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Objective To analyze the clinical value of percutaneous transhepatic biliary drainage (PTBD) in the treatment of obstructive jaundice.Methods A total of 479 patients with obstructive jaundice were enrolled in PLA General Hospital from July 2015 to July 2017 underwent percutaneous transhepatic biliary drainage,the preoperative serum total bilirubin was 92 ～ 614 μmol/L,the target bile duct was 2 ～ 16 mm in diameter.The PTBD was ultrasound guided.Results All of the 479 patients underwent PTBD successfully,and 99.6％ showed evident alleviation of jaundice postoperatively.Conclusions Ultrasoundguided PTBD is an effective method for reducing jaundice for preoperative or palliative treatment in patients with obstructive jaundice.The method of operation is worthy of further study.
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Objective To study the macrophage immune response after the percutaneous microwave coagulation therapy (PMCT) under the ultrasound guide. Methods Eighty-nine cases of primary hepatic carcinoma patients were treated by PMCT. At the time of the fourth week after PMCT and before PMCT, the patients were given percutaneous biopsy under ultrasound guide. And the samples were stained by immunohistochemical methods. Then the infiltration of macrophage on local treatment areas were compared before and after the treatment. Moreover the function of immunocytes were observed by electronic microscope. Results The infiltration of macrophage increased significantly in post-PMCT as compared with that in pre-PMCT. And there were more protuberance from the macrophage and much more lysosome and endoplasmic reticulum and mitochondrium observed by electronic microscope. Conclusion The local macrophage cellular immunity can be more improved after the primary hepatic carcinoma treated by PMCT.
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<p><b>OBJECTIVE</b>To evaluate the clinical application of gray scale and color Doppler sonography in the diagnosis of hepatic malignant cystic tumors.</p><p><b>METHODS</b>Characteristics of gray scale and color Doppler sonography were studied in 16 cases of malignant hepatic tumors confirmed by pathology. Tumor size, shape, number of lesion, thickness of cystic wall and echogenecity of the lesion were observed with gray scale sonography. Blood supply of the tumor and its velocity were observed with Color Doppler sonography.</p><p><b>RESULTS</b>One single lesion was common in primary malignancy while multiple lesions signified metastasis. Sonographic findings revealed that the shape of the tumor was spheroid in 8 cases, irregular in 5 and leaf-shaped in 3, with the diameter varying from 1.9 cm to 13.6 cm. Sonography showed malignant cystic tumor with irregular thick wall in 15 cases, multiple septa in 7 cases and papillary projections in 6 on gray scale. Color Doppler flow signal was detected in the irregular thick wall, multiple septa or papillary projections in 14 cases, of which the arterial blood flow signals were demonstrated in 13.</p><p><b>CONCLUSION</b>Color Doppler is able to clearly detect the blood flow signals in the irregular thick wall, multiple septa or papillary projections, providing an important sign for the diagnosis of hepatic malignant cystic tumors.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Cysts , Diagnosis , Diagnostic Imaging , Liver , Diagnostic Imaging , Pathology , Liver Neoplasms , Diagnosis , Diagnostic Imaging , Ultrasonography, Doppler, Color , MethodsABSTRACT
<p><b>OBJECTIVE</b>To evaluate the long-term results of percutaneous microwave coagulation therapy (PMCT) for primary hepatocellular carcinoma.</p><p><b>METHODS</b>From May 1994 to May 2000, 177 hepatocellular carcinoma patients with 265 nodules underwent PMCT with ultrasound (US) guidance. The tumor size varied from 1.5 to 8.7 cm (median 4.12 + 1.9 cm). Follow-up examination was carried out with colour US, CT, MRI and AFP. 184 nodules were re-biopsied during the follow up of 5 - 74 months (median 29 months).</p><p><b>RESULTS</b>After PMCT, colour Doppler flow signals disappeared in 92.0% (207/225) of patients. No enhancement was observed in 88.5% (138/156) by CT and 88.9% (32/36) by MRI. Re-biopsy of 184 nodules showed complete necrosis in 92.4% (170/184). Six resected lesions showed complete tumor necrosis in 5 and subtotal necrosis in 1. The 1- to 5-year survival rates were 90.1%, 76.9%, 68.3%, 64.2% and 57.8%, respectively. The survival rates of the well differentiated lesions were better than those of the poorly ones (P < 0.05). But there was not statistical significance between the moderately and the well differentiated ones. The new lesions development rates in 1 to 5 years were 26.1%, 37.8%, 43.5%, 48.6% and 58.9%, respectively. However, there was no severe complication.</p><p><b>CONCLUSION</b>Ultrasound-guided microwave coagulation is safe and effective for primary hepatocellular carcinoma. It can eliminate tumors less than 5 cm in diameter.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Carcinoma, Hepatocellular , Mortality , Therapeutics , Liver Neoplasms , Mortality , Therapeutics , Microwaves , Therapeutic Uses , Treatment OutcomeABSTRACT
Background and purpose:Tumour cell is recognized and rejected by immunocytes.The local infiltration of immunocytes and the clinical curative effect after the percutaneous microwave coagulation therapy(PMCT) is worthy of further study.We investigated the local immune response after PMCT under ultrasound guidance and evaluated if the local immune response had any influence on the prognosis of patients.Methods:89 cases of patients with hepatocellular carcinoma were treated by PMCT.At the time of the fourth week after PMCT and before PMCT,the patients were given percutaneous biopsy under ultrasound guidance.And the samples were stained by immunohistochemical methods.Then the infiltration of CD4+、CD57+ and CD68+ of local treatment areas were compared before and after the treatment of PMCT.Meanwhile,the patients underwent follow-up to survey the possibility of recrudescence.Moreover,the authors analyzed the relation between the infiltration of immunocytes and recrudescence.Results:A few CD4、CD57 and CD68 positive cells were observed in the cancer stoma and tissues surroundings the liver before PMCT.After PMCT,the immunocytes of CD4、CD57 and CD68 positive cells were significantly increased both in the cancer and the adjacent liver tissue.These immunocytes were enlarged in size.The infiltration of CD4+、CD57+ and CD68+ increased significantly in post-PMCT as compared with those of pre-PMCT(P