The Bell and Drum Tower Hospital in Nanjing has a very mature technology for treating gallstones - laparoscopic cholecystectomy, common bile duct lithotomy + T-tube drainage. Small stones can be treated conservatively without surgery.
Department Overview
The Department of General Surgery was founded in 1954. It is a national key discipline, a key clinical specialty in Jiangsu Province and a key medical specialty in Nanjing. It is a doctoral and master's degree-granting unit of Nanjing University and Nanjing Medical University. It has five wards: hepatobiliary surgery, endocrine surgery, gastrointestinal surgery, organ transplant center, minimally invasive surgery and an ultrasound interventional treatment center. It has 164 beds and currently has 76 medical staff, including 9 chief physicians and deputy chief physicians. 20 people, including 10 attending physicians.
Specialized medical treatment
1. Treatment of hepatobiliary tumors. In the mid-1980s, he was the first to advocate and use improved bloodless liver resection at room temperature in China. In 1993, he was the first in the world to successfully apply semi-isolated liver resection technology in clinical practice, breaking through the restricted area of ??liver surgery. In 2001, we were the first in China to carry out percutaneous and laparoscopic cold circulation radiofrequency treatment for primary liver cancer. In recent years, it has taken the lead in developing new technologies for precision liver surgical treatment in China. It is currently one of the most influential diagnosis and treatment centers for hepatobiliary diseases in China, completing more than a thousand cases of various complex hepatobiliary surgeries every year.
2. Liver transplantation. In 1996, we took the lead in carrying out piggyback liver transplantation in East China, and improved on this basis to treat 30 patients with fulminant liver failure. The success rate of the operation was 100%, and the survival rate over one year was 97%. The liver transplant success rate and patient survival rate are among the best in the country. The clinical and scientific research work on the combined use of artificial liver support system and liver transplantation for the treatment of severe liver failure, as well as combined liver and kidney transplantation, have been successful, and have won more than ten provincial and ministerial level scientific and technological progress awards. Through independent innovation, we have taken the lead in developing biological artificial liver technology at home and abroad, overcoming a number of technical difficulties, obtaining a number of national patents, and achieving satisfactory clinical efficacy.
3. Pancreatic surgery.
(1) Peripancreatic nerve resection technology: This technology was first studied by Japanese scholars and has been widely used in pancreatic cancer surgery. In radical surgery, it can significantly improve the pathological cure rate of surgery. , and can significantly reduce cancer pain caused by late recurrence, can significantly reduce cancer pain during palliative resection and bypass surgery, and effectively improve the quality of life. This specialty has been the first to apply this technology in China since 2001. It has been clinically applied in 80 cases and won the New Technology Introduction Award from the Jiangsu Provincial Department of Health in 2005.
(2) Intraoperative timing positioning technology for islet cell tumors: Since the research on this project began in 1994, the accurate positioning rate is 100%, and the radical cure rate is 100%. Currently, this technology has been recognized as the 12th The method of locating pancreatic islet cell tumors is especially suitable for cases where various preoperative imaging methods cannot locate the pancreatic islet cell tumor and cases where islet cell hyperplasia cannot confirm the extent of resection.
(3) Selective devascularization technology: This technology retains the compensatory portosystemic shunt vessels formed by the patient itself, and selectively blocks the perforating branch veins that cause upper gastrointestinal bleeding, that is, it has traditional devascularization. It has the advantages of small surgical damage and maximum protection of liver function. It also has the advantages of shunting to reduce portal vein pressure. It is a devascularization method with shunting effect. Since the clinical research of this technology began in 1996, the current database sample size has reached more than 300 cases, and almost 100% of the portosystemic communicating veins can be preserved, which is at the leading level in the country.
(4) Intraoperative radiofrequency or microwave ablation treatment technology for pancreatic cancer: This technology is mainly used for patients with advanced pancreatic body and tail cancer who are confirmed to be unresectable by exploration during surgery. It can perform intraoperative real-time ultrasound-guided treatment. Radiofrequency or microwave ablation treatment of pancreatic cancer and related celiac ganglia can effectively control the rapid growth of cancer and cancer pain, and partially improve the quality of life. Since this technology was first developed in China in 2002, it has been clinically applied in more than 30 cases and won the Nanjing New Technology Introduction Award in 2008.
(5) Spleen-preserving pancreatic body and tail resection and mid-section pancreatectomy technology: This technology is mainly used to treat benign or low-grade malignant tumors in the pancreatic body and tail, which can minimize the patient’s surgical damage and maximize the Preserving human organs and tissues is a new technology developed in pancreatic surgery in recent years.
Since the start of this clinical study in 2005, more than 10 cases of spleen-preserving distal pancreatectomy and 5 cases of mid-section pancreatectomy have been completed.
4. Gastrointestinal surgery.
(1) Standardized surgical treatment of gastric cancer: On average, the gastrointestinal surgery department treats more than 250 cases of gastric cancer every year. In conjunction with the oncology department, comprehensive treatments such as surgery, chemotherapy, and immunotherapy are used, and the 5-year survival rate is significantly improved.
(2) Standardized surgical treatment of colorectal cancer: Colorectal cancer is one of the important cancers that threatens human health. Globally, its incidence and mortality are on the rise. The mortality rate and mortality rate rank third and fourth among all cancers respectively. The gastrointestinal surgery department treats about 300 cases of colorectal cancer every year. The surgical treatment of colon cancer is to remove the tumor en bloc according to the anatomical characteristics of regional lymph nodes and blood vessels. For rectal cancer, standardized surgical resection is performed according to the TME principle. For partial obstruction or obstruction, Most patients with colorectal tumors undergo one-stage reconstructive anastomosis, which greatly reduces the patient's burden and pain. Carry out columnar resection of rectal cancer to solve the problem of radical resection for patients with T3 and T4 low rectal cancer. According to research progress, we used a method called cylindrical abdominoperineal resection (Cylindrical APR) for patients with stage T3 and T4 low rectal cancer. The purpose was to expand the resection through the perineum and make the specimen into a cylinder without narrow waist. It can increase the amount of tissue resected around the cancer, reduce the positive rate of CRM and the rate of intraoperative intestinal perforation, thereby reducing the local recurrence rate. The results of the cases have been good, and it provides a new way for the treatment of advanced low rectal cancer. In addition, perineal in situ artificial anus surgery after Miles surgery for rectal cancer is performed. The treatment method for rectal cancer is still surgery. The traditional Miles surgery has better results, but the permanent artificial anus in the abdomen cannot control feces at will, and a feces bag must be carried. It seriously affects life and work, and puts a huge mental burden on patients. Therefore, many patients prefer to refuse surgery and delay treatment. Perineal in situ artificial anus surgery after Miles surgery for rectal cancer was created in 1987 by Professor Gao Chunfang of the PLA Anorectal Research Institute and has been continuously improved. So far, 2,600 cases have been reported in a single center and good results have been achieved. The core technology of this surgery is to reconstruct the artificial rectal angle with the sigmoid colon and suture it to the perineum in situ. The technology is very demanding. We successfully performed this surgery with good results.
(3) Carry out laparoscopic minimally invasive gastrointestinal surgery: Minimally invasive surgery has developed rapidly in recent years. This technology has covered almost all traditional surgical procedures and is also an important part of future surgery. direction of development. We have become proficient in laparotomy, appendectomy, abdominal drainage, gastric cancer radical resection, colorectal cancer radical resection, abdominal wall hernia repair and other services, and we have all the equipment to carry out such services.
(4) Surgical treatment of major gastrointestinal bleeding caused by vascular malformations of the gastrointestinal tract: Gastrointestinal bleeding is more common in the stomach, duodenum, colorectum, and rectum. Diagnosis and treatment of bleeding caused by vascular malformations in the small intestine are We use preoperative gastroscopy and colonoscopy to rule out the difficulties, use capsule endoscopy to assist in preoperative primary screening, intraoperative colonoscopy to accurately characterize and locate small intestinal vascular malformations, and use a combination of point resection, wedge resection and intestinal segment resection. Methods to treat small intestinal vascular malformations can completely avoid postoperative rebleeding caused by missed diagnosis. Therefore, intraoperative enteroscopy has the most important value in the diagnosis and treatment of small intestinal vascular malformations and can be used as the main method for the diagnosis and treatment of small intestinal vascular malformations.
(5) Abdominal wall hernia surgery: Abdominal wall hernia includes inguinal hernia, abdominal wall incisional hernia, parastomal hernia, umbilical hernia, white line hernia, diaphragmatic hernia, hiatal hernia, etc., in addition to traditional surgical repair , relying on tension-free repair with new materials and new instruments, endoscopic repair has become the development direction of hernia surgery, especially for acquired hernias such as incisional hernias, minimally invasive repair has obvious advantages. Our department treats about 350 cases of various types of abdominal wall hernias every year, most of which are tension-free repairs relying on new materials. We also carry out various minimally invasive repairs.
(6) Anorectal surgery: Anorectal diseases are common and multiple diseases, especially III and IV degree annular hemorrhoids, which seriously affect the quality of life. Traditional surgery is not only painful, but also has a high recurrence rate. Traditional Chinese medicine Traditional Chinese medicine also lacks effective means for such diseases. Based on the theory that the occurrence of hemorrhoids is due to the downward movement of the anal cushion, PPH surgery can circumferentially excise the mucosa and submucosa 3cm above the dentate line of the rectum, and complete the anastomosis at the same time, thereby completing the lifting of the anal cushion and blocking of the hemorrhoid blood vessels. It can not only cure stubborn diseases, but also It can also prevent its recurrence and achieve good long-term effects. Therefore, hemorrhoid surgery has been reborn as a brand-new discipline.
(7) Nutritional support treatment: Nutritional support is an important achievement in the field of medicine in the twentieth century. The incidence of malnutrition among surgical inpatients is about 50%. Malnutrition can significantly reduce surgical tolerance and increase the incidence of surgical complications and mortality. Nutritional support, including parenteral nutrition and enteral nutrition, has become a basic treatment measure for surgical patients, especially critically ill patients. At present, the nutritional support targets provided by our gastrointestinal surgery department include: those who cannot take oral food for a long time after major surgery, malnutrition, short bowel syndrome, small intestinal transplantation, digestive tract fistula, intestinal obstruction, acute pancreatitis, and multiple visceral injuries. , sepsis, liver failure, kidney failure, respiratory failure, tetanus, etc.
5. Standardized diagnosis and treatment of breast cancer. High-resolution color ultrasound, mammography, CT, magnetic resonance imaging and other technologies are used for early diagnosis of breast cancer. Hollow needle biopsy system and color ultrasound-guided biopsy technology are used for preoperative pathological diagnosis and gene expression detection. , guide personalized treatment of breast cancer, and perform standardized comprehensive treatment of breast cancer according to NCCN treatment guidelines. Currently, routine work includes preoperative neoadjuvant therapy, radical surgery, postoperative adjuvant therapy, breast-conserving surgery and its comprehensive treatment, sentinel lymph node detection, and rescue treatment of advanced breast cancer. Other special diagnosis and treatments include breast cancer surgery. Post-breast reconstruction, basic and clinical research on bone marrow micro-metastasis of breast cancer, dendritic cell fusion tumor vaccine for the treatment of advanced breast cancer, etc. We attach great importance to humanistic care in clinical work, and established the Nanjing Cancer Friends Association Breast Cancer Activity Center to establish long-term communication with breast cancer patients and conduct standardized follow-up work.
6. Surgical diagnosis and treatment of thyroid disease. We have a long-term and stable relationship with the Department of Endocrinology and carry out personalized surgical diagnosis and treatment of thyroid and parathyroid diseases. Our current routine work includes functional neck lymph node dissection for thyroid cancer, regional neck lymph node dissection, and surgery for hyperthyroidism. treatment, qualitative localization diagnosis and surgical treatment of hyperparathyroidism, etc. Other special diagnosis and treatment include minimally invasive thyroid surgery, clinical research on parathyroid transplantation for the treatment of hypothyroidism, etc., and personalized follow-up and follow-up for patients undergoing surgical treatment. treatment to ensure therapeutic effect.
7. Laparoscopic minimally invasive surgery. Laparoscopic cholecystectomy, common bile duct lithotomy + T-tube drainage, benign and malignant gastric tumor resection, colorectal cancer radical treatment, splenectomy and liver resection are routinely performed.
8. Laparoscopic minimally invasive surgery. Laparoscopic cholecystectomy, common bile duct lithotomy + T-tube drainage, benign and malignant gastric tumor resection, colorectal cancer radical treatment, splenectomy and liver resection are routinely performed.
Discipline Leader
Ding Yitao, chief physician, professor of surgery at Nanjing University, doctoral supervisor, recipient of special government allowances, director of the Hepatobiliary Research Institute of Nanjing University, and director of Nanjing Drum Tower Hospital .
Being the first to advocate and apply improved bloodless liver resection in China. In the early 1990s, the semi-isolated liver cutting technology was pioneered at home and abroad, breaking through the restricted area of ??liver surgery. In 1996, he was the first in East China to successfully complete the internationally advanced "piggyback" orthotopic liver transplantation. The project "Artificial Liver Support System Combined with Liver Transplantation for the Treatment of Acute Liver Failure" completed in 1998 was an international frontier, filling the domestic gap and reaching the international advanced level.
The research on the structure and clinical application of the bioartificial liver completed in 2001 has reached the international leading level. He serves as a member of the International Hepatobiliary and Pancreatic Association, a standing committee member of the Organ Transplantation Society of the Chinese Medical Association, vice president of the Jiangsu Provincial Medical Association, chairman of the Organ Transplantation Society of the Jiangsu Provincial Medical Association, chairman of the Jiangsu Provincial Liver Surgery Group, and director of the Jiangsu Provincial Hepatobiliary Surgery Diagnosis and Treatment Center. , deputy director of the Jiangsu Provincial Society of Surgery and other society work, and an editorial board member of more than 20 professional magazines such as the Chinese Journal of Organ Transplantation. He has published more than 100 papers and books (parts), won 6 major national 863 projects, and won 10 first and second prizes for provincial and ministerial scientific and technological progress (all as the first author). He has won many honorary titles such as National Expert with Outstanding Contribution, Nanjing Science and Technology Hero, the First Top 100 Doctors in the Nation, National Outstanding Dean, and China’s Highest Physician Award. Elected representatives to the 15th, 16th and 17th National Congress of the Communist Party of China.