ObjectiveTo explore the safety and effectiveness of endoscopic treatment for biliary tract complications after liver transplantation.MethodsPatients who underwent endoscopic treatment for biliary tract complications after liver transplantation from January 2009 to December 2018 in West China Hospital were enrolled. Characteristics of patients, types of biliary tract complications, effectiveness of endoscopic treatment and endoscopic related complications were collected and analyzed.ResultsAmong the 57 patients with biliary tract complications, 37 patients had biliary stricture alone, 4 patients had bile leak alone, 15 patients had biliary stricture plus biliary stones or sludge, and 1 patient had biliary stricture combined with biliary leakage. A total of 112 treatments of endoscopic retrograde cholangiopancreatography (ERCP) were performed, among which 100 treatments were accomplished successfully (89.3%), including the improvement of bile duct stenosis, the cure of bile leak and the successful removal of common bile duct stones. The number of total ERCP related complications was 15 (13.4%), among which post ERCP pancreatitis was the most common (9.8%).ConclusionEndoscopic therapy can be considered as an initial treatment for biliary tract complications after liver transplantation as its safety and effectiveness.
ObjectiveTo compare the cost-effectiveness between endoscopic retrograde cholangio-pancreatography (ERCP) treatment and laparotomy treatment for simple common bile duct stone or common bile duct stone combined with gallbladder benign lesions. MethodsA total of 596 patients with common bile stone received ERCP (ERCP group) and 173 received open choledocholithotomy (surgical group) in our hospital between January 2009 and December 2012. Their clinical data were retrospectively analyzed. The curing rate, postoperative complications, hospital stay, preoperational preparation and total cost were compared between the two groups of patients. Meanwhile, for common bile stone combined with gallbladder benign lesion, 29 patients received ERCP combined with laparoscopic cholecystectomy (LC) (ERCP+LC group), 38 received pure laparoscopy treatment (laparoscopy group) and 129 received open choledocholithotomy combined with cholecystectomy (surgery group). ResultsFor simple common bile stone patients, no significant difference was found in cure rate and post-operative complication between endoscopic and surgical treatment groups (P>0.05). However, total hospitalization expenses[(13.1±6.3) thousand yuan, (20.6±7.5) thousand yuan)], hospital stay[(8.91±4.95), (12.14±5.15) days] and preoperative preparation time[(3.77±3.09), (5.13±3.99) days] were significantly different between the two groups (P<0.05). For patients with common bile stone combined with gallbladder benign lesion, no significant discrepancy was detected among the three groups in curing rate and post-operative complications (P>0.05). Significant differences were detected between ERCP+LC group and surgical group in terms of total hospitalization expense[(18.9±4.6) thousand yuan, (23.2±8.9) thousand yuan] hospital stay[(9.00±3.74), (12.47±4.50) days] and preoperative preparation time[(3.24±1.83), (5.15±2.98) days]. No significant difference was found in total hospitalization expense and hospital stay, while significant difference was detected in preoperative preparation time between ERCP+LC group and simple LC group. ConclusionFor patients with simple common bile stone, ERCP is equivalent to surgery in the curing rate, and has more advantages such as less cost, shorter length of hospital stay, and lower preoperative preparation time. For the treatment of common bile duct stone with gallbladder benign disease, ERCP combined with LC also has more advantages than traditional surgery.
Objective To explore the effects of celecoxib, a selective COX-2 inhibitor, on the expression of NHE1 and intracellular pH (pHi) of SGC-7901 human gastric carcinoma cells. Methods Human gastric carcinoma cell line SGC-7901 was used as research object. MTT method was used to detect the celecoxib's depressant effect on the proliferation of SGC-7901 cells after intervening with different concentrations of celecoxib (5, 12.5, 25, 50, 75, and 100 μmol/L) for different time. Western blot was applied to detect influence of different concentrations of celecoxib on NHE1 expression in SGC-7901 human gastric carcinoma cells. On this basis, pHi of SGC-7901 cells was tested by BCECF-AM immunofluorescence. Results Celecoxib could effectively inhibit the proliferation of SGC-7901 human gastric carcinoma cells. And within a certain concentration range, the inhibitory action on SGC-7901 cells increased with the increase of celecoxib concentration. It also increased with the extension of explosion time while at the same concentration (P<0.05). Different concentrations (except 5 μmol/L) of celecoxib could down-regulate the expression of NHE1 in SGC-7901 cells, which was concentration dependent (P<0.05). The pHi of SGC-7901 cells that were not intervened with celecoxib is alkaline. Compared the pHi of cells in control group, the pHi of SGC-7901 cells decreased significantly after intervening with different concentrations of celecoxib (except 5 μmol/L) for 24 h (P<0.05). And the decrease of pHi was also concentration dependent (P<0.05). Conclusion Celecoxib may inhibit the growth of SGC-7901 cells through down-regulating the expression of NHE1 and declining the pHi.