【Abstract】ObjectiveTo improve curative effects in the treatment of hilar bile duct stricture. MethodsIntrahepatic cholelithiasis was associated with the development of hilar bile duct stricture.Plastics of hilar bile duct stricture (PHBDS) using pedicled cholecystic graft and Roux-en-Y cholangiojejunostomy (RYCJ) were performed. The patients with hepatolithiasis treated with PHBDS or RYCJ between Jan. 1994 and Jan. 2004 were retrospectively analyzed.ResultsFollow-up was carried out from 16 months to 87 months with an average of 47 months. The postoperative morbidity of cholangitis was 5.66% and 21.88% (P=0.010) and recurring rate of hepatolithiasis was 3.77% and 16.67%(P=0.021).ConclusionPHBDS can preserve the physiological compatible, convenient and effective in treatment of hilar bile duct stricture. The late result after operation of PHBDS is better than that of RYCJ.
Objective To investigate the effect of ABO-incompatible liver transplantation on patients with acute hepatic failure. Methods A retrospective review was undertaken on the clinical data of 3 cases （1 case of Budd-Chiari syndrome, 1 case of liver cancer and 1 case of severe hepatitis B were included） undergoing ABO-incompatible liver transplantation for acute hepatic failure. The patients were given quadruple immunosuppression after operation. Results Postoperative complications including pulmonary infection, central pontine myelionlysis and acute rejection was suffered from by the patient of Budd-Chiari syndrome who was then given a positive deal and had survived for more than 14 months. The patient of liver cancer was aggravated by severe infection who died of multiple organ failure on day 13 after operation. The patient with severe hepatitis B was made more severe by acute renal failure whose kidney function was restored with continuous renal replacement therapy. Conclusion The outcome of ABO-incompatible liver transplantation can be improved with refined peri-transplant management and better immunosuppressive strategies. ABO-incompatible liver transplantation should be viewed as an important option in patients with acute hepatic failure awaiting an emergency procedure.