ObjectiveTo explore the feasibility and characteristics of three-port laparoscopic cholecystectomy (LC) in the treatment of cholecystitis with gallbladder calculi incarceration. MethodsThe clinical data of 160 patients with gallbladder calculi incarceration treated by three-port LC between July 2010 and December 2014 were analyzed retrospectively. Among the patients, there were 104 cases of calculi incarcerated in the gallbladder neck area, 20 cases in the cystic gall duct, and 36 cases in the gallbladder ampullar region. Elective operations were carried out for 120 patients and 40 underwent emergency operation. ResultsThree-port LC was successfully completed in 154 patients (96.25%), and the other 6 patients were converted to open surgery among whom 2 underwent elective operation (1.67%) and 4 underwent emergency operation (10.00%). Two converted patients in the elective operation group had Mirizzi syndrome and gallbladder carcinoma respectively; all the 4 converted patients in the emergency operation group had a disease course of about one week with compacted triangle structure and gallbladder edema thickening of 1.0 cm, causing difficult separation under laparoscope. Seventy patients had varying degrees of enlargement and edema of gallbladder, 60 had varying degrees of gallbladder atrophy, and 30 had almost normal gallbladder. There were 80 cases of dark green thick bile, 10 of purulent bile, 40 of white bile, and 30 of empty gallbladder and no bile. No complications were found during the follow-up of 6 to 36 months, except that one patient was found to have secondary common bile duct stones three months after discharge, and the patient was cured by endoscopic retrograde cholangiopancreatography. Conclusions Elective or emergency three-port LC is safe and feasible for gallbladder calculi incarceration as long as the operator had skilled technique and made the right decision on opportunity of conversion.
ObjectiveTo explore the value liver resection combined with intraoperative radiofrequency ablation during the same period in the treatment of multiple liver cancer. MethodsWe retrospectively analyzed the clinical data of 33 patients with multiple liver cancer treated between January 2005 and April 2013. All the patients were treated by liver resection combined with intraoperative radiofrequency ablation in the same period. There were 91 tumor foci in 33 patients, among which 39 tumor foci were surgically removed, and 52 tumor foci were radiofrequency ablated. Ultrasonography and enhanced CT/MRI were performed for the patients 1 year, 2 years and 3 years after surgery. ResultsNo bleeding or death occurred during the operation. It was observed that the transient liver function was damaged after surgery, but it quickly returned to A level after treatment. All the patients had no perioperative death or other serious complications. Tumor recurrence rate was 16.1% in the first year, 48.4% in the second year and 93.5% in the third year after surgery. ConclusionLiver resection combined with intraoperative radiofrequency ablation for multiple liver cancer in the same period is feasible and safe, without increasing the average length of hospital stay, operative mortality rate and postoperative tumor recurrence rate.