2020年 · 第58卷第03期

Anatomically, the seventh segment of the liver is located in the upper segment of the right posterior lobe of the liver, deep in position, and surrounded by right perihepatic ligament attachment, with relatively poor freedom. It belongs to "difficult liver segment" in both open and laparoscopic liver resection, and its difficulty is mainly reflected in the difficulty of exposing the target liver segment by simple abdominal incision. At present, Japanese hepatobiliary surgeons adopt combined thoracic and abdominal incision to solve this problem, but the combined incision is more traumatic, which is inconsistent with the current surgical injury control concept; Domestic scholars generally use the method of fully freeing the perihepatic ligament and left-rotating the liver through abdominal incision to expose the seven segments of the liver below the incision. However, the lesions of the seven segments of the liver are inevitably squeezed in the process of freeing the perihepatic ligament and moving and rotating the liver, which is contrary to the "no-touch" principle of tumor surgical treatment. Therefore, in situ anatomical 7-segment resection of the liver was once considered impossible to complete. With the continuous development of laparoscopic technology and the advantages of laparoscopy in the exposure of difficult liver segments, many centers in China have reported laparoscopic in situ anatomical 7-segment liver resection with different methods. This paper introduces the method of in situ anatomical 7-segment liver resection by laparoscopic extrathecal treatment in our center.

Pancreaticojejunostomy is the main method of pancreatic stump management in pancreaticoduodenectomy and middle pancreatectomy, but the safety of pancreaticojejunostomy still puzzles surgeons, especially postoperative pancreatic fistula^[1,2,3,4]。 At present, there are many methods of pancreaticojejunostomy in clinic, but there is still no consensus on the best method of pancreaticojejunostomy^[3,4]。 The pancreas and jejunum are two organs with different functions and morphologies. How they heal between them is currently unclear. The Department of Pancreatic Surgery, Digestive and Vascular Surgery Center, the First Affiliated Hospital of Xinjiang Medical University, treated 4 patients who needed secondary surgery after pancreatojejunostomy. The healing process and healing characteristics of pancreatojejunostomy of patients are reported as follows.

Femoral neck fracture refers to the fracture from under the femoral head to the base of the femoral neck, accounting for about 3.6% of total body fractures. With the aging of the population, its incidence is still increasing year by year. The elderly are the high risk of femoral neck fracture, mainly due to the decrease of bone mineral density in the elderly, which causes the increase of fracture susceptibility, and the degeneration of perihip muscle group, decrease of reaction ability, and cannot offset external stress^[1,2]。 Conservative treatment of elderly patients with femoral neck fracture is easy to increase the incidence of complications, which is not conducive to the recovery of patients. Therefore, surgical treatment is often adopted clinically. This article reviews the surgical methods of femoral neck fractures in the elderly.