The department of general surgery was founded by the older generation of experts headed by Professor Changlin Zhao in 1952, having the earliest Master Program (1981), Doctoral Program (1987), and the center for post-doctoral studies (1999) of general surgery. Our department is the key discipline of Shandong Province, the key discipline of Medicines and Health in Shandong Province, the key discipline of the strengthening construction of The Eleventh Five-Year Plan, and the key discipline of the second phase of the “985” Project. In 2012, Qilu Hospital was selected as the national key clinical specialty construction project and one of the first construction units of laparoscopic endoscopy training bases of the Ministry of Health, P.R. China. Also, it is the chairman unit of minimally invasive surgery committee of Chinese Research Hospital Association (CRHA), metabolic disease specialist committee of China Medicine Education Association (CMEA), the surgical branch of Shandong Provincial Medical Association, and several branches of Shandong Medical Doctor Association (SDMDA), including the endoscopic surgeons’ branch, gastrointestinal surgery branch, hernia and abdominal wall surgery branch, as well as weight-loss and metabolic surgery branch, etc.
Under the leadership of surgical pioneers of the older generation, the department of general surgery has formed the fine tradition of "practicality, innovation, solidarity, and cooperation". Under the leadership of young and middle-aged professors, our department has always been standing at the forefront of the development of modern general surgery, forming a series of characteristic subspecialties, which are gastrointestinal surgery, hepatobiliary surgery, colorectal surgery, pancreas-spleen surgery, thyroid surgery, breast surgery, liver transplantation surgery, vascular surgery, hernia and abdominal wall surgery, and weight loss and metabolism surgery. Besides, it has set up the endoscopic diagnosis and treatment technology training base of the National Health Commission of the People’s Republic of China, the laboratory of laparoscopic technology engineering of Shandong Province, The thirteenth Five-Year Plan’s key laboratory of diabetes and obesity surgery of universities in Shandong Province, the editorial department of the Journal of Laparoscopic Surgery, which is a top journal in China, and a national top-level minimally invasive treatment room. At present, there are 430 beds in the department of general surgery of Qilu Hospital, with an annual outpatient volume of more than 130000 people, an annual admission of more than 12000 inpatients, and an annual treatment of more than 2000 patients with critical and complex diseases. More than 10000 patients received surgical treatments every year, with an average bed utilization rate of 107%. In addition, we pay attention to the work of regional radiation. Doctors from our department go to local hospitals for specialist consultation more than 3000 times per year and receive more than 1000 referrals with urgent and critical conditions or difficult and complex diseases every year. We devote our efforts into building national and provincial academic exchange platforms, and regularly carry out academic conferences or training courses every year, such as the National Seminar Presentations of Laparoscopic Surgery and Qilu forum of various subspecialties. We believe such work would greatly promote the academic exchange of general surgery in our province and even in the range of the whole country.
The structure of our medical team is reasonable. At present, there are 110 doctors, including two Taishan scholars, one Taishan young scholar, one national “Ten thousand Talents Program” expert, 24 chief physicians, 20 associated chief physicians, 13 doctoral supervisors, and 14 master supervisors. 90% of young and middle-aged doctors have doctoral degrees. Meanwhile, our department undertakes the responsibility of clinical teaching and postgraduate students’ training for Shandong University. In recent years, the department of general surgery has been focusing on strengthening the incentive system of academic leaders, promoting the exploration of novel technologies and advanced research orientations from academic backbone scholars, and consequently, created a perfect academic and administrative environment. In the past five years, this department has undertaken 33 national and 38 provincial or ministerial research projects. It won five science and technology awards, which includes the second prize of the National Science and Technology Progress Award, the first prize of the Chinese Medical Science and Technology Award, two third-prizes of Shandong Science and Technology Progress Award, and the first prize of Excellent Scientific Research Achievement of Shandong Higher Education. Besides, staff in the department have published more than 400 academic papers in journals or magazines at all levels. Among them, 274 articles were included in the Science Citation Index (SCI), meanwhile, 42 articles have the impact factor (IF) of more than five points. On the rank list of hospital specialties published by the Institute of Hospital Management of Fudan University in 2018, the general surgery department of Qilu Hospital of Shandong University ranked fifth in the reputation of Huadong district hospitals. Besides, our department has been remaining ahead among the hospitals in the surrounding provinces of Shandong Province, helping and promoting the development of general surgery in hospitals of surrounding provinces.
Hepatobiliary Surgery
Department of Hepatobiliary Surgery of Qilu Hospital affiliated to Shandong University has a high reputation for its excellence and innovation in patient care, medical research, and medical education for physicians, scientists and health care professionals. At present, the department has formed a characteristic department atmosphere , and the spirit of "seeking truth, innovation, unity and cooperation" has been passed on from generation to generation. There are three clinical wards and 146 beds available. There are 34 surgeons, among whom 20 are professionals with the title of senior professors, associate professors, chief physicians, including 6 doctoral supervisors and 6 master supervisors. In addition, the department is responsible for the surgical education for undergraduate, master and doctoral students at Qilu Medical College of Shandong University. Annually, the department treats more than 5000 inpatients, performs more than 4000 surgical procedures and trains more than 350 residents .
The department is ranked the top of the list among Shandong Province in the comprehensive treatment for hepatobiliary and pancreatic benign and malignant diseases ,such as liver cancer, gallbladder cancer, cholangiocarcinoma, pancreatic cancer, intrahepatic and extrahepatic choledocholithiasis , liver transplantation. We have taken the lead in performing
anatomical hepatectomy, percutaneous transhepatic portal vein embolization (PVE), radiofrequency ablation (RFA) and microwave ablation (MWA). Equally important, the application and development of laparoscopic surgery has become the characteristics of the department. As early as the 1980s, we carried out liver transplantation in Shandong province. More than 300 cases of liver transplantation have been performed, which promoted liver transplantation as a routine operation in our hospital. Besides, hereditary hemorrhagic telangiectasia has been systematic studied and surgical treatments such as double constriction / ligation of hepatic artery has been established.
In recent years, the department has focused on the concept and practice of precise hepatobiliary surgery ,such as preoperative 3D digital evaluation, ICG fluorescence imaging technology, and laparoscopic and minimally invasive techniques. The department successively carried out laparoscopic cholecystectomy(LC) in April 1992, laparoscopic choledocholithotomy and T-tube drainage(LC+LCBDE) in June 1992, laparoscopic assisted pancreaticoduodenectomy(LPD) in 2007, transumbilical single port laparoscopic cholecystectomy and laparoscopic choledochojejunostomy in 2008, suspending transumbilical single port laparoscopic surgery in 2009, natural orifice transluminal endoscopic surgery(NOTES) in 2009, laparoscopic radical cholecystectomy for gallbladder cancer in 2010, laparoscopic radical resection of hilar cholangiocarcinoma in 2015, transumbilical single port laparoscopic hepatectomy in 2015, laparoscopic assisted associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in 2015. Currently, our laparoscopic techniques and surgical levels come up to advanced domestic standards.
The department is
devoted to academic communication in
domestic and abroad. It not only holds Qilu hepatobiliary surgery forum every year, the annual academic conference of Shandong Medical Association, hepatobiliary surgery branch and special committee of Shandong Research Hospital Association every year, but also undertake national hepatobiliary and pancreatic conferences. "The Qilu hospital liver cancer MDT seminar" is held every two weeks. Besides, it also pays great attentions to the growth of middle-aged and young surgeons and have provided chances for them by way of studying abroad or other famous hospitals in China.
Meanwhile, we attach great importance to the research of translational medicine and precision medicine. At present, there is one Taishan Scholars for Young Expert of Shandong Province and a leader of Qilu health area at our department. In the past five years, the department has published more than 100 papers in international and domestic academic journals. Especially, 27 papers were published in journals cited by SCI with the highest impact factor of 20.77 in 2019. In the past decade, we has won several national or
ministerial and provincial-level science and technology awards, including the second award of national science and technology progress, the second science and technology progress award of Ministry of Education, the first science and technology progress award of Shandong Province. In addition, we presided dozens of Scientific Research Projects, such as National Natural Science Foundation of China, the key projects and general projects of Shandong Natural Science Foundation. These achievements establish the leading status in the field of hepatobiliary surgery in Shandong Province and our department has boosted influence in domestic and abroad with the great effort of our team.
Gastrointestinal Surgery
As the key component of general surgery, department of Gastrointestinal Surgery of Qilu Hospital affiliated to Shandong University is developed from the Gastrointestinal Professional Group which was established in 1994. After nearly 30 years’ development，Gastrointestinal Surgery department has acquired a high reputation for its excellence in clinical diagnosis and treatment, medical research and education. “Professional, Accurate and Precise, Safe, Minimal invasive and ERAS” has been formed as the clinical characteristic of the department.
There are 5 therapeutic professional group consisted by 5 senior professors, 3 associate professors, and 6 attending physicians. Annually, the department treats about 500 gastric cancer and 500 colorectal cancer inpatients, and performs more than 1000 surgical procedures, most of which were accomplished through laparoscopic technique. More importantly, the department emphasize the innovation and promotion of new surgical technique, such as overlap technique and reverse puncture device (RPD) for esophagojejunostomy in totally laparoscopic total gastrectomy, Tubular stomach reconstruction for proximal gastrectomy, Natural orifice specimen extraction（NOSES）technique，Single-incision technique and Indocyanine green near-infrared imaging（ICG-NIR）technique in laparoscopic radical gastrectomy.
In recent years, the department attached equal importance to the clinical and fundamental research for gastric and colorectal carcinoma. We have presided and accomplished nearly 10 Scientific Research Projects, such as National Natural Science Foundation of China, the key projects and general projects of Shandong Natural Science Foundation. Annually, we publish about 5 papers in international academic journals cited by SCI and 10 papers in domestic academic journals.
Meanwhile, the department also focus on the academic communication domestically and abroad. Through the Qilu Gastrointestinal Surgery Forum and the annual academic conference of the gastrointestinal surgeons’ branch of Shandong Medical Doctor Association, the gastrointestinal committee and the gastric carcinoma MDT committee of Shandong Research Hospital Association, we devotes our effort to promote the popularizing of new clinical theory and surgical technique, and enhance communication in Shandong Province and domestic. Moreover, our department has drafted and published the Chinese expert consensus on the application of indocyanine green near-infrared imaging technique in laparoscopic radical gastrectomy for gastric cancer and the expert consensus on NOSES technique for colorectal carcinoma.
Colorectal Surgery
The Department of colorectal surgery in Qilu Hospital of Shandong University was founded in July 2011 and officially established in September 2014. Professor Yong Dai is the Department Director and Professor Dongsong Bi is the deputy director. At present, there are four chief surgeons, three associate chief physicians and four attending doctors. Ten of us have Doctor's degree, and five have overseas study experience. We have undertaken more than 10 national and provincial level research projects and published more than 30 SCI articles.
Under the leadership of Professor Yong Dai, our department has the characteristic of laparoscopic minimally invasive surgery, enhanced recovery after surgery (ERAS) and established the multidisciplinary team (MDT). Our department is one of the few specialties in Shandong Province can simultaneously diagnose and treat colorectal and anal benign and malignant diseases. We are performing anal function-preserving surgery for low rectal cancer, standardized treatment for colorectal cancer, standardized treatment for liver metastasis of colorectal cancer, treatment for gastrointestinal stromal tumors, and treatment for colorectal neuroendocrine tumors. Our department has rich experience in treatment of chronic constipation, inflammatory bowel disease, hemorrhoids, anal fistula, pelvic floor hernia and parastomal hernia. In recent years, a number of new technologies have been pioneered in our department, including laparoscopic low and ultra-low rectal cancer anus-preserving surgery, extralevator abdominoperineal excision (ELAPE), intersphincteric resection (ISR), natural orifice specimen extraction surgery (NOSES), transanal total mesorectal excision (TaTME), transanal endoscopic minimally invasive surgery (TEM), minimally invasive surgery for constipation and inflammatory bowel disease (subtotal resection of colon, STARR, IPAA) and procedure for prolapse and hemorrhoids (PPH).
In 2015, we firstly established the MDT team of colorectal cancer in Shandong Province, in 2017, the MDT group of the General Surgery Branch of Shandong Medical Association was established, and our department, as the leader unit, promoted the concept and shared the experience of MDT in our province. Since 2015, many academic conferences have been held annually, which has promoted the development of colorectal and anal surgery and the popularization of laparoscopic technology.
Pancreatic Surgery
The Department of Pancreatic Surgery is one of the earliest established departments in Qilu Hospital and has great impacts in China, especially in Shandong Province. In our department, the laparoscopic distal pancreatectomy has been routinely performed for the treatment of pancreatic cancer (RAMPs). Moreover, laparoscopic pancreatoduodenectomy has also been performed routinely in the treatment of PDAC, distal common bile duct cancer, ampullary cancer, duodenal cancer, etc. In addition, we have accumulated rich experience in the early treatment of severe acute pancreatitis (especially severe biliary pancreatitis), and have broad clinical expertise in choosing the timing of surgery and the surgical methods. We have conducted extensive studies on the mechanisms and treatments of pancreatic diseases, including the studies on the choice of extended lymph node dissection, combined vascular resection, regional arterial infusion chemotherapy, and different pancreaticojejunostomy, which have won us the Third Prize of Scientific and Technological Progress of Shandong Province in 2003. We have taken the lead in China and especially in Shandong Province to implement new surgical methods. For example, we are among the first to perform laparoscopic islet cell tumor resection, laparoscopic pylorus preserving pancreatoduodenectomy(LPPPD), modified pancreaticoduodenectomy with preservation of the horizontal part of duodenum, laparoscopic duodenum-preserving resection of the head of pancreas (LDPRHP), splenic preserving distal pancreatectomy (Kimura and Warshaw procedure), middle segment pancreatectomy, Laparoscopic internal drainage of pancreatic cyst, laparoscopic choledochotomy, and choledochoscopic exploration for biliary pancreatitis in China and Shandong Province. We have summarized our experience in treating pancreatic diseases with minimally invasive techniques, and formed the "Qilu style" of pancreatic disease treatment. We have won the Third Prize for Scientific and Technological Progress of Shandong Provincial Department of Education for our expertise in treating pancreatic diseases.
Vascular Surgery
Qilu Hospital of Shandong University firstly conducted the diagnosis and treatment of vascular diseases in Shandong Province. Many typical surgeries were firstly performed in our hospital in 1960s, such as axillary-femoral venous bypass surgery. We firstly performed endovascular intervention in 1980s in Shandong. It entered into a stage of rapid development from 2000, and several advanced procedures were performed, including endovascular repair for aortic dissection, hybrid surgery of aortic dissection, endovascular repair for abdominal aortic aneurysm, fenestrated stent-graft technique for preserving aortic branches, and open and endovascular repair for mycotic aortic aneurysms. For diagnosis and treatment of limb vascular diseases, we firstly performed femoral-popliteal-posterior tibial artery bypass surgery with autogenous inverted great saphenous vein, and hybrid surgery for lower extremity ischemia. For visceral vessels, endovascular therapy was firstly performed for superior mesenteric artery dissection and renal artery dissection in Shandong. Meanwhile, we firstly studied the etiology of deep venous thrombosis and performed hybrid surgery of carotid artery stenosis and carotid artery aneurysms in Shandong.
Vascular surgery in Qilu Hospital developed under the pioneering spirit, innovation, and guidance of the old generation of highly respected specialists, for example, Prof. Zhenxiang Zhang and Prof. Zhanmin Wang. Department of Vascular surgery was established in 2004 in Qilu Hospital of Shandong University and had an independent ward later. It was a national key discipline construction unit, a training base for peripheral vascular interventional diagnosis and treatment of National Health Commission, an excellent unit for national venous thrombosis prevention and treatment, the chairman unit of Vascular Surgery Branch of Research Hospital Association of Shandong Province, and the chairman unit of Vascular Disease Special Committee of Shandong Cardiac Function research Society.
The rapid development of vascular surgery in Qilu Hospital of Shandong University is based on the inheritance of the rigorous scholarship spirit of the older generation of experts. The concept of discipline development is safe, effective and economical; first of all, emphasizing the normative diagnosis and treatment of diseases, and then reducing medical costs on the base of safety and efficacy of treatment. Guiding ideology: focus on the diagnosis and treatment of great vascular diseases and difficult and critically ill cases, and promote the innovation of technologies and approaches in diagnosis and treatment of difficult and critically ill cases. The department has been awarded the first prize or the second prize in the competition of difficult and critically ill cases for four consecutive years. At present, it undertakes the graded diagnosis and treatment of difficult, acute, and critically ill cases in vascular surgery in all levels of hospitals in Shandong province and surrounding provinces. In diagnosis and treatment of complicated visceral vascular diseases, it is located at the leading level in China. The results of clinical studies have been published in the authoritative journals of Vascular Surgery, such as Journal of Vascular Surgery, Annals of Thoracic Surgery, Annals of Vascular surgery, etc.
The department of Vascular Surgery has more than 10,000 outpatient visits per year, more than 200 emergency surgeries per year, and nearly 300 great vascular surgeries per year. There are 7 doctors, all of whom have doctor's degree. We have presided over a number of projects of provincial natural science foundation and postdoctoral foundation. We are undertaking the teaching and training of undergraduates, postgraduates, interns, and foreign students in medical college of Shandong University, as well as standardized training doctors and refresher doctors. In international communication, the director of our department had ever studied in Harbor Medical Center, University of California, Los Angeles at an early stage, and conducted surgical communication and performance with vascular surgeons from United Kingdom, Germany, Italy and United States at unscheduled time.
The discipline construction of Department of Vascular Surgery is based on high starting point, high standard, and high level. The scope of diagnosis and treatment includes: 1. Endovascular, hybrid, and open surgery of thoracic and abdominal aortic dissection, visceral arterial dissection, and peripheral arterial dissection; 2. Open and minimally invasive surgery of thoracic and abdominal aortic aneurysms, peripheral artery aneurysms, visceral artery aneurysms, carotid artery aneurysms, and subclavian artery aneurysms; 3, Surgical and endovascular treatment of occlusive artery diseases, such as lower extremity arteriosclerosis obliterans, carotid artery stenosis, renal artery stenosis, thromboangiitis obliterans, multiple arteritis, and other diseases; 4. Surgical and endovascular treatment of acute arterial embolism, including abdominal aortic embolism, limb artery embolism, superior mesenteric artery embolism, and other diseases; 5. Surgical and interventional treatment of lower extremity varicosity, chronic venous insufficiency, deep venous thrombosis, pulmonary embolism, Budd-chiari syndrome, Cockett's syndrome, superior and inferior vena cava obstruction syndrome, nutcracker syndrome, and so on; 6. Minimally invasive treatment of congenital vascular malformation, arteriovenous fistula, and limb lymphedema, etc.
Thyroid Surgery
The Thyroid Surgery Department of Qilu Hospital of Shandong University is based on the state key discipline-thyroid specialty group of General Surgery. Since 2011, the Thyroid Surgery Department has been set up as a independent department, with 20 beds in the central hospital and 34 beds in the east hospital. Over 30,000 outpatients are received and 1,800 operations are performed annually, and the number is increasing year by year. In addition to traditional open surgery for the treatment of thyroid diseases, we also carry out laparoscopic assisted small incision thyroid surgery and complete endoscopic thyroid surgery without scarring of the neck. In order to protect the functions of recurrent laryngeal nerve and parathyroid gland, intraoperative nerve monitoring technology and negative parathyroid visualization by nanocarbon technology have also been operated in our department, which lead us to be a national training base for nerve monitoring technology. Since 2019, our department has become a member of the Training Center Alliance of National Thyroid Endoscopic Surgery.
Bariatric and metabolic surgery
Bariatric and metabolic surgery was founded in April 2019 as the 10
th subdiscipline of general surgery. There are 3 specialists in the department，Dr. Shaozhuang Liu, Dr. Teng Liu and Dr. Xin Huang. The lab of Diabetes and Obesity Surgery, which is a provincial key lab of colleges and universities, is affiliated to the department.
The department is one of leading centers of bariatric and metabolic surgery in China and the leading center in Shandong province. It is famous for the excellent clinical techniques, clinical and basic researches. Although the department was founded in 2019, the clinical work started in 2006, marked by the first sleeve gastrectomy in China. On July 11, a patient with the body weight of 334.4kg (BMI 106kg/㎡), known as the heaviest man in China, accepted SG in the department. On Oct. 29, the second heaviest man in China, with the body weight of 310kg (BMI 101kg/㎡), accepted SG in the department. Currently, more than 200 cases accept SG, SG and repair of hiatus hernia, revisional surgeries in the department every year.
In clinical research aspect, the department was certificated as national clinical research center of bariatric and metabolic surgery by Society of Surgery, Chinese Medical Association. Dr. Liu founded the first regional registration system for cases of bariatric and metabolic surgery, Shandong bariatric and metabolic surgery registration system (SDBMSR). The focuses of the clinical research includes (1)SG for obese polycystic ovary syndrome (SGOP), (2) SG for low BMI diabetes, (3) predictors of diabetes control and weight loss after surgeris, (4) psychological intervention on obesity patients, et al.
In basic research aspect, the research group was funded by national and provincial foundations with more than 30 programs. We mainly focuse on the role of small intestine on glucose and lipid metabolism and diabetes remission after bariatric and metabolic surgeries.
The research group have published 43 SCI papers in Annals of Surgery, SOARD, Obesty Surgery and other famous journals. And we proposed the small intestine hypothesis as the key mechanism of diabetes control after bariatric and metabolic surgeries. In 2019, the group was awarded the first prize of scientific and technological progress of Shandong Province due to the achievement on series of SG researches.
Hernias and Abdominal Wall Surgery
Our department initiated tension-free inguinal hernia repair in the 1990s，and we started laparoscopic inguinal hernia, incisional hernia and esophageal hiatal hernia repair separately in 2007. We specialize in treating various hernias and abdominal wall diseases, including inguinal hernia, incisional hernia, parastomal hernia, esophageal hiatus hernia, umbilical hernia, rectus abdominis separation, abdominal wall tumors and many other diseases. We can complete 400 surgeries of various hernia every year, and more than 90% of all surgeries are conducted laparoscopically, which is at the domestic advanced level. To achieve the goal of shortening hospital stays and saving medical resources, we are also implementing and promoting day surgery and ERAS in the field of inguinal hernia repair, which are well received by patients. With the increase of major abdominal surgeries and the aging of patients, the incidence of incisional hernias is increasing, with a reported incidence of 2-10%. The treatment of huge incisional hernias is still a tuff work. We use open, laparoscopic and as well as hybrid methods to treat huge incisional hernias, which has achieved lower postoperative complications and recurrence rates, which are at the leading level in China. Our department has established an effective treatment system in the fields of inguinal hernia, hiatal hernia, incisional hernia, parastomal hernia, rectus abdominis separation, etc., which solved the suffering of patients from all over the province and enabled them to return to normal life.
