mulberry bags vdq nbb bhmx zlw

asbryobvrz · Wysłany: Czw 13:11, 10 Mar 2011

Postoperative liver transplant patients in the observation of psychotic symptoms

12 cases of benign tumor resection Zhen Qi Fu Wu Shao-fu Zhao Pingrong Vichy men in this group 1 patient in 12 cases, 11 female; aged 16 to 52 years, median age 34 years. Accidentally discovered by physical examination in 8 cases of pancreatic head lesions and one hospital. 4 had symptoms were upper abdominal pain in 1 case, 2 cases of upper abdominal mass, fasting syncope, irritability, coma, after glucose supplemented clear in 1 case. 1 case of preoperative fasting blood glucose 37me/dl, serum insulin 15.5U / L, serum insulin and blood glucose ratio of 0.42, after fasting blood glucose 102ms/dl, the pathological diagnosis of insulinoma. The remaining 11 patients before and after the fasting blood glucose to normal. Preoperative B-, CT, MRI or left upper abdomen shows pancreatic head in 4 cases of solid tumor,[link widoczny dla zalogowanych], solid and cystic mass in 8 cases, enhanced CT,[link widoczny dla zalogowanych], MRI examination substantial part of a strengthening. The median tumor size was 5.4cm × 6.2cm. 3 cases of calcification within the tumor. Pathological report of 7 cases of pancreatic islet cell tumors, cystic and solid tumors in 2 cases, 1 case of serous cystadenoma, 2 cases of mucinous cystadenoma. Maximum 32cm × 22cm, is non-functional islet cell tumors. Insulinoma minimum, and 2 lesions, one located in the pancreatic head, diameter 0.8cm; the other one in the tail of the pancreas, diameter of 0.6cm. Line pancreatic head excision of the tumor in 8 cases, BegerS method to retain the duodenum subtotal pancreatic head in 3 cases, Freys method in 1. The average operation time 2.5h, the average blood loss was 400ml. 1 case of postoperative pancreatic leakage, and the remaining 11 cases without complications. 11 cases followed up for 10 months to 7 years and 2 months, the average time of 3 years in July, lost 1 case. Follow-up showed no tumor recurrence, postoperative pancreatic endocrine and exocrine normal. Discuss the cases in this group of functional and nonfunctional islet cell tumors constitute a ratio of 1:6, and 7:3 reported in the literature about which I Department Cancer Hospital, functional islet cell tumor because of obvious clinical symptoms of patients The doctor at the general hospital and more relevant. Nonfunctioning islet cell tumors are often found in large, generally no clinical symptoms, many accidentally discovered by a physical examination, oppression of surrounding organs or tumor caused by a huge epigastric discomfort and other symptoms and treatment. Preoperative B-show uneven pancreatic solid mass or echo. CT, MRI clearly prompted the border of the pancreatic head unit: 100021 Beijing, China Academy of Medical Sciences Cancer Hospital, Peking Union Medical College Abdominal Surgery. Case report. Mass, in solid or mixed solid and liquid tumor, some with calcification,[link widoczny dla zalogowanych], and more without pancreatic duct dilatation. Enhanced scan with marked enhancement of tumor blood supply was high, more easily identify with pancreatic head cancer. Pancreatic endocrine tumors based primarily on whether the distinction between benign and malignant liver, pancreatic distant organs and lymph node metastasis. Endocrine tumors of the 7 patients diagnosed before the academic image accuracy was 71%. Cystic solid tumors, also known as papillary cystic tumor is a rare pancreatic tumor, more common in young women, preoperative imaging studies is difficult under the correct diagnosis. 2 patients in this group were female, aged 16 years and 40 years old, were not correctly diagnosed before surgery, intraoperative frozen section failed to make a clear diagnosis. This group of patients the preoperative imaging, intraoperative exploration and tumor biopsy cytology diagnosis of benign tumor removal, we have taken to retain the head of the pancreas and duodenum subtotal. As a complete tumor capsule, clear boundaries and pancreatic tissue, pancreatic duct pushed most of the shift is due to the tumor, intraoperative sharp anatomical detail, the main pancreatic duct are often able to maintain its integrity. If the tumor is located in the surface of the head of pancreas, local complete excision is not difficult. If the tumor deep in the, along the separation of the tumor within the pancreas,[link widoczny dla zalogowanych], pancreatic tissue injury serious or suspected pancreatic duct injury, the line should be retained BegerS law or FreyS law duodenum subtotal resection of pancreatic head, pancreatic jejunal Roux-section ell-Y anastomosis,[link widoczny dla zalogowanych], or cover-type pancreatic jejunal Roux-ell-Y anastomosis. Intraoperative rupture of the main pancreatic duct as far as possible set of people to find small silicone tube, proximal pancreatic duct ligation, catheter end through the jejunum, 25 ~ 30cm away from the stoma through the abdominal wall for external drainage of the intestinal wall and to prevent the occurrence of pancreatic leakage. The treatment of this group of cases from the results, the local pancreatic head resection of benign tumors is feasible, short and long term effect is good.