2018年 · 第56卷第06期

After resection of hilar cholangiocarcinoma, many liver duct openings often appear. These openings are sometimes far apart, and it is difficult to come together to form a large opening and jejunum for bilioenteral anastomosis. Some scholars have adopted the method of combined hemihepatectomy to reduce the number of hepatic duct openings and win space for anastomosis. Of course, this is also the need for radical resection^[1,2]； Some scholars also adopt the method of double-port anastomosis or even multi-port anastomosis, but because of the difficulty of anastomosis, they have designed the method of hepatointestinal anastomosis without suturing the anterior wall of bile duct^[3]； Other scholars sutured the seromuscular layer at the posterior edge of the jejunal incision directly with the wall of the portal vein^[4]Instead of even doing gallbladder reconstruction, simple external drainage is used^[5]Each of these methods has its own pros and cons. From January 2009 to December 2016, the Liver Cancer Diagnosis and Treatment Center of Jiangxi Cancer Hospital completed gallbladder reconstruction in 28 patients with hepatointestinal anastomosis with circular hepatic ligament interposition, and achieved good results, which are now introduced.

Pulmonary artery transannular patch was once the standard procedure for the correction of tetralogy of Fallot. Some cases had persistent pulmonary regurgitation after radical trans-annular patch surgery, which led to right ventricular dilatation, right ventricular failure, intractable arrhythmia, and even sudden death^[1,2,3]。 If the operation of trans-annular patch is reduced and only limited outflow tract dredging is performed, there will be a series of problems such as right ventricular residual obstruction, which is not suitable for low-weight, infants and small annular cases. Some scholars attempt to implant pulmonary valves at the same time as completely dredging the outflow tract, or routinely implant prosthetic valves after radical resection of tetralogy of Fallot, but the size of the annulus limits the application of this technique in children. Some scholars have attempted to use PTFE pericardial patch material to construct artificial single-leaf valve or double-leaf valve implanted into the right ventricular outflow tract, and achieved satisfactory clinical results^[4,5]。 In March 2012, we started to use PTFE artificial patch material technology to reconstruct the right ventricular outflow tract of patients with pulmonary valve implantation to protect right ventricular function. The experience is reported below.

The results of the study published in the journal JAMA showed that among patients undergoing transcatheter aortic valve replacement, younger age, male, with a history of diabetes, and moderate to severe aortic insufficiency were associated with an increased risk of endocarditis. The researchers also found that patients with endocarditis had higher in-hospital mortality and 2-year mortality rates^[1]。