22 October 2025, Volume 38 Issue 5

    

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  Expert consensus on the selection of surgical treatment modalities for hepatocellular carcinoma （the fourth revision）

  Liver Surgery Group, Society of Surgery, Chinese Medical Association

  Journal of Abdominal Surgery. 2025, 38(5): 331-339. https://doi.org/10.3969/j.issn.1003-5591.2025.05.001

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  Clinical decision on surgical resection for patients with complete response after conversion therapy for hepatocellular carcinoma： controversy and consensus

  Luo Xuan, Chen Yajin

  Journal of Abdominal Surgery. 2025, 38(5): 340-345. https://doi.org/10.3969/j.issn.1003-5591.2025.05.002

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  The conversion therapy is an important strategy to provide surgical opportunities for patients with unresectable hepatocellular carcinoma at the initial stage. With the advancement of combination therapy， some patients can achieve radiographic complete response（rCR） or even pathological complete response（pCR）. Whether surgical resection is still necessary at this time point has become a difficult part in clinical decision-making. Based on existing evidence-based research， this article suggested that surgical decision-making should be based on multidimensional evaluation： tumor biological behavior， liver function tolerance， and anatomical feasibility assessment. For high-risk patients with recurrence or progression（e. g. ，high tumor burden， pathological evidence of residual activity， circulating tumor DNA［ctDNA］ positivity）， an active surgery can bring survival benefits. For low-risk patients （e. g. ，rCR with continuous negative ctDNA and normal tumor markers）， close observation and follow-up may be a reasonable choice. The final decision should follow the principle of individualization and be made within the framework of a multidisciplinary team（ MDT）.
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  Current status and perspectives on conversion therapy for hepatocellular carcinoma in the era of targeted immunotherapy

  Li Xin, Cai Changchun

  Journal of Abdominal Surgery. 2025, 38(5): 346-351. https://doi.org/10.3969/j.issn.1003-5591.2025.05.003

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  Hepatocellular carcinoma（HCC） is a globally prevalent malignancy with a high mortality rate.Curative resection remains the cornerstone for achieving the long-term survival of HCC. However,the majority of HCC patients are diagnosed at an advanced stage that lose the opportunity for surgery.With the development of targeted therapies, immune checkpoint inhibitors, and locoregional treatments, some patients with initially unresectable HCC can now achieve oncological downstaging through combination therapy,thereby becoming eligible for curative surgery and gaining long-term survival benefits.Nevertheless,oncological conversion for HCC is in its developmental stage,and a comprehensive, standardized system for its assessment and treatment has yet to be established. Numerous issues closely related to clinical practice remain to be addressed.This article aims to systematically review the current status of conversion therapy in HCC, focusing on target populations, efficacy evaluation,and key challenges, and to explore several core issues in depth.
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  Research progress in triplet therapy for advanced biliary tract cancers

  Leng Kaiming, Shi Guangjun

  Journal of Abdominal Surgery. 2025, 38(5): 352-356. https://doi.org/10.3969/j.issn.1003-5591.2025.05.004

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  Biliary tract cancers（BTC） are a group of malignancies originating from the biliary system, including intrahepatic cholangiocarcinomas（ICC）, extrahepatic cholangiocarcinomas（ECC）, and gallbladder carcinomas（GBC）. Due to their insidious onset, most BTC patients are diagnosed at an advanced stage and have lost the opportunity for curative surgical resection. Patients with advanced BTC have a poor prognosis, and the efficacy of traditional chemotherapy regimens is limited. In recent years, with the deepening understanding of tumor biological characteristics and the continuous development of clinical research, a variety of new therapeutic drugs and combined treatment regimens have emerged, bringing new hope for the treatment of advanced BTC.This article aims to review the research progress of chemotherapy combined with immunotherapy/targeted therapy for advanced BTC, in order to provide references for clinical practice.
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  A prospective real-world study of transcatheter arterial chemoembolization combined with hepatic arterial infusion chemotherapy, camrelizumab, and apatinib in the treatment of unresectable hepatocellular carcinoma

  Lyu Jiahui, Wang Yan, Lai Zisen, Lai Yongping, Guo Wuhua, Yan Maolin, Zhang Zhibo, Zhao Jianfeng, Wu Junzheng, Wang Congren, Yu Wenchang, Su Yongjie, Wang Yongzhong, Chen Jiafei, Xie Wenxi, Chen Yufeng, Zhang Qingxian, Wang Wei, Zeng Wenlong, Ding Zongren, Huang Liming, Zhang Jiacheng, Lin Kongying, Zeng Yongyi

  Journal of Abdominal Surgery. 2025, 38(5): 357-365. https://doi.org/10.3969/j.issn.1003-5591.2025.05.005

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  Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization（TACE） combined with hepatic arterial infusion chemotherapy（HAIC）, camrelizumab and apatinib in the treatment of unresectable hepatocellular carcinoma（uHCC） in the real world. Methods This was a multicenter, prospective,real-world study involving 135 uHCC patients treated with camrelizumab and apatinib from July 2022 to March 2025 in 19 medical centers.Patients were divided into the TACE group（58 cases） and the TACE+HAIC group（77 cases） based on the interventional treatment plan.The primary endpoints were overall survival（OS）, progression-free survival（PFS）, and treatment-related adverse events（TRAEs）.Propensity score and inverse probability treatment weighting（IPTW） were used to adjust for baseline differences between the groups. Results The median follow-up time for the overall cohort was 17.7 months. After IPTW, the Objective response rate（ORR） in the TACE+HAIC group was significantly higher than that in the TACE group（45.2% vs.31.3%,P=0.027）. Compared with the TACE group, the TACE+HAIC group showed a trend of improved PFS and OS,but the differences were not statistically significant （OS： P=0.490;PFS： P=0.425）.Subgroup analysis revealed that in patients achieving Objective response, the PFS in the TACE+HAIC group was significantly better than that in the TACE group（P=0.048）. In terms of safety, the overall rate of TRAEs in the TACE+HAIC group was significantly lower than that in the TACE group（67.5% vs. 86.2%,P=0.012）,but there was no significant difference in the rate of grade≥; 3 TRAEs（27.6% vs.28.6%,P=0.900）.No treatment-related deaths occurred in either group. Conclusion TACE combined with HAIC,camrelizumab and apatinib can significantly improve tumor response depth in uHCC patients, showing an overall high safety. However, the long-term survival benefit still needs to be verified through further follow-up.
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  Correlation of the changing rate of FOXP1 and EpCAM with the decreasing rate of tumor markers after surgery of intrahepatic cholangiocarcinoma and the clinical significance

  Li Honglei, Zhang Huijuan, Zhang Wujie, Xie Yading

  Journal of Abdominal Surgery. 2025, 38(5): 366-373. https://doi.org/10.3969/j.issn.1003-5591.2025.05.006

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  Objective To investigate the correlation of the changing rate of forkhead box transcription factor P1（FOXP1） and epithelial cell adhesion molecule （EpCAM） with the decreasing rate of tumor markers in patients with intrahepatic cholangiocarcinoma （ICC） after surgery, as well as their early warning role in disease progression in the early postoperative period. Methods This was a prospective study involving 209 patients who were diagnosed with ICC and underwent surgical resection in Handan First Hospital from January 2022 to February 2024 as the research subjects. Patients were divided into the progression group and non-progression group based on the postoperative progression.The changes in FOXP1,EpCAM, carbohydrate antigen （CA） 19-9,carcinoembryonic antigen （CEA）,and CA242 before and after surgery were compared between the two groups. Pearson correlation was used to analyze the correlation of the changing rate of FOXP1 and EpCAM after surgery with the decreasing rate of tumor markers. Variables were screened by multicollinearity. Multivariate logistic regression was used to analyze the impact of changing rates of FOXP1 and EpCAM and the decreasing rate of tumor markers on early postoperative progression of ICC.The receiver operating characteristic （ROC） curve was used to analyze the value of changing rates of FOXP1 and EpCAM and the decreasing rate of tumor markers in predicting the early postoperative progression of ICC. A nomogram was constructed for early warning of the risk of early postoperative progression of ICC, and the predictive performance of the nomogram was tested. Results During the follow-up period, 5 cases were lost, and 204 cases were finally included in the study. Among them, 91 cases were included in the progression group and 113 cases were included in the non-progression group.FOXP1 at 1 month postoperatively was significantly elevated, and postoperative EpCAM,CA19-9, CEA and CA242 were significantly reduced than pre-surgical levels （all P<; 0.05）.FOXP1 level at 1 month postoperatively was significantly lower, and postoperative levels of EpCAM, CA19-9, CEA and CA242 were significantly higher in the progression group than the non-progression group （all P<; 0.05）.Changing rates of FOXP1 and EpCAM, and the decreasing rates of CA19-9,CEA and CA242 were significantly lower in the progression group than the non-progression group （all P<; 0.05）. Pearson correlation analysis revealed that the changing rates of FOXP1 and EpCAM were positively correlated with the decreasing rates of CA19-9（r=0.816 and 0.772, respectively）,CEA（r=0.763 and 0.854, respectively） and CA242（r=0.795 and 0.806, respectively）（all P<; 0.05）.Logistic regression showed that the changing rates of FOXP1 and EpCAM, and decreasing rates of CA19-9, CEA and CA242 were independent influencing factors for postoperative early progression of ICC （all P<; 0.05）. The area under the curve （AUC） of the changing rates of FOXP1 and EpCAM, and decreasing rates of CA19-9,CEA and CA242 in predicting the postoperative early progression of ICC was 0.747,0.769,0.761,0.751 and 0.789,respectively（P<; 0.001）. Based on the above five indicators, a nomogram was constructed with a C-index of 0.897. The AUC of the nomogram in predicting the postoperative early progression of ICC was 0.897 （95% CI 0.854, 0.939）,which was significantly greater than that of changing rates of FOXP1 and EpCAM, and decreasing rates of CA19-9,CEA and CA242（P<; 0.05）.The prediction results were in good agreement with the actual results, and there was a significant positive clinical net benefit. Conclusions Changing rates of FOXP1 and EpCAM after surgery for ICC are positively correlated with the decreasing rates of CA19-9, CEA and CA242.They are independent risk factors for the postoperative early progression.A nomogram created based these variables has good predictive performance and positive clinical net benefit for early postoperative progression of ICC, and can be used as an effective model for clinical prediction of early postoperative disease progression and to guide clinical decision-making.
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  The application of vasculoskeletal anatomy in Kasai surgery for children with type Ⅲ biliary atresia

  Li Dandan, Song Yang, Yang Jixin, Feng Jiexiong, Wang Wenjing

  Journal of Abdominal Surgery. 2025, 38(5): 374-377. https://doi.org/10.3969/j.issn.1003-5591.2025.05.007

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  Objective To evaluate the effect of vascular skeletonization anatomy in Kasai surgery for type Ⅲ biliary atresia （BA） patients. Methods Clinical data of 140 BA patients admitted to Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, from January 2020 to December 2024 were retrospectively analyzed. The data included patient gender, age at surgery, weight, surgery time, hepatic portal dissection time, intraoperative blood loss, and postoperative complication rates. From January 2020 to December 2021, 55 patients underwent conventional Kasai surgery（C-K group） From January 2022 to December 2024,85 patients underwent Kasai surgery with vascular skeletonization（VS-K group）. Results There were no significant differences in gender, operative age, weight,portal vein dissection time,and blood loss between the C-K group and the VS-K group（all P>; 0.05）.All patients underwent complete removal of the extrahepatic bile duct and hepatic fibrous plate, with no short-term postoperative complications like bleeding or bile leakage.Compared to the C-K group, patients in the VS-K group had significantly longer operation duration（192±; 19 min vs.133±; 22 min,P=0.032）and lower jaundice clearance rate at 6 months of surgery（34.5% vs.52.9%,P=0.033）. Conclusion Vascular skeletonization anatomy in Kasai surgery for BA patients can improve surgical safety while completely removing the hepatic fibrous plate and shortening surgery time.
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  Clinical effect of delayed and immediate coloanal anastomosis on low rectal cancer：a meta-analysis

  Lin Xiangjie, Huang Wei, Yang Xuefei

  Journal of Abdominal Surgery. 2025, 38(5): 378-387. https://doi.org/10.3969/j.issn.1003-5591.2025.05.008

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  Objective To compare the efficacy and safety of delayed coloanal anastomosis （DCA） versus immediate coloanal anastomosis （ICA） with temporary ostomy following surgery for low rectal cancer （LRC）, thus providing valuable references for clinical surgical decision-making. Methods Articles reporting LRC surgery by DCA and ICA in English and Chinese language published from October 2013 to October 2023 were searched in the databases such as PubMed, Elsevier, Cochrane Library, CNKI, and Wanfang.The Revman 5.4 software was used to assess the quality of included literatures, and forest plots were created for meta-analysis of the corresponding observed indicators. Funnel plots were used to assess publication bias. Results A total of 15 studies（n=1 503） were included, with 937 cases in the ICA group and 566 cases in the DCA group. Compared to ICA with temporary prophylactic ostomy, patients undergoing DCA had a significantly lower incidence of overall postoperative complications（OR=0.63, 95%CI：0.41-0.96, P=0.03） and anastomotic leaks（OR=0.37, 95% CI：0.23-0.58, P<; 0.001）.No significant differences were found between DCA and ICA in terms of local tumor recurrence（OR=0.94, 95%CI：0.41-2.16, P=0.89）, distant tumor metastasis（OR=0.86, 95%CI：0.38-1.94, P=0.72）, postoperative anastomotic stenosis（OR=0.74, 95%CI： 0.19-2.80, P=0.65）, postoperative anastomotic bleeding（OR=0.35, 95% CI：0.07-1.70, P=0.19）, postoperative pelvic infection（OR=0.64, 95%CI：0.35-1.18, P=0.15）, postoperative sepsis（OR=1.30, 95%CI：0.36-4.72, P=0.69）, postoperative intestinal obstruction （OR=0.72, 95%CI：0.15-3.35, P=0.67）, postoperative dysuria （OR=0.63, 95%CI：0.25-1.56, P=0.32）, and postoperative pulmonary infection （OR=1.46, 95%CI： 0.33-6.56, P=0.62）. Conclusion DCA is associated with a lower incidence of overall complications and anastomotic leaks, but the rates of local tumor recurrence, distant tumor metastasis, and postoperative anastomotic stenosis, anastomotic bleeding, pelvic infection, sepsis, intestinal obstruction, dysuria, and pulmonary infection are similar to those of ICA.Therefore, DCA appears to be safe and feasible, and may serve as a safe alternative to ICA.However, further validation is required through more high-quality randomized controlled trials.
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  Clinical study on the recurrence of gallstone after a combined treatment of gallbladder-preserving cholecystolithotomy with laparoscopy and choledochoscopy

  Zhu Mingqiang, Xie Xing, Luo Jing, Xiao Yuansheng, Liao Qicheng, Wang Xiaohua

  Journal of Abdominal Surgery. 2025, 38(5): 388-392. https://doi.org/10.3969/j.issn.1003-5591.2025.05.009

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  Objective To explore the risk factors and the predictive value of combined indexes for gallstone recurrence after gallbladder-preserving cholecystolithotomy with laparoscopy and choledochoscopy（LC-GPC）. Methods Clinical data of 44 patients undergoing LC-GPC in the First Affiliated Hospital of Gannan Medical University from September 2019 to May 2024 were retrospectively collected. Based on the 6-month gallstone recurrence after LC-GPC, patients were divided into the gallstone recurrence（GR） group （n=6） and the non-GR group （n=38）. The t-test or Mann-Whitney U test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. Logistic regression analysis was used for univariate and multivariate analyses, and the receiver operating characteristic （ROC） curve was used to evaluate the predictive power of the combined indicators. Results GR occurred in 6 out of 44 patients（13.6%）. Multivariate logistic analysis showed that the Gallbladder Status Score（GSS）（OR=0.361,95%CI：0.131-0.994,P=0.049）,and total cholesterol（OR=0.215,95%CI：0.056-0.822,P=0.025） were independent risk factors for the recurrence of gallstone after LC-GPC.The area under ROC the curve（AUC） of GSS,total cholesterol and GSS+total cholesterol for predicting gallstone recurrence after LC-GPC was 0.759, 0.811 and 0.930, respectively. Conclusion GSS+total cholesterol has a good predictive value and clinical significance for gallstone recurrence after LC-GPC.
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  Role of the systemic immune inflammation index and C-reactive protein/albumin ratio in evaluating the progression of acute pancreatitis

  Lin Shuting, Lin Zhiqian

  Journal of Abdominal Surgery. 2025, 38(5): 393-397. https://doi.org/10.3969/j.issn.1003-5591.2025.05.010

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  Objective To investigate the role of systemic immune inflammation index （SII） and C-reactive protein/albumin ratio（CRP/ALB） in evaluating the progression of acute pancreatitis. Methods The clinical data of 166 patients with acute pancreatitis admitted to the Dongnan Hospital of Xiamen University from January 2020 to December 2021 were retrospectively analyzed. Patients were divided into progressive group（n=41） and non-progressive group（n=125） based on whether they were diagnosed with progression of severe acute pancreatitis upon admission.The correlation of SII and CRP/ALB with the Acute Physiologic Assessment and Chronic Health Evaluation Ⅱ（APACHE Ⅱ） score, modified Marshall score, modified CT severity index（MCTSI） score, CRP, blood urea nitrogen （BUN）, blood calcium, serum calcium,creatinine （Cr） and procalcitonin （PCT） was analyzed.Univariate and multivariate analyses were performed to identify to influencing factors in patients of progression group.Receiver operating characteristic（ROC） curve were plotted to evaluate the predictive performance of SII,and CRP/ALB for severe acute pancreatitis. Results There were no significant differences in general data between the two groups（all P>; 0.05）.SII and CRP/ALB significantly increased in patients with APACHE Ⅱ score ≥; 8,modified Marshall score ≥; 2 and MCTSI score ≥; 4 （P<; 0.05）. SII was positively correlated with CRP,BUN,Cr and PCT（r=0.784,0.736,0.714 and 0.773,respectively; all P<; 0.05）.CRP/ALB was positively correlated with CRP, BUN, Cr and PCT（r=0.856,0.775,0.737 and 0.790,respectively;all P<; 0.05）. CRP（OR=13.144,95%CI 2.653-22.365）, PCT（OR=38.206,95%CI 2.436-57.364）,SII （OR=14.673,95%CI 1.536-24.364）,CRP/ALB（OR=11.257,95%CI 2.042-20.536） and APACHE Ⅱ scores（OR=16.232,95%CI 1.464-28.362） were independent influencing factors of disease progression（all P<; 0.05）. Conclusions Increased SII and CRP/ALB are correlated with the severity of pancreatitis,which can predict the progression of the disease and has certain clinical application value.
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  Clinical analysis of different approaches for extraperitoneal patch repair in the treatment of lumbar hernia

  Peng Quan, Chen Liang, Yu Huajie, Zheng Yu, Chen Xu, Zhang Mingjin

  Journal of Abdominal Surgery. 2025, 38(5): 398-402. https://doi.org/10.3969/j.issn.1003-5591.2025.05.011

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  Objective To investigate the clinical effect of using different surgical approaches to place mesh in the treatment of lumbar hernia. Methods The clinical data of 7 patients with lumbar hernia who were admitted in the 901th Hospital, PLA from May 2015 to September 2023 and treated by mesh repair were retrospectively analyzed, and the efficacy of different surgical methods was observed. Results All the 7 patients completed operation successfully, including 2 cases of open operation,2 cases of laparoscopic transabdominal approach,and 3 cases of laparoscopic complete extraperitoneal approach. The operation time ranged from 40 min to 170 minutes. The visual analogue scale（VAS） score was 2-4 points at 24 h postoperatively, and 1-3 points at 48 h postoperatively. The postoperative hospital stay ranged from 1 day to 6 days, with 3 patients who underwent the laparoscopic complete extraperitoneal approach staying for 1 to 2 days. The average hospitalization cost was 23 442 Yuan, and the average cost for patients undergoing the laparoscopic complete extraperitoneal approach was 14,156 Yuan. No complications such as incision infection and effusion in the operation area were reported. The follow-up time ranged from 12 months to 84 months.All patients with postoperative pain relieved within 3 months, and there was no recurrence during the follow-up period. Conclusion Mesh repair is an effective surgical method for the treatment of lumbar hernia. Complete extraperitoneal approach by laparoscopy has the advantages of minimal invasiveness and quick postoperative recovery. It should be promoted in appropriate patients.
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  Retrospective analysis of 33 children with Meckel's diverticulum in the Xizang Plateau

  Yonten Sherop, Tsering Purpo, Panden, Kinzi Tenzin, Pan Sijia, Lhamo Psering, Li Shuai

  Journal of Abdominal Surgery. 2025, 38(5): 403-406. https://doi.org/10.3969/j.issn.1003-5591.2025.05.012

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  Objective To summarize the unique clinical presentation of Meckel's diverticulum （MD） in pediatric patients in the Tibetan Plateau, and to evaluate the safety and efficacy of laparoscopic-assisted surgical management. Methods Clinical data of 33 children with MD admitted to Lhasa People's Hospital from September 2021 to October 2024 were retrospectively analyzed, including clinical manifestations, diagnostic methods, surgical approaches, perioperative indicators, and follow-up data. Among them, there were 17 males and 16 females, with an average age of 4.8±; 4.1 years. Results Clinical symptoms of MD in children mainly included hematochezia（36.3%,12/33）,intestinal obstruction （27.3%,9/33）,and peritonitis（27.3%,9/33）.Preoperative diagnosis rate by ultrasound was 50.0%（14/28）.Five （15.2%） were misdiagnosed as perforated appendicitis. Laparoscopic-assisted small-incision resection was successfully completed in 30（90.9%） cases, while 3 required open conversion due to severe adhesions.The mean operative time was 1.6±; 0.5 hours, and 14.9±; 8.4 mL of blood loss was quantified. Postoperative hospitalization averaged 12.0±; 3.4 days. Follow-up was completed for all patients, spanning 5-43 months. Complications included 5 cases of ascites （15.2%） and 2 cases of intestinal obstruction （6.1%）. No mortality occurred. Conclusion Pediatric MD in the Tibetan Plateau demonstrates high complication rates and diagnostic challenges. Laparoscopic-assisted small-incision surgery is a safe, effective first-line intervention for this population.
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  Hepatic hemolymphangioma： a case report and literature review

  Zhou Xinhong, Wei Zheng, Yi Jieming, Zeng Changjiang, Zhang Zhonglin

  Journal of Abdominal Surgery. 2025, 38(5): 407-411. https://doi.org/10.3969/j.issn.1003-5591.2025.05.013

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  Objective To investigate the clinical features, diagnosis and treatment methods and prognosis of hepatic hemolymphangioma. Methods A case of hepatic hemolymphangioma in Xiantao First People's Hospital was analyzed. Clinical symptoms, imaging examination, treatment and prognosis of the patient in our hospital plus 5 cases reported in domestic and foreign literature were reviewed and summarized. Results A 58-year-old male admitted due to intermittent distending pain and discomfort in the upper abdomen for more than 6 months. The computed tomography（CT） scan of the upper abdomen showed a space-occupying lesion in the left lobe of the liver, mostly considered as a cystadenoma, but cystadenocarcinoma was not excluded. He underwent left hemihepatectomy. The postoperative pathology showed a large number of lymphatic vessels and blood vessels,suggesting a hepatic hemolymphangioma. There was no recurrence during the six-month follow-up.Literature review of 5 cases and this case,totaling 6 cases, was summarized.There were 4 males and 2 females, with a male-to-female ratio of 2∶; 1. The oldest was 60 years old, the youngest was 6 months old, with a median age of 32 years. Abdominal pain, masses, and distension were the main manifestations, partly due to the huge mass compression of the gastrointestinal tract leading to nausea and discomfort, accompanied by loss of appetite. One patient presented with severe anemia, and most patients showed a large mass in the right upper abdomen with tenderness on physical examination, which was medium in texture and could not be pushed. Laboratory examinations were summarized. Two patients had slightly low albumin, and grade A Child-pugh score of liver function. One patient had severe anemia, with hemoglobin levels of 65 g/L. In all patients, the alpha-fetoprotein （AFP） was normal. carcinoembryonic antigen（CEA） and cancer antigen 125（CA125） were slightly elevated in 2 patients, and CA19-9 was slightly elevated in 1 patient. Imaging examination showed that all patients in this group underwent abdominal contrast-enhanced CT or magnetic resonance imaging （MRI） before surgery. Five patients had the masses located in the right lobe of liver, and one had the mass located in the left lobe of liver. Abdominal CT examination showed mostly multilocular cystic low-density shadows with internal separation and slight enhancement of the cyst wall, and the enhancement in the venous phase and delayed phase was more obvious than that in the arterial phase.Abdominal MRI showed that the tumor was in the mixture of cystic-solid component, and the signal of cystic component of the lesion was mainly low on T1-weighted images（T1WI）, and high on T2-weighted images（T2WI）. Sometimes they appeared as liquid-liquid flat. Treatment and prognosis showed that three patients underwent right hemihepatectomy, two underwent partial hepatectomy, and one underwent left hemihepatectomy. The postoperative pathological report was hepatic hemolymphangioma. No special treatment was given after surgery, and no signs of recurrence were found during follow-up. Conclusion Hepatic hemolymphangioma is a rare benign tumor of liver.Preoperative diagnosis of hepatic hemolymphangioma can be made according to the history, signs and auxiliary examination. Improving the understanding of this disease can guide the correct diagnosis and treatment,and improve the coincidence rate of disease diagnosis.
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  Progress in the diagnosis, treatment and prevention of cholangitis after biliary atresia Kasai surgery

  Ye Mao, Liu Xuelai

  Journal of Abdominal Surgery. 2025, 38(5): 412-415. https://doi.org/10.3969/j.issn.1003-5591.2025.05.014

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  Cholangitis is highly prevalent after Kasai surgery for biliary atresia. The occurrence of cholangitis accelerates the failure of liver function and seriously affects the survival rate of the autologous liver. The diagnosis of cholangitis is lack of specificity, and early diagnosis can be made from multiple perspectives according to the diagnostic criteria at home and abroad. Reasonable, sufficient and sufficient antibiotic application is very critical to the treatment of cholangitis. Before identifying the pathogenic bacteria, the third-generation cephalosporins or carbapenems can be empirically selected for treatment. The treatment courses and antibiotic types of different types of cholangitis vary a lot. It is generally accepted that prophylactic antibiotics within 6 months are used to prevent cholangitis, although the efficacy is not clear.