. Results The procedure was successful in all patients with no complications. Abdominal distension was relieved (9), ascites resolved (2) or was reduced (2),and diarrhearesolved (1). During follow-up, the patients were stable (6)with survival of more than 3 months (12), 6 months (10), 12 months (8), and 18 months (5). The shunt was obstructed in 7 patients. Conclusion Endovascular radiofrequency ablation combined with covered-stent placement may be better than endovascular radiofrequency ablation alone in treating portal vein tumor thrombus. It is safe under the protection of the sheath to biopsy the tumor thrombus with forceps.
Objective To explore the possibility of pancreatic carcinogenesis induced by small dose 7,12-dimethylbenzanthracene ( DMBA) implantation in Sprague-Dawley( SD) rats.Methods Totally 70 male SD rats were randomly divided into two groups:DMBA (2 mg/100 g) was implanted into the parenchyma of rats pancreas in experimental group( n=60); No drugs were implanted into the parenchyma of pancreas in control group.Rats were killed after surgery operation(2, 4 and 6 months).Finally, the pancreases of rats were fixed in formalin for HE staining and immunohistochemical analysis.Results ①No significant differences were observed with the weight of rats between experimental and control groups(P=0.680);②The incidence of pancreatic cyst was 33.3%in the experimental group 4 months after surgery.The incidence of pancreatic cyst was 38.9% and that of leiomyosarcoma was 5.6% in the experimental group 6 months after surgery.Conclusion Small dose of DMBA(2 mg/100 g) implanted into SD rats can cause acute pancreatitis, chronic pancreatitis, pancreatic cyst, and pancreatic leiomyosarcoma.The incidence of pancreatic leiomyosarcoma is very low.But no pancreatic ductal cell carcinoma was found.Further reaserch is needed.
Background: Laparoscopic common bile duct exploration (LCBDE) has already been established for the treatment of patients with common bile duct stones (CBDS) in elective situations. However, the effect of emergent LCBDE on those patients with nonsevere acute cholangitis has not been assessed. The aim of this study was to evaluate the effect of emergent LCBDE on patients with nonsevere acute cholangitis complicated with CBDS.Methods: Seventy-two patients with CBDS admitted from January 2009 to December 2012 were included for this retrospective study. LCBDE of transductal approach for CBDS was performed to all patients. Thirty-seven patients underwent emergent LCBDE for nonsevere acute cholangitis and 35 patients underwent elective LCBDE. Duration of the procedure, complications, retained stone of bile duct, hospital stay, and total charges were compared between the two groups. In addition, the characteristics of patients underwent emergent LCBDE were also compared before and after surgery.Results: There was no significant difference with regard to the diameter of common bile duct and number of CBDS from imaging and/or operative findings between the two groups. There was no conversion to open common bile duct exploration, no major bile duct injuries, and no mortality in both the group of patients. There was no significant difference in patients with or without acute or chronic cholecystitis, duration of surgery, overall hospital stay (16.41 +/- 1.03 versus 14.54 +/- 0.94, P > 0.05), and total charges (18,603 +/- 1774.64 versus 14,951 +/- 1257.09 Yuan in renminbi, P > 0.05) between the two groups. Four cases with retained stones were found in patients with emergent LCBDE and two in elective LCBDE patients. There were four cases of biliary leak in patients with emergent LCBDE and three cases in elective LCBDE group, respectively. However, there was no statistical difference between the two groups. The biliary leak was cured postoperatively after drainage. Control of septic symptoms was achieved in all patients after emergent LCBDE.Conclusions: Our data indicated that emergent LCBDE is as safe and effective as elective LCBDE for the treatment of patients with nonsevere acute cholangitis complicated with CBDS. (C) 2014 Elsevier Inc. All rights reserved.
<正>胆囊结石合并胆总管结石(common bile ductstones,CBDS)是胆道外科的常见病、多发病,文献报道因胆囊结石行胆囊切除术的患者,3%~14.7%合并CBDS[1]。随着腹腔镜胆囊切除术