Pancreolith with pancreatic carcinoma is a rare disease. It’s difficult to be diagnosed before operation. In this study we summerized 29 cases of pancreolith (including cases of pancreolith with pancreatic carcinoma) during Jan. 1989 to Oct. 1994 treated in our hospital. The clinical characteristics were the following more male patients encomtered; many had the history of chronic alcoholic pancreatitis and many accompanied with diabetes; the main symptoms were persistent upper abdominal pain, pain in the back anoxia, diarrhea, wasting, but rarely jaundice. Main points in diagnosis: ①When the symptoms of chronic pancreatitis are getting worse and the patients become wasting, the carcinoma should be considered. ②Mutiple investigations such as B-US, CT, and MRI, CA19-9, CEA should be taken. ③Exploretory laparotomy and freezy biopsy is performed If nesscessery. Two patients were diagnosed before operation in this study. 3 cases had pancreatoduodenectomy. One had biopsy and other had pancreatojejunostomy.
Analysis of hospital cases of cholelithiasis in every four years of the recent 3 decades clearly shows the tendency of changes of cholelithiasis in clinical appearance in Chengdu.Constituent ratio of gallbladder stone was 12.56% in 70’s,47.54% in 80’s and 81.38% in 90’s.Bill duct stones including acute obstructive suppurative cholangitis was 71.01%, 46.08%,and 15.82% respectively. Biliary ascariasis was 11.67%, 2.75% and 0.68% respectively. Age incidence shows right moving, i.e. old patients increased. Urban patients increased.The influencing factors listed are: improvement of diagnostic methods; improvement of livelihood and diet; increased life expectancy; more health follow up examinations; technical improvements in rural areas and etc.
Objective To study the clinical diagnosis and treatment of juxtapapillary duodenal diverticula with biliary deseases.Methods Eighteen duodenal diverticulum treated in our department in recent 5 years were retrospectivly analyzed, especially investigated the postcholecystectomy cases whose symptoms were continuing existence after operatoins. Articles about the surgical treatment were reviewed. Results The total of 18 duodenal diverticulum with 17 cases of juxtapapillary duodenal diverticulum were included in this study. The ages of 12 cases were over 50 years old. Sixteen cases(88.89%) presented biliary stones. Seven cases once had performed cholecystectomy or cholecystectomy plus choledochotomy,but symptoms persisted after operations. The duodenal diverticulum were found by endoscopic retrograde cholangiopancreatography (ERCP) and hypotonic duodenography. Sixteen patients underwent surgical treatment with good effect. Conclusion The juxtapapillary duodenal diveticula has the close relationship with biliary stones. ERCP and hypotonic duodenogrphy are the most reliable methods to get the correct diagnosis. In case of recurrent common bile duct stones after operations or persisting billiary symptoms after cholecystectomy, the coexistence of juxtapapillary duodenal diverticulum should be ruled out. The surgical treatment is only considered for the duodenal diverticulum with complication.
ObjectiveTo observe the effect of 5Fluorouracil(5FU) on the exocrine pancreas. MethodsThe effects of 5FU were investigated in 8 patients who had undergone pancreatoduodenectomy. The pancreatic juice was temporarily diverted to the exterior via a pancreatic duct catheter.Ten days after operation,the patients were injected intravenously with 5FU 500 mg/d for three days. The samples of pancreatic juice were taken for measurement of amylase,pH, HCO3-, Na+, K+, Cl-, Ca2+ and Mg2+.ResultsThe amylase, pH, HCO3-, Na+, K+, Cl-, Ca2+ and Mg2+ did not alteredsignificantly before and after 5FU injection.Conclusion5FU has no shortterm effect on exocrine pancreas. Therefore, improvement of acute pancreatitis cannot be achieved through inhibiting pancreatic enzymes synthesis.
