ObjectiveTo investigate the clinical features, diagnosis, therapeutic methods of Paget's disease involving the scrotum. MethodsThe clinical data of 18 patients with Paget's disease treated in our hospital between 2008 and 2013 involving the scrotum were analyzed retrospectively. The patients' age ranged from 55 to 81 years old with an average of 69. The disease course ranged from 9 months to 18 years, averaging 6 years and 3 months. The main clinical pr was itching (94.4%), followed by exudation (66.7%), pain (11.1%), and desquamation (5.6%). All patients underwent extended resection. ResultsThe patients were followed up for 8 to 52 months averaging 34 months. Four patients' postoperative pathological report found focus on the excision margin, and one of them had local recurrence after 14 months. The remaining 14 cases had no local recurrence. One patient's pathological findings reported Paget's disease combined with invasive adenocarcinoma which invaded subcutaneous fat tissue layer, and this patient developed inguinal lymph node metastasis 20 months after operation. Another patient combined with adenocarcinoma which invaded deep dermis layer developed liver and lung metastasis 18 months after operation. ConclusionPaget's disease involving the scrotum is more commonly seen in older patients, and its main clinical presentation is itching. Paget's disease is usually misdiagnosed, so patients should undergo pathological examination early to clear diagnosis. Surgery is the main treatment. Paget's disease combined with invasive adenocarcinoma has poor prognosis.
ObjectiveTo investigate the efficacy and safety of laparoscopic cholecystectomy and common bile duct exploration(LCBDE) with biliary stent drainage or T tube drainage. MethodsThe clinical data of 68 cases of gallbladder and bile duct stones with the LCBDE by the same surgeon in our hospital from June 2008 to June 2013 were retrospectively analyzed. Twenty-two patients were treated with LCBDE and biliary stent drainage(stent drainage group), 46 patients were treated with LCBDE and T tube drainage(T tube drainage group). ResultsThe operation were successfully completed of 2 groups. The anal exhaust time, peritoneal drainage time, postoperative hospitalization time, and hospital expenses in stent drainage group were shorter or less than thoes T tube drainage group(P < 0.05). There were no significant difference in the operative time, postoperative bilirubin level, and incidences of postoperative complications between the two groups(P > 0.05). ConclusionsThe stent drainage and T tube drainage after LCBDE has its own indications. Laparoscopic common bile duct exploration and biliary stent drainage is superior to the laparo-scopic common bile duct exploration and T tube drainage.