BACKGROUND Mirizzi syndrome(MS)remains a challenging biliary disease,and its low rate of preoperative diagnosis should be resolved.Moreover,technological advances have not resulted in decisive improvements in the surg...BACKGROUND Mirizzi syndrome(MS)remains a challenging biliary disease,and its low rate of preoperative diagnosis should be resolved.Moreover,technological advances have not resulted in decisive improvements in the surgical treatment of MS.Complex bile duct lesions due to MS make surgery difficult,especially when the laparoscopic approach is adopted.The safety and long-term effect of MS treatment need to be guaranteed in terms of preoperative diagnosis and surgical strategy.AIM To analyze preoperative diagnostic methods and the safety,effectiveness,prognosis and related factors of surgical strategies for different types of MS.METHODS The clinical data of MS patients who received surgical treatment from January 1,2010 to December 31,2020 were retrospectively reviewed.Patients with malignancies,choledochojejunal fistula,lack of data and lost to follow-up were excluded.According to preoperative imaging examination records and documented intraoperative findings,the clinical types of MS were determined using the Csendes classification.The safety,effectiveness and long-term prognosis of surgical treatment in different types of MS,and their interactions with the clinical characteristics of patients were summarized.RESULTS Sixty-six patients with MS were included(34 males and 32 females).Magnetic resonance imaging/magnetic resonance cholangiopancreatography(MRI/MRCP)showed specific imaging features of MS in 58 cases(87.9%),which was superior to ultrasound scan(USS)in the diagnosis of MS and more sensitive to subtle biliary lesions than USS.The overall laparoscopic surgery completion rate was 53.03%(35/66),where the completion rates of MS type I,II and III were 69.05%(29/42),42.86%(6/14)and zero(0/10),respectively.Thirty-one patients(46.97%)underwent laparotomy or conversion to laparotomy including 11 cases of iatrogenic bile duct injury which occurred in type I patients,and 25 of these patients underwent bile duct exploration,repair and T-tube drainage.In addition,25 patients underwent intraoperative choledochoscopy and T-展开更多
To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 wer...To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score(CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score.展开更多
文摘BACKGROUND Mirizzi syndrome(MS)remains a challenging biliary disease,and its low rate of preoperative diagnosis should be resolved.Moreover,technological advances have not resulted in decisive improvements in the surgical treatment of MS.Complex bile duct lesions due to MS make surgery difficult,especially when the laparoscopic approach is adopted.The safety and long-term effect of MS treatment need to be guaranteed in terms of preoperative diagnosis and surgical strategy.AIM To analyze preoperative diagnostic methods and the safety,effectiveness,prognosis and related factors of surgical strategies for different types of MS.METHODS The clinical data of MS patients who received surgical treatment from January 1,2010 to December 31,2020 were retrospectively reviewed.Patients with malignancies,choledochojejunal fistula,lack of data and lost to follow-up were excluded.According to preoperative imaging examination records and documented intraoperative findings,the clinical types of MS were determined using the Csendes classification.The safety,effectiveness and long-term prognosis of surgical treatment in different types of MS,and their interactions with the clinical characteristics of patients were summarized.RESULTS Sixty-six patients with MS were included(34 males and 32 females).Magnetic resonance imaging/magnetic resonance cholangiopancreatography(MRI/MRCP)showed specific imaging features of MS in 58 cases(87.9%),which was superior to ultrasound scan(USS)in the diagnosis of MS and more sensitive to subtle biliary lesions than USS.The overall laparoscopic surgery completion rate was 53.03%(35/66),where the completion rates of MS type I,II and III were 69.05%(29/42),42.86%(6/14)and zero(0/10),respectively.Thirty-one patients(46.97%)underwent laparotomy or conversion to laparotomy including 11 cases of iatrogenic bile duct injury which occurred in type I patients,and 25 of these patients underwent bile duct exploration,repair and T-tube drainage.In addition,25 patients underwent intraoperative choledochoscopy and T-
文摘To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score(CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score.
