Physician News (Rong Media Reporter Xiangxue Huang Jing) In the impression of many people, biliary tract and pancreatic surgery will definitely open a huge incision in the abdomen. Today, the "SELECT" multi-mirror combination of minimally invasive diagnosis and treatment of traditional Chinese and Western medicine, the "keyhole" can solve the major problem of difficult biliary and pancreatic diseases, and the perioperative period is supplemented with traditional Chinese medicine treatment, so as to realize the combination of traditional Chinese and Western medicine to accelerate recovery.
A few days ago, Professor Shang Dong, Dean of the Institute of Integrated Traditional Chinese and Western Medicine of Dalian Medical University, Vice President of the First Affiliated Hospital, and Professor of General Surgery, in an interview with the reporter of "Physician Daily", first introduced the gospel brought to patients by the one-stop diagnosis and treatment model innovatively constructed by his team in the world. At present, this model has been promoted to more than 100 hospitals across the country, treating a large number of patients with complex biliary and pancreatic acute abdomen, and has been invited to broadcast this minimally invasive technology to the world for many years. This technology combines soft and hard endoscopy and integrates traditional Chinese and Western medicine, learning from each other's strengths and complementing each other's advantages, and solving difficult clinical biliary and pancreatic diseases, and the related achievements won the first prize of scientific and technological progress of the Chinese Association of Integrative Medicine.
Over the years, Professor Shang Dong has also been committed to the scientific research of biliary and pancreatic diseases, realizing the early screening of pancreatic cancer, distinguishing "good and evil" with one shot, and the kit for early diagnosis of pancreatic cancer will also be launched soon. At the same time, as a teacher, he taught what he knew and learned, and devoted himself to cultivating successors in the medical career.
Professor Shang Dong always takes patients as the center, puts the life and health of patients first, has the courage to create miracles, and climbs the peak of "pancreatic" road to benefit patients with biliary and pancreatic diseases.
01 One mode: multi-mirror combination of minimally invasive diagnosis and treatment of traditional Chinese and Western medicine
As a doctor, we must always be concerned about the patient, and in my clinical work for many years, I have seen too many patients with difficult biliary and pancreatic diseases rushing between internal and surgical procedures, which takes a long time and costs a lot, and cannot get a perfect one-stop diagnosis and treatment. Keeping in mind the original intention of doctors, Professor Shang Dong has led the team to create the "SELECT" multi-mirror combination of minimally invasive one-stop diagnosis and treatment model of Chinese and Western medicine.
The SELECT concept, which means "selection" and "selection", will form a "trump card army" of various endoscopes and laparoscopes that are the most advanced in clinical practice, and traditional Chinese medicine will serve as a logistical helper, adopting the "operational" concept of combining traditional Chinese and Western medicine with multi-mirror combination and minimally invasive, and selecting the best combination according to the specific condition and disease, and cooperating with each other to defeat the enemy.
The six letters SELECT have their own unique meanings: "S" is Single-Operator Cholangiopancreatoscopy, which refers to the biliary pancreatic scope; "E" is ERCP, which is retrograde cholangiopancreatography through duodenoscopy; "L" is Laparoscopy, laparoscopic (including surgical robots); The second "E" is EUS, endoscopic ultrasound; Version 1.0 is Choledochoscopy, which refers to choledochoscopy, and version 2.0 is Confocal Laser Endomicroscopy, which is the most cutting-edge endoscopic technology, which combines miniaturized confocal laser microscopy with traditional endoscopes, and can carry out real-time cell-level accurate diagnosis of biliary and pancreatic diseases in vivo through "optical biopsy"; "T" stands for Traditional Chinese Medicine. The team independently developed traditional Chinese medicines such as Pancreatic Qing Granules, Qing Heat and Choleretic Granules, Tongfu Dixing Heat Detoxification Granules, as well as Kuangushu Granules and Qigui Buyi Granules, which were applied to patients with biliary and pancreatic diseases in the perioperative period to accelerate recovery through the integration of traditional Chinese and Western medicine.
The diagnosis and treatment of biliary and pancreatic diseases under the guidance of the SELECT concept, according to the specific condition, through different multi-mirror combinations for precise diagnosis and treatment, and the use of traditional Chinese medicine for syndrome differentiation and treatment in the perioperative period, has achieved precision, individualization and minimally invasiveness, and truly achieved people-oriented, patient-centered, life first, health first, achieved a new height in the diagnosis and treatment of biliary and pancreatic diseases, and demonstrated the benevolence of doctors with actions.
In September 2023, a patient in his 50s in Changhai County, Dalian, suffered from severe pancreatitis caused by gallstones falling into the common bile duct, which is severe pancreatitis.
"After coming to our hospital, he successively underwent endoscopic ultrasound to drain infected necrotic pus through the posterior wall of the stomach into a covered metal stent, surgical removal of infected pancreatic necrotic tissue, ICU rescue, traditional Chinese medicine recuperation, removal of infected necrotic tissue through the sinus tract through choledoscope, laparoscopic pancreatic fistula-jejunostomy to treat pancreatic duct rupture syndrome." Professor Shang Dong said that because the patient's condition was quite serious and complex, the team used a combination of multi-mirror minimally invasive diagnosis and treatment mode of traditional Chinese and Western medicine, and successively used a number of "SELECT" endoscopic techniques and laparoscopic techniques, supplemented by traditional Chinese medicine, and successfully saved the patient's life after 6 months of treatment.
Professor Shang Dong conducted a live broadcast of SELECT multi-scope surgery to the world
In 2018, Professor Shang Dong led the team to innovatively propose the construction of the "SELECT" multi-mirror combination of minimally invasive diagnosis and treatment concept of traditional Chinese and Western medicine in the world, and the three-combination model of combination of soft and hard mirrors, medical and surgical combinations, and integration of traditional Chinese and Western medicine, to create a one-stop accurate minimally invasive diagnosis and treatment system and platform for patients with digestive diseases (biliary, pancreatic and gastrointestinal), so that patients with digestive diseases can avoid referral between multiple departments, and complete the diagnosis and treatment of difficult diseases in a one-stop platform, which shortens the hospital stay, reduces medical costs, reduces pain, and accelerates postoperative recovery. Many patients from all over the country come to see them. At present, the "SELECT" diagnosis and treatment model has been promoted to more than 100 hospitals across the country.
In 2023, at the 31st European Congress of Endoscopic Surgery (EAES) and the 21st Annual Meeting of Italy Endoscopic Surgery, Professor Shang Dong, as the first Chinese surgeon to give a report at the conference, demonstrated the advanced concept and exquisite technology of SELECT's one-stop minimally invasive platform for handling complex biliary and pancreatic diseases, as well as his unique and incisive insights on biliary and pancreatic minimally invasive surgery. It has aroused enthusiastic responses from the participants and won unanimous praise from international experts.
The Italy Annual Congress of Digestive Surgery is the largest digestive surgery conference in Italy and even Europe, in 2020-2022, invited by Professor Giorgio Palazzini of the University of Rome, the chairman of the annual meeting, Professor Shang Dong's team has conducted laparoscopic live broadcast of laparoscopic surgery to more than 100 countries around the world for 3 consecutive years, showing laparoscopic pancreaticoduodenectomy, laparoscopic combined with choledoscopy for the treatment of hepatobiliary stones, laparoscopic combined with choledoscopy for the treatment of common bile duct duodenal fistula, hepatobiliary duct plasty, The bile duct-jejunostomy Roux-Y anastomosis demonstrated the advanced diagnosis and treatment concept with Chinese characteristics to experts from all over the world, showing the demeanor of Chinese doctors.
02 A scientific research: early screening of pancreatic cancer realizes a shot to distinguish good from evil
Pancreatic cancer has become a major problem in the medical community due to its insidious onset, low early diagnosis rate, rapid progression, and extremely poor prognosis. In recent years, Professor Shang Dong has devoted himself to the scientific research of early diagnosis of pancreatic cancer, looking for ways and means of "early detection, early diagnosis and early treatment" of pancreatic cancer, so as to improve the cure rate of pancreatic cancer.
"When we clinicians do scientific research, we first find problems in the clinic, and then explore the key points to solve and the key links of the disease through basic research, and then feedback to the clinic, apply it to the clinic, and continuously develop new technologies through research and innovation, improve the level of diagnosis and treatment, and serve the majority of patients." Professor Shang Dong said.
"The pancreas is located behind the peritoneum, behind the stomach, pancreatic diseases, especially patients with pancreatic tumors, the early symptoms are atypical, can be manifested as epigastric distension, pain and discomfort, etc., which are very similar to the manifestations of gastric diseases, often causing misdiagnosis or missed diagnosis, a small number of low back pain symptoms may be at an advanced stage, how to detect pancreatic cancer early is a world problem." Professor Shang Dong said that the traditional conventional examination methods cannot obtain biopsy specimens, and can only preliminarily evaluate benign and malignant through imaging examination and tumor marker examination, which is not completely reliable, may cause misdiagnosis, and is not conducive to the choice of doctors' treatment plan. Pancreatic lesions can be definitively diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA). Under the guidance of endoscopic ultrasound, pancreatic lesions can be punctured at close range and with clear paths, so as to obtain accurate pathological diagnosis basis, which is the best means to obtain the pathological diagnosis basis of pancreatic lesions before surgery. It is especially advantageous for cases of early-stage pancreatic tumors that cannot be diagnosed after CT, MRI, and PET-CT examinations.
In collaboration with the University of Pittsburgh School of Medicine in United States, they used spatially domain low coherence quantitative phase microscopy (SL-QPM) technology for rapid cell detection, which increased the sensitivity of EUS-FNA for pancreatic cancer cytology from 72% to 94% while maintaining 100% specificity. It can reduce the number of FNAs, reduce the complications of EUS-FNA, shorten the operation time, and reduce the cost. This minimally invasive technique also realizes that pancreatic cancer can be detected at a very young age, and laparoscopic resection is used in time to improve the cure rate of pancreatic cancer.
Professor Shang Dong's team has also jointly carried out the research and development of pancreatic cancer early diagnosis kit with other scientific research teams at home and abroad, using the kit to detect traces related to tumor cells in peripheral blood and carry out early diagnosis of pancreatic cancer.
03 A lesson: Correct any wrong punctuation in time
Professor Shang Dong is not only a doctor with both virtue and art, but also a conscientious people's teacher, who imparts medical knowledge, clinical experience and scientific research technology to students without reservation.
"The power of one person is limited, and we must make the team bigger and stronger, and cultivate more disciplinary reserve forces and medical talents, so as to relieve the pain of more patients." As the leader of the national key discipline of integrated traditional Chinese and Western medicine clinical practice of Dalian Medical University, Professor Shang Dong is dedicated to cultivating medical successors.
Professor Shang Dong gave a lecture on the key points of the interpretation film to the students
Professor Shang Dong's first impression on students is that he is rigorous in his studies, and when listening to students' reports, even if there is a punctuation mark or word error in the PPT of the report, he will correct it in time.
"A punctuation point may seem like a small thing, but if you think about it, if it is a small mistake in the treatment of a patient, it may bring unexpected consequences." Professor Shang Dong said that the strictness of students is to cultivate students' excellence and meticulous scientific style.
As the leader of the first batch of national first-class undergraduate majors, Professor Shang Dong actively promotes the internationalization of education, and has sponsored many young teachers and outstanding students to study in foreign medical colleges. He also selflessly gave the teaching materials accumulated over the years to young teachers, rewarded them for learning, and helped young teachers grow rapidly. Under the leadership of Shang Dong, many teachers of the team won awards in the national teaching competition, and the team was selected by the Ministry of Education as the second batch of "Huang Danian-style Teacher Team of National Universities".
Professor Shang Dong delivered a speech at the graduation ceremony
04 A kind of inheritance: give the motivation to keep moving forward
Whether it is the concept and platform of minimally invasive diagnosis and treatment of multi-mirror combination of traditional Chinese and Western medicine, or the realization of early screening of pancreatic cancer to distinguish good from evil, or the discipline has become a national key discipline and the first batch of national first-class undergraduate majors, Professor Shang Dong believes that these achievements are the result of the efforts of the team of integrated traditional Chinese and Western medicine of Dalian Medical University for several generations.
"These achievements are also a vivid interpretation of the efforts of the team of integrated traditional Chinese and Western medicine of Dalian Medical University to move forward and care for patients, and they are inseparable from the long disciplinary accumulation and discipline spirit of Dalian Medical University." Professor Shang Dong said that as early as 1958, the team of integrated traditional Chinese and Western medicine of Dalian Medical University took the lead in carrying out research on the treatment of acute abdomen, especially biliary and pancreatic diseases. In 1961, he published the first monograph on integrated traditional Chinese and Western medicine in mainland China, "New Acute Abdomen", and his related research results have won the National Science Conference Award and the National Science and Technology Progress Award. In 1996, it was approved as the first clinical doctoral program of integrated traditional Chinese and Western medicine in Northeast China. In 2007, it was approved as a national key discipline by the Ministry of Education. The university and the hospital attach great importance to the construction of the discipline of integrated traditional Chinese and Western medicine and the development of specialties, and the university has formulated the development direction of the construction of the medical discipline group driven by the discipline of integrated traditional Chinese and Western medicine, and the hospital is built with the national flagship hospital of integrated traditional Chinese and Western medicine as the core. For more than 60 years, several generations have worked hard and forged ahead, and the team has insisted on attaching equal importance to traditional Chinese and Western medicine, giving full play to the characteristics and advantages of the development of integrated Chinese and Western medicine in Western hospitals, and promoting the all-round rapid development of the team.
"Looking back on the journey, it is the careful guidance and selfless help of my predecessors that has given me the motivation to keep moving forward. For the future development, Professor Shang Dong also has a planning map, and will lead the team to continue to have the courage to create miracles and the road of "pancreas" to climb the peak in medical research and teaching, constantly explore new methods for the treatment of difficult biliary and pancreatic diseases, cultivate more successors to the medical career, benefit the majority of patients with biliary and pancreatic diseases, and contribute to the construction of "Healthy China".
Professor Shang Dong gave a lecture while making rounds