Yifan Wang

Sir Run Run Shaw Hospital, Hang-hsien, Zhejiang Sheng, China

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Publications (14)29.16 Total impact

  • Ren-An Jin · Yifan Wang · Hong Yu · Xiao Liang · Xiu-Jun Cai ·
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    ABSTRACT: Background: Primary hepatolithiasis is prevalent in some Asian countries. Hepatectomy is a definitive treatment for this disease. Whether laparoscopic left hepatectomy (LLH) is suitable for primary hepatolithiasis remains controversial, because LLH is more challenging technically. The aim of this study was to evaluate the outcomes of LLH for primary hepatolithiasis in a single center. Methods: This retrospective study included 96 consecutive patients who underwent LLH for primary hepatolithiasis in the Sir Run Run Shaw Hospital from May 2005 to December 2012. In addition, 105 patients who met the same inclusion criteria for LLH but underwent open left hepatectomy (OLH) for hepatolithiasis during the same period were reviewed for comparison. The patient characteristics, operative features, postoperative course, residual stone rate, and recurrent stone rate were analyzed. Results: In the LLH group, 81 patients (84.4%) underwent total LLH and 15 (15.6%) were converted to open hepatectomy. The volume of intraoperative blood loss was less in the LLH than OLH group (383 ± 281 vs 554 ± 517 mL; P = .005). The intraoperative transfusion rate was also significantly lower in the LLH group (8.3% vs 30.5%; P < .001). There were no differences between the LLH and OLH groups in operation time, duration of postoperative hospitalization, postoperative complication rate, residual stone rate, or recurrent stone rate. Conclusion: In experienced hands, total LLH is a safe, effective, and promising treatment for patients with hepatolithiasis.
    Surgery 10/2015; DOI:10.1016/j.surg.2015.09.022 · 3.38 Impact Factor
  • XiuJun Cai · Lian Duan · YiFan Wang · Wenbin Jiang · Xiao Liang · Hong Yu · LiuXin Cai ·
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    ABSTRACT: Background: In 1998, the technique of laparoscopic hepatectomy by curettage and aspiration was developed and a special instrument, laparoscopic multifunctional operative dissector (LPMOD), was designed for this procedure. In the past 17 years, this procedure was developed gradually and had become the routine procedure for laparoscopic hepatectomy in local area. This paper is to report results of 17-year practice of this procedure. Methods: Patients who underwent laparoscopic hepatectomy from August 1998 to March 2015 were reviewed. Hepatectomies were performed using the technique of laparoscopic hepatectomy by curettage and aspiration. By using the LPMOD, liver parenchyma was crashed and aspirated immediately and the intrahepatic ducts and small vessels were preserved and were safely dissected for ligation. Laparoscopic selective hepatic flow occlusion was performed routinely for hemi-hepatectomies to control intraoperative blood loss. Results: A total of 855 cases underwent laparoscopic hepatectomy by curettage and aspiration. No perioperative death, 105 patients were converted to open operation, and 84 of them were converted before liver transection without any emergency. Postoperative bleeding occurred in three patients (0.4 %), and bile leakage occurred in seven patients (0.8 %). Conclusion: Laparoscopic hepatectomy by curettage and aspiration is a safe procedure for liver resection with acceptable morbidity and mortality.
    Surgical Endoscopy 10/2015; DOI:10.1007/s00464-015-4576-0 · 3.26 Impact Factor
  • XiuJun Cai · ShuYou Peng · Lian Duan · YiFan Wang · Hong Yu · ZeYong Li ·
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    ABSTRACT: Abstract The "ALPPS" (associating liver partition with portal vein ligation for staged hepatectomy) procedure enables the rapid growth of the future liver remnant and extended surgical indication to patients with an "insufficient" future liver remnant. In May 2014, a 64-year-old male patient was admitted. The computed tomography (CT) scan showed multiple right liver lesions, which were diagnosed to be hepatocellular carcinoma by liver biopsy. The future liver remnant volume after right hemihepatectomy was calculated to be 35.6% based on the CT reconstruction. Completely laparoscopic ALPPS using round-the-liver ligation, which replaced liver splitting, was performed on him. The two-stage operation was performed successfully. The future liver remnant volume increased to 37.9% according to the CT scan on Day 10 after the first-stage operation. The second-stage operation was performed on Day 14 after the first-stage operation. The patient recovered uneventfully. No bile leakage occurred. Thus the round-the-liver ligation can be safely executed in laparoscopy. Completely laparoscopic ALPPS using round-the-liver ligation is feasible and could result in a rapid hypertrophy of the liver remnant in patients with liver cancer complicated with cirrhosis.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 11/2014; 24(12). DOI:10.1089/lap.2014.0455 · 1.34 Impact Factor
  • Xu Feng · Xiao Liang · Yifan Wang · Shilin He · Xiujun Cai ·
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    ABSTRACT: Background: A new procedure of colonic anastomosis with a degradable stent has already been proven to be simple, feasible, and safe in our porcine model. In this study, we evaluated its impact on the colonic physiologic functions. Methods: A total of 20 pigs were assigned randomly to either a stent anastomosis group (SA, n = 10) or a conventional anastomosis group (CA, n = 10). Colonic anastomosis with a degradable stent was performed in the SA group, and conventional hand-sewn anastomosis was performed in the CA group. Body weight, fecal weight, total colonic transit time, immunohistochemistry staining of interstitial cells of Cajal (ICC), plasma diamine oxidases (DAO) levels, and Western blotting analysis of occludin were evaluated before and after anastomosis. Results: No obvious diarrhea or constipation was observed in all pigs. No significant difference in body weight between the groups was detected at any time. Yet, the fecal weight was less in the CA group compared with the SA group on postoperative day (POD) 7. No observable colonic paralysis or retention occurred. For total colonic transit time, there was no significant difference between the two groups at any time or among different time points in the same group. The integrated optical density of ICC showed no significant difference on either POD 14 or 30. The plasma DAO levels were remarkably elevated after surgery, and began to decrease since POD 3. However, there was no significant difference between both two groups in plasma DAO levels at any time either. For both groups, the expression of occludin was not significantly different from their pre-surgery level on either POD 14 or 30. Conclusions: According to these results, this procedure with a degradable stent was supposed to be the same as the conventional hand-sewn procedure in their impact on the colonic physiologic functions.
    Chinese medical journal 09/2014; 127(18):3249-53. DOI:10.3760/cma.j.issn.0366-6999.20140517 · 1.05 Impact Factor
  • Xiujun Cai · Zheyong Li · Hong Yu · Kun Liu · Xiao Liang · Yifan Wang · Yuelong Liang ·

    Chinese medical journal 09/2014; 127(17):3194-5. DOI:10.3760/cma.j.issn.0366-6999.20131351 · 1.05 Impact Factor
  • Rui Ma · Jiang Chen · Zheyong Li · Jiacheng Tang · Yifan Wang · Xiujun Cai ·
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    ABSTRACT: Background: Considering the existence of a large number of liver cell degeneration and necrosis in fibrotic liver, liver function was damaged severely and could not effectively regenerate after partial hepatectomy (PHx). The aim of this study was to investigate whether decorin (DCN) could promote the liver regeneration after PHx in fibrotic mice. Methods: Forty mice (5-week-old, Balb/c) were injected with CCl4 intraperitoneally and liver fibrosis model was established after 5 weeks. The survival mice were randomly divided into two groups: control group and DCN group. Then, we performed 70% PHx on all these mice and injected DCN or phosphate-buffered saline plus normal saline (NS) to each group, respectively, after surgery. Liver body weight ratio (LBR), quantitative real-time polymerase chain reaction, and immunohistochemistry were used to analyze liver regeneration and fibrosis degree in both groups, and to find out whether exogenous protein DCN could promote the regeneration of fibrosis liver after PHx. Results: Expressions of a-smooth muscle actin (SMA) mRNA and LBR had significant increases in the DCN group at postoperative Day 3 (POD 3, P < 0.05). The protein expressions of CD31, a-SMA, and tumor necrosis factor (TNF)-a were higher in the DCN group than those in the control group by immunohistochemistry at POD 3 (P < 0.05). Conclusion: Exogenous protein DCN could promote liver regeneration after PHx in fibrotic mice.
    Chinese medical journal 07/2014; 127(14):2679-85. DOI:10.3760/cma.j.issn.0366-6999.20131361 · 1.05 Impact Factor
  • Yifan Wang · Xiaoyan Cai · Jinhua Mei · Kun Liu · Xiujun Cai ·
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    ABSTRACT: Background: Matrix metalloproteinases (MMPs) are supposed to be potential drug targets to prevent leakage after colonic anastomosis. A method of colonic anastomosis by using a stent coated with doxycycline, a MMP inhibitor, was developed and its safety and feasibility, as well as the effect of locally regulating MMPs, were evaluated by comparing with the conventional method or the method with a doxycycline-free stent. Methods: 48 pigs were assigned randomly to doxycycline-coated stent anastomosis group (DSA), doxycycline-free stent anastomosis group (SA), or conventional anastomosis group (CA). In each group, pigs were subdivided into four subgroups according to postoperative observation time (3, 7, 14, and 30 days). Healing of anastomosis and expressions of MMP-2/9 were evaluated. Results: No anastomotic leakage, stricture or necrosis was observed in the DSA group. No significant difference of bursting pressure was found between the DSA group and SA group. Relative expression of MMP-2 in the DSA group was significantly lower than in the SA group on postoperative days 3 and 7. No significant differences of hydroxyproline content, microvessel density and TGF-β1 level were found in these groups. Conclusion: These results suggested this method was feasible and safe for colonic anastomosis with the advantage of locally inhibiting MMPs.
    Digestive surgery 04/2014; 31(2):87-94. DOI:10.1159/000358811 · 2.16 Impact Factor
  • Yifan Wang · Yuelong Liang · Weijia Wang · Renan Jin · Xiujun Cai ·
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    ABSTRACT: Electrothermal injury of common bile duct is a frequent type of biliary injury. A long-term postoperative course and biliary leakage after removing T-tube are associated with external drainage. A method was developed to repair the injury with a degradable biliary stent instead of T-tube insertion. Pigs were divided into a stent repair (SR) group (n = 18), a T-tube repair (TR) group (n = 4), and a suturing repair (SUR) group (n = 4). An electrothermal injury model was made by electric coagulation. Pigs in the SR group were further divided into five subgroups according to the observation time (2 weeks and 1, 3, 6, and 18 months). Pigs in the TR group and SUR group were observed for 6 months. Cholangiography was repeated and bilirubin level was monitored. Pigs were reoperated for further evaluation at the end of observation. No biliary stricture, bile leakage, or bile duct necrosis occurred in the SR group. The stent could be detected in the first 2 months. No stent migration or stent-related obstruction was observed. Three pigs in the SUR group had biliary stricture with elevated bilirubin levels. These results suggested that the developed method for repairing electrothermal injury of common bile duct is feasible and safe.
    Journal of Gastrointestinal Surgery 08/2013; 17(10). DOI:10.1007/s11605-013-2316-0 · 2.80 Impact Factor
  • Kun Liu · Yuelong Liang · Xiao Liang · Hong Yu · Yifan Wang · Xiujun Cai ·
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    ABSTRACT: Isolated hepatic splenosis is a rare condition in hepatobiliary surgery. In this study, we report a case of this condition managed by laparoscopic surgery. A 38-year-old male hepatitis B virus carrier, who had a motorcycle accident and splenectomy 14 years before the current incident, was hospitalized due to a hepatic mass. His laboratory tests were consistent with a hyposplenic state, whereas radiologic images revealed a benign tumor in the left liver lobe located in a site difficult to access with preoperative biopsy. Therefore, we performed a laparoscopic exploration and total resection, which revealed a bluish oval encapsulated nodule in the narrow gap between the diaphragm, falciform ligament, and left hepatic capsule. The pathologic diagnosis was hepatic splenosis. Unlike other patients with multiple intraperitoneal lesions and relatively normal splenism, this is the first case of isolated hepatic splenosis with evident hyposplenism managed by laparoscopic approach in the English literature.
    Surgical laparoscopy, endoscopy & percutaneous techniques 10/2012; 22(5):e307-11. DOI:10.1097/SLE.0b013e318263a3f3 · 1.14 Impact Factor
  • Kun Liu · Hong Yu · Minghui Zhang · Yichen Yu · Yifan Wang · Xiujun Cai ·
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    ABSTRACT: Purpose: Colonic perforation with fecal peritonitis is a life-threatening clinical condition. For these patients, a two-stage operation of fecal diversion and a postponed colostomy closure is generally recommended. Accordingly, a simple and feasible primary repair technique was explored. Methods: A sutureless banding method using a biodegradable stent and a porcine model of artificial colonic perforation were introduced. The colonic perforation model was created successfully with an open procedure in 34 pigs. The primary repair with a stent or the conventional hand-sewn control was performed 72 h later. Morbidity and mortality were recorded. Pigs in each group were also sacrificed to evaluate the healing on postoperative days (PODs) 3, 7, 14, and 90. The peripheral white blood cell counts, albumin, anastomotic bursting pressure, hydroxyproline contents, and histology data were evaluated. Results: There were 17 pigs in either group. Four pigs (23.5 %) of the control group died, but no mortality occurred in the stent group. There were no significant differences in white blood cell counts and albumin. Though anastomotic hydroxyproline contents between the two groups were comparable, the collagen per protein ratio on POD 14 in the stent group was higher, as well as the bursting pressure on PODs 3 and 7. Microscopically, the local inflammation of the cut edges in the control group was more severe, and the collagen synthesis started later. Conclusions: A sutureless primary repair of a colonic perforation with a degradable stent is a feasible method in a porcine model of fecal peritonitis.
    International Journal of Colorectal Disease 06/2012; 27(12). DOI:10.1007/s00384-012-1511-x · 2.45 Impact Factor
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    ABSTRACT: Anastomotic leakage is a major complication of colon resection. Fecal diversion is necessary in most patients and restoration of intestinal continuity has to be performed several months later. It carries a long treatment time and a considerable financial cost. We have developed a method of primary repair of colonic leakage with a degradable stent. Thirty pigs were included in this study. Colonic anastomotic leakage model was made successfully by open procedure in 15 pigs and primary repair with a degradable stent was performed 3 days later. Conventional colonic anastomosis was performed in the other 15 pigs without making leakage. Pigs of each group were sacrificed at schedule to evaluate the healing of anastomosis and observe the occurrence of complications. No re-leakage occurred after primary repair, and no anastomotic stricture, peritoneal abscess, or colonic necrosis occurred in either group. No significant difference in bursting pressure or hydroxyproline content was found between the two groups. Primary repair of colonic leakage with a degradable stent is a feasible method in this porcine model.
    Journal of Gastrointestinal Surgery 06/2011; 15(11):1995-2000. DOI:10.1007/s11605-011-1593-8 · 2.80 Impact Factor
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    ABSTRACT: Intestinal anastomosis is a major technical component of gastrointestinal procedures. We have developed a new procedure of colonic anastomosis with a degradable stent. This article evaluates this procedure. Forty pigs were assigned randomly to a stent group (n = 20) and a control group (n = 20). A colonic anastomosis with a degradable stent was performed in the stent group, and hand-sewn anastomosis was performed in the control group. Pigs of each group were divided evenly into 4 subgroups according to time of death (days 3, 7, and 14, and month 10 postoperatively) to evaluate the healing of anastomosis. All procedures were completed successfully. The surgical time of the stent group was significantly less than the control group. No complications occurred in either group. Bursting pressure of the stent group was significantly higher than the control group on postoperative days 3 and 7. No significant difference of hydroxyproline content or microvessel density was found between the 2 groups. The procedure of colonic anastomosis with a degradable stent is a simple, feasible, and safe procedure in this porcine model.
    American journal of surgery 02/2010; 199(6):833-9. DOI:10.1016/j.amjsurg.2009.05.044 · 2.29 Impact Factor
  • Xiujun Cai · Yifan Wang · Hong Yu · Xiao Liang · Bin Xu · Shuyou Peng ·
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    ABSTRACT: A 55-year-old male patient, complaining of skin and sclera yellowing, came in for clinical investigation. After complete evaluation, the primitive diagnosis of periampullary carcinoma was made and radical surgical resection was planned to be performed. Later, a complete laparoscopic pancreaticoduodenectomy was performed successfully. The mean operating time was 510 minutes. The intraoperative blood loss was 800 mL without intraoperative blood transfusion. No complication was noticed. The length of postoperative hospital stay was 14 days. Pathologic examination showed well-differentiated adenocarcinoma of common bile duct. The patient has been followed-up for 23 months. He is living very well and is capable of carrying on daily routine without any evidence of tumor recurrence. Despite long operating time, complete laparoscopic pancreaticoduodenectomy is feasible. To develop this procedure as more clinical application, some special instruments or new technique for laparoscopic intracorporal biliojejunostomy or pancreatojejunostomy should be evolved, and a large number of clinical trials are also needed to prove its feasibility.
    Surgical laparoscopy, endoscopy & percutaneous techniques 09/2008; 18(4):404-6. DOI:10.1097/SLE.0b013e31816f7763 · 1.14 Impact Factor
  • Xiujun Cai · Yifan Wang · Hong Yu · Xiao Liang · Shuyou Peng ·
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    ABSTRACT: Hepatolithiasis is a prevalent disease in Southeast Asia. Hepatectomy was considered the best treatment for majority of cases. Laparoscopic hepatectomy is a new procedure for liver lesions that uses a minimal invasive approach. The aim of this study was to evaluate the feasibility and safety of laparoscopic hepatectomy for hepatolithiasis by comparing it with open hepatectomy. From November 2002 to March 2006 a total of 30 consecutive patients underwent laparoscopic hepatectomy for hepatolithiasis in Sir Run Run Shaw Hospital. Twenty-nine were included in this study (a converted case was excluded) and called the laparoscopic hepatectomy group (LH). During the same period 22 patients with hepatolithiasis who met the inclusion criteria for laparoscopic hepatectomy were selected for open hepatectomy and called the open group (OH). All operations were performed by the authors. There was no significant difference in preoperative data between the two groups. Data were statistically compared. Compared with open hepatectomy, those who underwent laparoscopic hepatectomy had a shorter postoperative hospital stay and fasting time, a lower postoperative serum aminotransferase level, and a higher postoperative serum albumin level. Stone clearance rate (intermediate rate, 89.7% vs. 86.4%; final rate, 100% vs. 96.5%), stone recurrence rate (0% vs. 4.5%), operating time, and intraoperative blood loss were similar for the two groups. Six complications occurred, two (6.8%) in LH and four (18.2%) in OH. There was no perioperative mortality in either group. Laparoscopic hepatectomy for hepatolithiasis is feasible and safe in selected patients.
    Surgical Endoscopy 08/2007; 21(7):1074-8. DOI:10.1007/s00464-007-9306-9 · 3.26 Impact Factor