Biomedical subjects

Li-Bo Li

Publications and source records attributed to Li-Bo Li.

5 recordsLinked to original sources

PubMed2005

Factors influencing the results of treatment of bile duct injuries during laparoscopic cholecystectomy.

BACKGROUND: The short-term results of repair of laparoscopic bile duct injuries have been well discussed, but the long-term results have been rarely reported. This study was undertaken to evaluate the factors influencing the outcome of repair of bile duct injuries caused by laparoscopic cholecystectomy. METHODS: The outcomes of repair of bile duct injuries caused by laparoscopic cholecystectomy in 31 patients were reviewed retrospectively, and the effects of injury recognition, cholangiography, repair modality and techniques on the long-term results were analyzed. RESULTS: Bile duct injuries were repaired successfully in 19 (95%) of 20 patients with injuries who had been recognized intraoperatively, and in 10 (90%) of 11 patients with injuries who had been recognized postoperatively. Repair was successful in 29 (93%) of the 31 patients after complete cholangiography. Closure of partial division, laceration, or small perforation of the bile duct with or without T tube drainage was satisfactory in the 23 patients. End to end repair over T tube was successful in 2 transection patients, who were detected intraoperatively. Roux-en-Y hepaticojejunostomy was used successfully to repair transection, excision or stricture of the bile duct in 4 of 5 patients (80%). CONCLUSION: Early detection of bile duct injuries caused by laparoscopy, complete evaluation of the biliary duct, and appropriate surgical modality and techniques are helpful to improve the results of repair for laparoscopic bile duct injuries.

Age Distribution↗

PubMed2004

Biliary drainage after laparoscopic choledochotomy.

AIM: Transcystic biliary decompression (TCBD) has been proposed as an alternative to T-tube placement after laparoscopic choledochotomy (LCD). This permits safe primary closure of the choledochotomy and eliminates the complications associated with T-tubes. TCBD tube has been secured by Roeder knots and transfixation, and removed later than 3 wk after surgery. We presented a modified TCBD (mTCBD) method after LCD using the ureteral catheter and the Lapro-Clip (David and Geck, Danbury, Connecticut, USA), and compared it with T-tube drainage. METHODS: Between October 2002 and June 2003, patients with choledocholithiasis undergoing LCD with mTCBD (mTCBD Group, n = 30) were retrospectively compared to those undergoing LCD with T-tube drainage (T-tube Group, n = 52) at a single institution. RESULTS: There were no significant differences in operative time and retained stones between the two groups. Patients in mTCBD group had a significantly decreased average output of bile compared with those in T-tube group (306+/-141 vs 409+/-243 mL/24 h, P = 0.000). Removal of drain tubes in mTCBD group was done significantly earlier than that in T-tube group (median, 5 vs 29 d, P = 0.000). No complication related to drain tubes was found in mTCBD group, and morbidity rate with the T-tube was significantly higher (11.5%), and bile leakage following T-tube removal was 5.8%. CONCLUSION: A modified TCBD after LCD is safe, effective and easy to perform. It may reduce postoperative complications, especially bile leakage.

Adult↗

PubMed2004

[Laparoscopic liver resection for benign liver tumors].

OBJECTIVE: To assess the feasibility, safety, and outcome of laparoscopic liver resection for benign liver tumors. METHODS: Fourteen patients with benign liver tumors, including 11 cases of hepatic hemangioma, 1 case of hepatic focal nodular hyperplasia, 1 case of hepatic granulomatous inflammation, and 1 case of liver cyst with hyaline degeneration and calcification underwent laparoscopic liver resection by PMOD. RESULTS: Hepatectomy was performed successfully under laparoscope in these 14 patients. There was no conversion to open approach, no postoperative mortality and no postoperative complication. The mean postoperative hospital stay was 6.4 days without recurrence. CONCLUSION: Laparoscopic liver resection of benign liver tumors by PMOD is feasible and safe for patients with symptomatic and undetermined hepatic tumor, and is applicable in hepatic hemangioma complicated with cholecystitis.

Adult↗

PubMed2003

Management of choledocholithiasis: comparison between laparoscopic common bile duct exploration and intraoperative endoscopic sphincterotomy.

AIM: Choledocholithiasis is present in 5 to 10 percent of patients who have cholelithiasis. In the area of laparoscopic cholecystectomy (LC), laparoscopic common bile duct exploration (LCBDE) and intraoperative endoscopic sphincterotomy (IOES) have been used to treat choledocholithiasis. The purpose of this study was to compare the clinical outcomes and hospital costs of LCBDE with IOES. METHODS: Between November 1999 and October 2002, patients with choledocholithiasis undergoing LC plus LCBDE (Group A, n=45) were retrospectively compared to those undergoing LC plus IOES (Group B, n=57) at a single institution. RESULTS: Ductal stone clearance rates were equivalent for the two groups (88% versus 89%, P=0.436). The conversion rate was higher for Group B (8.8% versus 4.4%, P=0.381), as was the morbidity (12.3% versus 6.7%, P=0.336). There were no other significant differences between the two groups. The complications were mainly related to endoscopic sphincterotomy (ES), and the hospital costs were significantly increased in this subset of Group B (median, 23,910 versus 14,955 RMB yuan, P=0.03). Although hospital stay was longer in Group A (median, 7 versus 6 days, P=0.041), the patients in Group A had a significantly decreased cost of hospitalization compared with those in Group B (median, 11,362 versus 15,466 RMB yuan, P=0.000). CONCLUSION: The results demonstrate equivalent ductal stone clearance rates for the two groups. LCBDE management appears safer, and is associated with a significantly decreased hospital cost. The findings suggest LCBDE for choledocholithiasis is a better option.

Adult↗

PubMed2002

[Construction of adeno-associated virus vector carried mutated dihydrofolate reductase and green fluorescent protein and its expression in NIH3T3 cells].

The aim of this study was to construct recombinant mDHFR-GFP/AAV vector containing mutated dihydrofolate reductase (mDHFR) and green fluorescent protein (GFP) fusion genes and its expression in NIH3T3 cells, to investigate the resistance of the cells to methotrexate. Amplified cDNA of mDHFR and GFP segmented from their plasmid separately were linked by PCR with the aminoacetic acid linker. The fusion gene was inserted into T vector, and after enzyme cutting the fusion gene fragment was inserted into AAV vector, then packaging the vector into recombined AAV and infected NIH3T3 cells. Expression of gene fusion was observed by PCR, fluorescent microscopy and flow cytometry. mDHFR and GFP cDNA were found in NIH3T3 genomic DNA, the GFP expression rate was about 25%, and resistance of the transferred cells to MTX was increased markedly. The results showed that AAV vector can transfer mDHFR and GFP fusion gene into NIH3T3 cells and increase resistance to MTX in gene modified cells. This data provided a basis for application of mDHFR and AAV vector in gene therapy.

3T3 Cells↗