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Wyświetlanie 1-5 z 5
Tytuł:
Is the Age of Patients with Iatrogenic Bile Duct Injuries Increasing?
Autorzy:
Stankiewicz, Rafał
Najnigier, Bogusław
Krawczyk, Marek
Powiązania:
https://bibliotekanauki.pl/articles/1395562.pdf
Data publikacji:
2015-03-01
Wydawca:
Index Copernicus International
Tematy:
cholecystectomy
complication
iatrogenic bile duct injury
Opis:
Resection of the gall-bladder is still the most common surgical procedure performed at general surgery departments. The laparoscopic method used in the majority of cases offers considerable benefits but at the same time is associated with an increased rate of bile duct complications. So far, a slim female aged 25-50 years was a typical patient with a iatrogenic bile duct injury. The aim of the study was to identify the age of patients with iatrogenic bile duct injuries as well as the clinical course observed in recent years. Material and methods. Gender and age structure of patients admitted to the Department of General, Transplant and Liver Surgery between the beginning of 2011 and June 2014 and treated for iatrogenic bile duct injuries, complications of laparoscopic cholecystectomy, were analysed. The patients were referred to the department as a reference centre. Results. In the group of 186 patients, females predominated (69.4%) and the mean age was 52 years. A considerable increase in the mean age of patients treated in 2014 as compared with previous years was seen. This was related to an increased rate of bile duct injuries in patients aged over 70 years, who accounted for about 25% of the group. In previous years, bile duct injuries in patients of such an advanced age happened considerably less frequently. Conclusions. A iatrogenic bile duct injury in an elderly person may prove a fatal complication. A repair surgery, i.e. the biliary-enteric anastomosis, is a major and burdensome procedure, particularly in the case of patients aged over 70 years. Special caution during laparoscopic cholecystectomy is advised in this population, and the slightest doubts should lead to conversion.
Źródło:
Polish Journal of Surgery; 2015, 87, 3; 129-133
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Management of Giant Hepatic Hemangioma in Atypical Localization; Report of a Case and Literature Review
Autorzy:
Stankiewicz, Rafał
Kobryń, Konrad
Patkowski, Waldemar
Krawczyk, Marek
Powiązania:
https://bibliotekanauki.pl/articles/1395563.pdf
Data publikacji:
2015-03-01
Wydawca:
Index Copernicus International
Tematy:
giant hemangioma
liver benign neoplasm
cholecystectomy
tumor enucleation
liver surgery
Opis:
Hemangiomas are the most common benign primary hepatic neoplasms, often being incidentally discovered. In most of the cases they are small and asymptomatic. It is widely accepted that clinical intervention is indicated only for symptomatic hemangiomas. We present a case of an asymptomatic giant hemangioma managed by enucleation due to its atypical localization. The hemangioma, originally located in segment 5, was now described in Computer Tomography (CT) Imaging as separating the gallbladder from the liver parenchyma. A careful evaluation of images revealed proximity to the portal vein (PV), right hepatic artery (RHA), right hepatic duct (RHD) and right branch of the portal vein (RBPV). Thus, in the case of an emergent operation, surgical maneuvers in the area of the altered hepatic anatomy and proximity to the hemangioma itself, would in fact increase the risk endangering the patient’s life. After patient’s consent, a surgical enucleation en block with the gall-bladder was performed. It is of great importance that specifically selected, asymptomatic patients diagnosed with a giant hemangioma, with the above mentioned or similar localization should be considered for surgical treatment.
Źródło:
Polish Journal of Surgery; 2015, 87, 3; 139-142
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Comparison of Total Tumor Volume, Size and Number of Colorectal Liver Metastases in Prediction of Survival in Patients after Liver Resection
Autorzy:
Hołówko, Wacław
Grąt, Michał
Wronka, Karolina Maria
Stypułkowski, Jan
Roszkowski, Rafał
Studnicki, Paweł
Krawczyk, Marek
Powiązania:
https://bibliotekanauki.pl/articles/1395543.pdf
Data publikacji:
2015-02-01
Wydawca:
Index Copernicus International
Tematy:
colorectal liver metastases
liver resection
total tumor volume
Opis:
Liver is the most common location of the colorectal cancer metastases occurrence. Liver resection is the only curative method of treatment. Unfortunately it is feasible only in 25% of patients with colorectal liver metastases, often because of the extensiveness of the disease. The aim of the study was to evaluate the predictive value of total tumor volume, size and number of colorectal liver metastases in patients treated with right hemihepatectomy. Material and methods. A retrospective analysis was performed in a group of 135 patients with colorectal liver metastases, who were treated with right hemihepatectomy. Total tumor volume was estimated based on the formula (4/3)πr3. Moreover, the study included an analysis of data on the number and size of tumors, radicality of the resection, time between primary tumor resection and liver resection, pre-operative blood serum concentration of carcinoembryonal antigen (CEA) and carcinoma antigen Ca19-9. The predictive value of the factors was evaluated by applying a Cox proportional hazards model and the area under the ROC curve. Results. The univariate analysis has shown the predictive value of size of the largest tumor (p=0.033; HR=1.065 per each cm) on the overall survival, however no predictive value of number of tumors (p=0.997; HR=1.000) and total tumor volume (p=0.212; HR=1.002) was observed. The multivariate analysis did not confirm the predictive value of the size of the largest tumor (p=0.141; HR=1.056). In the analysis of ROC curves, AUROC for the total tumor volume, the size of the largest tumor and the number of tumors were 0.629, 0.608, 0.520, respectively. Conclusions. Total tumor volume, size and number of liver metastases are not independent risk factors for the worse overall survival of patients with colorectal liver metastases treated with liver resection, therefore increased values of these factors should not be a contraindication for surgical treatment
Źródło:
Polish Journal of Surgery; 2015, 87, 2; 53-58
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Evolution Of The Results Of 1500 Liver Transplantations Performed In The Department Of General, Transplant And Liver Surgery Medical University Of Warsaw
Autorzy:
Krawczyk, Marek
Grąt, Michał
Grąt, Karolina
Wronka, Karolina
Krasnodębski, Maciej
Stypułkowski, Jan
Masior, Łukasz
Hołówko, Wacław
Ligocka, Joanna
Nyckowski, Paweł
Wróblewski, Tadeusz
Paluszkiewicz, Rafał
Patkowski, Waldemar
Zieniewicz, Krzysztof
Pączek, Leszek
Milkiewicz, Piotr
Ołdakowska-Jedynak, Urszula
Najnigier, Bogusław
Dudek, Krzysztof
Remiszewski, Piotr
Grzelak, Ireneusz
Kornasiewicz, Oskar
Kotulski, Marcin
Smoter, Piotr
Grodzicki, Mariusz
Korba, Michał
Kalinowski, Piotr
Skalski, Michał
Zając, Krzysztof
Stankiewicz, Rafał
Przybysz, Marta
Cieślak, Bartosz
Nazarewski, Łukasz
Nowosad, Małgorzata
Kobryń, Konrad
Wasilewicz, Michał
Raszeja-Wyszomirska, Joanna
Piwowarska, Jolanta
Giercuszkiewicz, Dorota
Sańko-Resmer, Joanna
Rejowski, Sławomir
Szydłowska-Jakimiuk, Monika
Górnicka, Barbara
Wróblewska-Ziarkiewicz, Bogna
Mazurkiewicz, Michał
Niewiński, Grzegorz
Pawlak, Jacek
Pacho, Ryszard
Powiązania:
https://bibliotekanauki.pl/articles/1395614.pdf
Data publikacji:
2015-05-01
Wydawca:
Index Copernicus International
Tematy:
liver transplantation
survival
outcomes
donors
center experience
center volume
Opis:
Liver transplantation is a well-established treatment of patients with end-stage liver disease and selected liver tumors. Remarkable progress has been made over the last years concerning nearly all of its aspects. The aim of this study was to evaluate the evolution of long-term outcomes after liver transplantations performed in the Department of General, Transplant and Liver Surgery (Medical University of Warsaw). Material and methods. Data of 1500 liver transplantations performed between 1989 and 2014 were retrospectively analyzed. Transplantations were divided into 3 groups: group 1 including first 500 operations, group 2 including subsequent 500, and group 3 comprising the most recent 500. Five year overall and graft survival were set as outcome measures. Results. Increased number of transplantations performed at the site was associated with increased age of the recipients (p<0.001) and donors (p<0.001), increased rate of male recipients (p<0.001), and increased rate of piggyback operations (p<0.001), and decreased MELD (p<0.001), as well as decreased blood (p=0.006) and plasma (p<0.001) transfusions. Overall survival was 71.6% at 5 years in group 1, 74.5% at 5 years in group 2, and 85% at 2.9 years in group 3 (p=0.008). Improvement of overall survival was particularly observed for primary transplantations (p=0.004). Increased graft survival rates did not reach the level of significance (p=0.136). Conclusions. Long-term outcomes after liver transplantations performed in the Department of General, Transplant and Liver Surgery are comparable to those achieved in the largest transplant centers worldwide and are continuously improving despite increasing recipient age and wider utilization of organs procured from older donors.
Źródło:
Polish Journal of Surgery; 2015, 87, 5; 221-230
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
1000 Liver Transplantations at the Department of General, Transplant and Liver Surgery, Medical University of Warsaw - Analysis of Indications and Results
Autorzy:
Krawczyk, Marek
Grąt, Michał
Barski, Krzysztof
Ligocka, Joanna
Antczak, Arkadiusz
Kornasiewicz, Oskar
Skalski, Michał
Patkowski, Waldemar
Nyckowski, Paweł
Zieniewicz, Krzysztof
Grzelak, Ireneusz
Pawlak, Jacek
Alsharabi, Abdulsalam
Wróblewski, Tadeusz
Paluszkiewicz, Rafał
Najnigier, Bogusław
Dudek, Krzysztof
Remiszewski, Piotr
Smoter, Piotr
Grodzicki, Mariusz
Korba, Michał
Kotulski, Marcin
Cieślak, Bartosz
Kalinowski, Piotr
Gierej, Piotr
Frączek, Mariusz
Rdzanek, Łukasz
Stankiewicz, Rafał
Kobryń, Konrad
Nazarewski, Łukasz
Leonowicz, Dorota
Urban-Lechowicz, Magdalena
Skwarek, Anna
Giercuszkiewicz, Dorota
Paczkowska, Agata
Piwowarska, Jolanta
Gelo, Remigiusz
Andruszkiewicz, Paweł
Brudkowska, Anna
Andrzejewska, Renata
Niewiński, Grzegorz
Kilińska, Beata
Zarzycka, Aleksandra
Nowak, Robert
Kosiński, Cezary
Korta, Teresa
Ołdakowska-Jedynak, Urszula
Sańko-Resmer, Joanna
Foroncewicz, Bartosz
Ziółkowski, Jacek
Mucha, Krzysztof
Senatorski, Grzegorz
Pączek, Leszek
Habior, Andrzej
Lechowicz, Robert
Polański, Sławomir
Leowska, Elżbieta
Pacho, Ryszard
Andrzejewska, Małgorzata
Rowiński, Olgierd
Kozieł, Sławomir
Żurakowski, Jerzy
Ziarkiewicz-Wróblewska, Bogna
Górnicka, Barbara
Hevelke, Piotr
Michałowicz, Bogdan
Karwowski, Andrzej
Szczerbań, Jerzy
Powiązania:
https://bibliotekanauki.pl/articles/1396689.pdf
Data publikacji:
2012-06-01
Wydawca:
Index Copernicus International
Tematy:
liver transplantation
indications
results
mortality
Opis:
The aim of the study was to analyze indications and results of the first one thousand liver transplantations at Chair and Clinic of General, Transplantation and Liver Surgery, Medical University of Warsaw.Material and methods. Data from 1000 transplantations (944 patients) performed at Chair and Clinic of General, Transplantation and Liver Surgery between 1994 and 2011 were analyzed retrospectively. These included 943 first transplantations and 55 retransplantations and 2 re-retransplantations. Frequency of particular indications for first transplantation and retransplantations was established. Perioperative mortality was defined as death within 30 days after the transplantation. Kaplan-Meier survival analysis was used to estimate 5-year patient and graft survival.Results. The most common indications for first transplantation included: liver failure caused by hepatitis C infection (27.8%) and hepatitis B infection (18%) and alcoholic liver disease (17.7%). Early (< 6 months) and late (> 6 months) retransplantations were dominated by hepatic artery thrombosis (54.3%) and recurrence of the underlying disease (45%). Perioperative mortality rate was 8.9% for first transplantations and 34.5% for retransplantations. Five-year patient and graft survival rate was 74.3% and 71%, respectively, after first transplantations and 54.7% and 52.9%, respectively, after retransplantations.Conclusions. Development of liver transplantation program provided more than 1000 transplantations and excellent long-term results. Liver failure caused by hepatitis C and B infections remains the most common cause of liver transplantation and structure of other indications is consistent with European data.
Źródło:
Polish Journal of Surgery; 2012, 84, 6; 304-312
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
    Wyświetlanie 1-5 z 5

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