Multi-visceral resection of malignant tumors with left-sided portal hypertension.

Background/aims: Left-sided portal hypertension (LSPH) is an uncommon clinical syndrome which may lead to bleeding from isolated gastric varices and pancreatitis is the most common etiology. Despite the particular rare incidence of LPSH caused by malignant tumor, the optimal management remains undefined.

Methodology: From January 2006 to December 2009, a total of 8 patients of left-sided portal hypertension caused by malignancies were admitted into the department of surgery of our hospital.

Surgical management in biliary restricture after Roux-en-Y hepaticojejunostomy for bile duct injury.

Aim: To discuss the surgical method and skill of biliary restricture after Roux-en-Y hepaticojejunostomy for bile duct injury.

Methods: From November 2005 to December 2006, eight patients with biliary restricture after Roux-en-Y hepaticojejunostomy for bile duct injury were admitted to our hospital. Their clinical data were analyzed retrospectively.

[Clinical degree of the superior mesenteric vein involvement with the surgery in the pancreas uncinate process carcinoma].

Objective: To create the clinical degree of the superior mesenteric vein (SMV) involvement in pancreas uncinate process carcinoma (PUPC) and its clinical significance to be discussed.

Methods: According to the contiguous relationship between the SMV and the PUPC, the clinical degree of SMV involvement in PUPC are as followings four grades, 1 grade, the grade of clear boundary. 2 grade, the grade of fuzzy boundary.

The solid-pseudopapillary tumor of pancreas: the clinical characteristics and surgical treatment.

Background And Objective: Since being named and reclassified by WHO in 1996, solid-pseudopapillary tumor (SPT) of pancreas has been recognized as a special entitative disease that is different from pancreatic cancer and should be recognized and treated more accurately in the surgical process. The clinic characteristics and surgical strategy on 25 cases of SPT of pancreas from the authors' center are discussed.

Methods: The clinical pathology and the surgical methods of 25 SPTs were retrospectively studied.

Clinical misdiagnosis of solid pseudopapillary tumour of pancreas.

Background: Since being reclassified by WHO in 1996, solid pseudopapillary tumour (SPT) of pancreas has been recognized as the internationally accepted name. Clinicians are lacking in knowledge of this rare disease so the misdiagnosis and inappropriate therapy are hard to avoid. The clinic data on 22 patients were summarized to study the misdiagnosis and treatment of a sample of SPTs.

Reasonable choice of surgical procedures for patients with portal hypertension.

Objective: To assess individualized therapeutic protocol for patients with portal hypertension on the basis of accumulated knowledge about the mechanism of portal hypertension.

Data Sources: Patients data on shunt and other surgical procedures from Ruijin Hospital, Shanghai, China and the published papers.

Results: The direction of blood flow of the collateral vessels in the gastro-splenic region is an important factor in deciding surgical strategy because there is a close relationship between surgical risk and the classification of liver function.