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Chinese interpretation of Japanese Gastric Cancer Treatment Guidelines 2021 (6th edition) and Ruijin clinical practice YAN Chao, LU Sheng, YAN Min, ZHU Zhenggang Journal of Surgery Concepts & Practice    2023, 28 (04): 326-354.   DOI: 10.16139/j.1007-9610.2023.04.010 Abstract （931）   HTML （23）    PDF（pc） （4954KB）（2291）       Knowledge map    Save “Japanese Gastric Cancer Treatment Guidelines” have been important guidelines for the treatment of gastric cancer in Japan and worldwide. The English version “Japanese Gastric Cancer Treatment Guidelines 2021 (6th Edition)” published in January 2023 consists of two parts. The first part includes diagnostic and treatment methods, such as surgery, endoscopic resection, chemotherapy, follow-up. The second part addresses clinical issues, including recommendations and explanations for clinical hot topics. This article will provide a Chinese interpretation of the guidelines and briefly introduce our hospital's clinical practice in the diagnosis and treatment of gastric cancer. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Interpretation of the 2022 edition of “guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis in China” XU Bojin, PENG Wenfang, HUANG Shan Journal of Surgery Concepts & Practice    2023, 28 (06): 512-519.   DOI: 10.16139/j.1007-9610.2023.06.05 Abstract （198）   HTML （1）    PDF（pc） （889KB）（782）       Knowledge map    Save “Guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis in China” (2022) (referred to as the “guidelines”) was officially published in August 2022 in the Chinese Journal of Endocrine Metabolism. These guidelines have been extensively updated from the 2007 version, with 15 sections covering the etiology, clinical manifestations, diagnosis, evaluation, and treatment of hyperthyroidism, as well as the management of specific types of thyrotoxicosis. The new version guidelines proposed 107 recommended opinions supported by stronger evidence, offering comprehensive and reliable guidance for clinical doctors and medical professionals dealing with thyrotoxicosis. This article aimed to extract the key points and recommended strategies from the guidelines to help clinical doctors better understand and apply the latest guiding principles. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Development and prospects of ERCP in China LI Wen Journal of Surgery Concepts & Practice    2023, 28 (04): 279-282.   DOI: 10.16139/j.1007-9610.2023.04.001 Abstract （483）   HTML （10）    PDF（pc） （838KB）（616）       Knowledge map    Save Endoscopic retrograde cholangio-pancreatography (ERCP) is an interventional endoscopic technique aimed at the diagnoses and treatment of biliary and pancreatic diseases under the guidance of endoscopy and X-ray ima-ging. ERCP was introduced into China from the 1970s. In the 1990s, ERCP was gradually popularized and applied in China with the development of medical technique and improvement of equipment, more medical institutions started to carry out ERCP. After 2000, ERCP technology and equipment were further upgraded and improved in China. Many secondary and tertiary hospitals began to establish the ERCP centers. Meanwhile, workshops and training also facilitated the teaching and practice of ERCP and cultivated more professionals of ERCP. In recent years, the technical level of ERCP in China has been continuously improved, and technologies and equipments are constantly updated and iterated. Currently, ERCP has become one of important techniques in the endoscopic field, playing an important role in the diagnosis and treatment of biliary and pancreatic diseases. The vigorous development of ERCP in China is attributed to the advancement of medical science, the improvement of technology and the efforts of generations of ERCP specialists. Reference | Related Articles | Metrics | Comments（0）

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The current status of thermal ablation in the treatment of papillary thyroid microcarcinoma LIN Tingyu, ZHAO Yanna, FEI Jian Journal of Surgery Concepts & Practice    2023, 28 (05): 477-482.   DOI: 10.16139/j.1007-9610.2023.05.14 Abstract （79）   HTML （3）    PDF（pc） （865KB）（251）       Knowledge map    Save Thermal ablations are rapidly developing techniques for minimally invasive treatment, including laser ablation, radiofrequency ablation, and microwave ablation. Such remarkable success has been achieved in treatment malignant neoplasms, for instance, hepatocellular carcinoma and renal cell adenocarcinoma. In recent years, the practice has been gradually adopted into the treatment of papillary thyroid microcarcinoma (PTMC). Many reports have stated that thermal ablations have distinctive advantages over traditional thyroidectomy owing to its efficacy and safety for treatment primary PTMC, meanwhile there are many controversial issues which hotly debated regarding to first-line treatments. Recently, indications and contraindications of thermal ablation for PTMC have been successively proposed by guidelines and consensuses. Many follow-up reports related to thermal ablation in the treatment of PTMC have been reported in clinical practice as well. In this review, we summarized the principles, indications and contraindications, and the efficacy and safety of thermal ablation in the treatment of PTMC, and compared it with traditional surgery. Reference | Related Articles | Metrics | Comments（0）

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Prognostic analysis of breast-conserving surgery or mastectomy in patients with stage Ⅰ-Ⅲ triple-negative breast cancer ZHU Qiaoli, MIAO Yiming, CHEN Xiaosong Journal of Surgery Concepts & Practice    2023, 28 (04): 371-377.   DOI: 10.16139/j.1007-9610.2023.04.014 Abstract （116）   HTML （1）    PDF（pc） （1370KB）（152）       Knowledge map    Save Objective: To investigate the effect of breast-conserving surgery (BCS) or mastectomy (M) in patients with stage Ⅰ-Ⅲ triple-negative breast cancer (TNBC) on disease free survival (DFS) and overall survival (OS). Methods: A total of 844 patients with stage Ⅰ-Ⅲ TNBC who were admitted to Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2009 to December 2018 were collected and divided into BCS and M groups according to the surgical method. COX regression analysis was used to evaluate the influence of clinical characteristics and surgical methods on DFS and OS of the patients. The propensity score was further used to balance the differences in baseline characteristics between the two groups of patients, and to evaluate the differences in the prognosis of two groups of patients. Results: There were 533 patients (63.15%) underwent M and 311 patients (36.85%) underwent BCS. Patients with younger age, smaller tumor size, negative lymph node, and loss of HER2 expression (HER2-0) were more tend to BCS group compared to M group. Median follow-up time was 72 months. Multivariate COX analysis showed that the OS of M group was lower than that of BCS group (HR=2.02, 95% CI: 1.04-3.91, P=0.038), but there was no significant difference in DFS between the two groups (HR=1.42, 95% CI: 0.94-2.15, P=0.100). After propensity score matching for factors such as T stage, N stage and age, the results showed that there was no significant difference in OS (P=0.114) and DFS (P=0.124) between BCS and M groups. Conclusions: Among patients with stage Ⅰ-Ⅲ TNBC, patients with younger age, smaller tumor, negative lymph node, and HER2-0 were more likely to choose BCS. After propensity score matching for relevant clinicopathological parameters, the results indicated that there was no significant difference in OS and DFS of the TNBC patients undergoing BCS or M surgery. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Endoscopic treatment of gallbladder diseases ZHANG Jianguo Journal of Surgery Concepts & Practice    2023, 28 (04): 321-325.   DOI: 10.16139/j.1007-9610.2023.04.009 Abstract （114）   HTML （3）    PDF（pc） （910KB）（148）       Knowledge map    Save In recent years, with the rapid development of digestive endoscopy technology, new endoscopic diagnosis and treatment techniques and methods for gallbladder diseases have emerged, showing unique advantages, vitality and good application prospects. It can be predicted that the diagnosis and treatment of gallbladder diseases in the future will be more diversified and more minimally invasive, and the diagnosis and treatment strategy will be more individual rather than "one-size-fits-all". Endoscopic gallbladder technology is expected to become another important method after the era of laparoscopic gallbladder surgery, or even a milestone method. Although the current gallbladder endoscopy technology is still in the development stage, it still faces many problems and challenges. However, opportunities often coexist with challenges, and this trend seems unstoppable in any case. Reference | Related Articles | Metrics | Comments（0）

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Application of endoscopic ultrasound interventional therapy in biliary and pancreatic diseases HOU Senlin, YU Tingting, LIU Pengxiang, ZHANG Lichao Journal of Surgery Concepts & Practice    2023, 28 (04): 300-306.   DOI: 10.16139/j.1007-9610.2023.04.005 Abstract （121）   HTML （8）    PDF（pc） （968KB）（145）       Knowledge map    Save Endoscopic ultrasound (EUS) has been greatly developed in the diagnosis of digestive diseases. In recent years, with the continuous innovation of endoscopic technology and accessories, important breakthroughs have been made in endoscopic ultrasound-guided interventional therapy, especially in the treatment of refractory biliary and pancreatic diseases. Based on the latest literatures and work experience, in this paper, we reviewed the latest progress of EUS interventional treatment for biliary and pancreatic diseases, including EUS- guided bile duct drainage, EUS-guided gallbladder drainage, EUS-guided pancreatic duct drainage, EUS guided-pancreatic pseudocyst drainage, and EUS guided pancreatic tumor treatment. Reference | Related Articles | Metrics | Comments（0）

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Risk factors and prevention methods for post-ERCP pancreatitis NIE Haihang, WANG Fan, WANG Hongling, ZHAO Qiu Journal of Surgery Concepts & Practice    2023, 28 (04): 310-315.   DOI: 10.16139/j.1007-9610.2023.04.007 Abstract （156）   HTML （2）    PDF（pc） （872KB）（129）       Knowledge map    Save Endoscopic retrograde cholangio-pancreatography (ERCP) is one of the primary procedural techniques used for diagnosing biliary and pancreatic diseases. Post-ERCP pancreatitis (PEP) is the most common complication of ERCP, which resulted in prolonged hospitalization and potential risk of patients' lives, especially in severe cases. Understanding the risk factors associated with PEP is of paramount importance for its prevention. Currently, recognized risk factors for PEP encompass both patient-related factors and ERCP procedure-related factors. By considering these risk factors, implementing appropriate preoperative, intraoperative, and postoperative interventions could effectively reduce the incidence of PEP. In this article, we concisely summarized the common risk factors and preventive methods for PEP, offering valuable insights for healthcare professionals in clinical practice. Reference | Related Articles | Metrics | Comments（0）

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Incidence, mortality and survival analysis of small intestine cancer in Shanghai population⁃based study from 2002 to 2016 WU Chunxiao, GU Kai, PANG Yi, WANG Chunfang, SHI Liang, XIANG Yongmei, GONG Yangming, DOU Jianming, SHI Yan, FU Chen Journal of Surgery Concepts & Practice    DOI: 10.16139/j.1007-9610.2023.03.00 Accepted: 02 August 2023

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Current status and prospect of endoscopic photodynamic therapy for unresectable extrahepatic cholangiocarcinoma and ampullary carcinoma ZHANG Hongzhan, ZHANG Kai Journal of Surgery Concepts & Practice    2023, 28 (04): 316-320.   DOI: 10.16139/j.1007-9610.2023.04.008 Abstract （121）   HTML （1）    PDF（pc） （907KB）（120）       Knowledge map    Save Unresectable extrahepatic cholangiocarcinoma and ampullary carcinoma have high malignant degree and poor prognosis. At present, internal or external biliary drainage is the main palliative treatment, which can improve patients' quality of life，but has no therapeutic effect on the tumor itself. Endoscopic photodynamic therapy (PDT) is a new technology for minimally invasive treatment of biliary tumors in recent years. It can kill tumor cells locally and cause systemic immune response, prolong the survival time of patients, and has a broad clinical application prospect. With the deepening of the research on the molecular mechanism of PDT and the combination with chemotherapy, radiotherapy，immunotherapy and so on, endoscopic PDT has achieved significant efficacy in killing primary tumor, reducing the tumor stage and treating the recurrent tumors. In this paper, we analyze the current status of endoscopic PDT in unresectable extrahepatic cholangiocarcinoma and ampullary carcinoma， and look forward to the future direction. Reference | Related Articles | Metrics | Comments（0）

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Diagnostic application of SpyGlass in indeterminate stricture of hilar bile duct HU Xianrong, YANG Dangdang, WU Jun, ZHAO Yi, CHEN Cui, ZHANG Ting, HU Bing Journal of Surgery Concepts & Practice    2023, 28 (04): 361-365.   DOI: 10.16139/j.1007-9610.2023.04.012 Abstract （123）   HTML （2）    PDF（pc） （2105KB）（113）       Knowledge map    Save Objective: To investigate the diagnostic value of SpyGlass choledochoscopy system in indeterminate stricture of hilar bile duct. Methods: A retrospective analysis was conducted on 146 patients with indeterminate stricture of the hilar bile duct who underwent endoscopic retrograde cholangio-pancreatography (ERCP) and SpyGlass examinations at our hospital between January 2018 and December 2022. The study recorded the visual impressions of the lesions, direct visualization-guided biopsy pathology, and conventional brush cytology results obtained using SpyGlass system. The sensiti-vity, specificity, and accuracy of different diagnostic methods were compared, taking pathological diagnosis as the gold standard and considering long-term follow-up results as well. Results: Out of the 146 patients, the procedure was successful in 145 cases (99.3%). The average procedure time was （51.5±16.9） min. The sensitivity, specificity, and accuracy of SpyGlass visual impression diagnosis for indeterminate biliary stricture were 83%, 84%, and 83%, respectively, outperforming brush cytology results (47%, 100%, and 52%). The combination of visual diagnosis and SpyBite biopsy yielded sensiti-vity of 91%, specificity of 63%, and accuracy of 85%. Adverse events occurred in 24.7% of cases, all of which were clinically mild. Conclusions: SpyGlass choledochoscopy has a high accuracy and safety in differential diagnosis of indeterminate stricture of the hilar bile duct. Its widespread application is warranted. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Role of the spleen in patients with liver cancer and cirrhosis CHANG Jessica, CHEN Xuxiao, CHEN Yongjun Journal of Surgery Concepts & Practice    2023, 28 (04): 394-398.   DOI: 10.16139/j.1007-9610.2023.04.018 Abstract （101）   HTML （6）    PDF（pc） （906KB）（104）       Knowledge map    Save The spleen is the largest lymphoid organ that can affect the immunological microenvironment in the liver via the portal system. Patients with liver cancer, often develop hypersplenism and splenomegaly from underlying cirrhosis and portal hypertension. The malfunction of the spleen not only induces hepatic fibrogenesis, but also changes the immune responses in the liver, so that liver cirrhosis accelerates while liver regeneration subdues. As a result, the hepatic microenvironment and the rest of the immune system reach a “tumor progressing” or “tumor tolerant” state. Splenectomy has been shown to improve immune responses, liver function and general condition in patients with liver cancer. Hence, splenectomy may possibly improve the tolerance in live cancer patients for other anticancer treatments. However, the long-term benefits and effects on the overall survival of concomitant hepatectomy and splenectomy for liver cancer patients with portal hypertension and hypersplenism still remain controversial. Reference | Related Articles | Metrics | Comments（0）

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Endoscopic diagnosis and treatment of benign pancreatic diseases WANG Zhenyu Journal of Surgery Concepts & Practice    2023, 28 (04): 288-295.   DOI: 10.16139/j.1007-9610.2023.04.003 Abstract （81）   HTML （1）    PDF（pc） （887KB）（98）       Knowledge map    Save Benign pancreatic diseases include inflammation and its complications, anatomical and structural abnormalities, and benign tumors，etc. For the diagnosis and treatment of pancreatic diseases, endoscopic retrograde cholangiopancreatography（ERCP) and endoscopic ultrasound (EUS) were most widely used, which has its own advantages and indications, also they were often used in combination. The development of cholangiopancreatoscope is rapid, and its value in diagnosis and treatment needs further improvement of technique. Endoscopic technology has been carried out in different types of benign pancreatic diseases for its diagnosis and treatment. Due to its advantages of minimally invasive, safe, effective and repeatable，endoscopic technology has become the main method. Reference | Related Articles | Metrics | Comments（0）

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The role of ERCP in the diagnosis and treatment of chronic pancreatitis ZHANG Ling, ZOU Duowu Journal of Surgery Concepts & Practice    2023, 28 (04): 283-287.   DOI: 10.16139/j.1007-9610.2023.04.002 Abstract （176）   HTML （3）    PDF（pc） （876KB）（91）       Knowledge map    Save Chronic pancreatitis (CP) is a chronic progressive disease that causes varying degrees of functional damage on pancreatic endocrine and exocrine, seriously affecting the quality of life of the patients. Endoscopic retrograde cholangio-pancreatography (ERCP) with minimal trauma, high safety, and good efficacy has become a first-line treatment method for CP. ERCP is a first-line treatment method for pancreatic duct stones and pancreatic duct stricture, and complications of CP. Reference | Related Articles | Metrics | Comments（0）

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Tracheal diverticula discovered during surgery: a report of 2 cases and literature review HE Wen, GU Jianhua, XING Xujian, WENG Ziyi, FEI Jian Journal of Surgery Concepts & Practice    2023, 28 (04): 383-387.   DOI: 10.16139/j.1007-9610.2023.04.016 Abstract （118）   HTML （2）    PDF（pc） （2334KB）（84）       Knowledge map    Save To analyze the reasons why tracheal diverticula is easy to be missed or misdiagnosed in the diagnosis and treatment of thyroid tumors, and to strengthen the understanding of the clinical characteristics of the disease. The reasons of the misdiagnosis and missed diagnosis in similar cases were analyzed, and the anatomy, differential diagnosis, and examination methods by reviewing the relevant literature in the past 20 years were further analyzed. At the same time, a retrospective analysis was carried out on two recent clinical cases of tracheal diverticula discovered during surgery. Tracheal diverticula is easily confused with thyroid tumor and may be misdiagnosed for the following reasons: tracheal diverticula is asymptomatic in most patients; symptomatic tracheal diverticula has similar clinical symptoms to thyroid nodules; lack of character in imaging findings. General surgeons should improve their awareness and vigilance of tracheal diverticula. Neck CT should be listed as a routine examination before thyroid-related surgery. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Application experience of enteroscopy ERCP in benign biliary stricture after cholecystojejunostomy WENG Mingzhe, WANG Xuefeng Journal of Surgery Concepts & Practice    2023, 28 (04): 296-299.   DOI: 10.16139/j.1007-9610.2023.04.004 Abstract （119）   HTML （3）    PDF（pc） （3765KB）（79）       Knowledge map    Save Benign biliary stricture is a common complication of cholecystojejunostomy and is hard to handle. Ente-roscopy ERCP possesses the advantages such as repeatability, minimally invasive, and compliance with normal physiological structures in treatment. We shared our experiences of enteroscopy ERCP in benign biliary stricture after cholecystojejunostomy, hoping to improve the success rate of this treatment. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Endoscopic intervention strategy for pancreaticoduodenectomy-related cholangiopancreatic diseases DONG Yuanhang, CHEN Jie Journal of Surgery Concepts & Practice    2023, 28 (04): 307-309.   DOI: 10.16139/j.1007-9610.2023.04.006 Abstract （102）   HTML （0）    PDF（pc） （893KB）（78）       Knowledge map    Save The pancreaticoduodenectomy-related cholangiopancreatic complications include anastomotic stricture, cholangiopancreatic duct stones, cholangitis, pancreatitis, obstructive jaundice due to tumor recurrence, etc. Because of the complexity of the operation, the multiple organs involved and digestive tract reconstruction, endoscopic retrograde cholangio-pancreatography is difficult to carry out. In this article, we introduced two kinds of endoscopic interventional strategies, retrograde gastrostomy via biliary/pancreaticojejunostomy and endoscopic ultrasonography (EUS)-guided biliary drainage/ EUS-guided pancreatic drainage through digestive wall to provide some reference for clinicians. Reference | Related Articles | Metrics | Comments（0）

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Physiological function of polyploid hepatocytes and pathological changes in its associated diseases ZHANG Yifan, LU Yiquan, HAO Fengjie, WANG Junqing Journal of Surgery Concepts & Practice    2023, 28 (06): 574-579.   DOI: 10.16139/j.1007-9610.2023.06.015 Abstract （41）   HTML （1）    PDF（pc） （857KB）（78）       Knowledge map    Save Liver is a unique organ with polyploidy. About 20 to 50 percent of hepatocytes in adult human are polyploid cells, which contain more than two sets of chromosomes. Hepatocytes polyploidization is triggered by the changes in insulin signal during weaning, and regulated by various cell cycle regulator genes to ensure the polyploid cells proportion, ploidy and zonation. The regulation of polyploid hepatocytes is crucial for liver's metabolic and regenerative function, and protecting liver from tumorigenesis. However, in chronic virus hepatitis and nonalcoholic fatty liver disease, the pathological hepatocytes polyploidization can be found in disease progression because of cell cycle checkpoint inhibition and oxidative stress. Distinguishing physiological and pathological hepatocyte polyploidization will be helpful for the understanding the relationship between chronic liver disease and tumorigenesis. Reference | Related Articles | Metrics | Comments（0）

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Efficacy with prognostic value of postoperative prophylactic hyperthermic intraperitoneal chemotherapy for locally advanced gastric cancer SUN Qi, HUANG Wenbo, HE Bingliang, LIU Chang, XU Yuhang, ZHAO Wei Journal of Surgery Concepts & Practice    2023, 28 (04): 366-370.   DOI: 10.16139/j.1007-9610.2023.04.013 Abstract （464）   HTML （0）    PDF（pc） （889KB）（71）       Knowledge map    Save Objective To explore the efficacy with prognostic value of postoperative prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) for locally advanced gastric cancer with clinical stage cT3-4NxM0. Methods A retrospective collection and analysis of clinical data was conducted from 60 patients with locally advanced gastric cancer (cT3-4NxM0) who underwent D2 radical surgery between January 2016 and December 2021 at our department. Patients who underwent prophylactic HIPEC were classified into the HIPEC group (n=30), while patients who did not undergo prophylactic HIPEC were clssified into the control group (n=30). Both groups of patients routinely were treated with postoperative adjuvant systemic chemotherapy. The median survival time, and overall survival rate of the two groups were compared through follow-up, and the risk factors affecting the overall survival rate were analyzed. Results The median survival time of the HIPEC group was 51.0 months (95% CI: 40.7-61.3), which was higher than that of the control group with 30.0 months (95% CI: 16.3-43.7). The 3-year and 5-year overall survival rates of the HIPEC group (66.7%, 53.3%)were higher than those of the control group（56.7%, 43.3%） (P=0.019). Prophylactic HIPEC was the protective factor affecting the overall survival rate of postoperative patients with locally advanced gastric cancer (P=0.021). Conclusions For patients with locally advanced cT3-4NxM0 gastric cancer, prophylactic HIPEC plays an important role in prolonging the median survival time, hence impro-ving the overall survival rate of patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Risk factors and prognosis of carbapenem-resistant Klebsiella pneumoniae bloodstream infection in ICU patients: a report of 81 cases LIU Meng, XU Wen, DAI Yunqi, TAN Ruoming, LIU Jialin, GU Feifei, CHEN Erzhen, WANG Xiaoli, QU Hongping, QIU Yuzhen Journal of Surgery Concepts & Practice    2023, 28 (05): 454-462.   DOI: 10.16139/j.1007-9610.2023.05.11 Abstract （64）   HTML （1）    PDF（pc） （987KB）（62）       Knowledge map    Save Objective Comprehensive mortality risk analyses and therapeutic assessment in real-world practice are beneficial to guide individual treatment in patients with Carbapenem-resistant Klebsiella pneumoniae bloodstream infections (CRKP-BSI). Methods Retrospective analysis of the clinical characteristics of 81 CRKP-BSI patients in our intensive care unit from July 2016 to June 2020, to indentify the risk factors of death and treatment effects of different antibiotic regimens. Results In 81 CRKP-BSI cases, the majority source were from abdominal and respiratory, accounting for 56.79% (46 cases) and 22.22% (18 cases), respectively. The 28-day mortality and hospitalization mortality of CRKP-BSI were 54.32% (44 cases) and 65.43% (53 cases). Multivariate regression analysis suggested that biliary tract disease before admission (P=0.026) and increased SOFA score at the onset of BSI (P=0.006) were independent risk factors for 28-day mortality. There was no statistically significant difference in 28-day mortality between the groups of antibiotic treatment based on tigecycline (44 cases) and polymyxin B (26 cases) [56.82% (25/44) vs. 57.69% (15/26), P=0.943]. Patients were evaluated based on their age (≤ 65 years vs. >65 years), gender, body mass index (≤25 kg/m2 vs. >25 kg/m2), and APACHE Ⅱ score (≤20 vs. >20), the use of renal replacement therapy and mechanical ventilation, there was no difference in the mortality among each subgroup. Conclusions Biliary tract disease before admission and SOFA score were independent risk factors for 28-day mortality. There was no significant difference outcomes between tigecycline- and polymyxin B-based therapy. Table and Figures | Reference | Related Articles | Metrics | Comments（0）