Autor: Budzyński, Andrzej - Katalog OPAC zbiorów

Skocz do pozycji: 1.

Tytuł:: Elective laparoscopic cholecystectomy – is it safe in the hands of residents during training?
Autorzy:: Kisielewski, Michał
Pędziwiatr, Michał
Pisarska, Magdalena
Major, Piotr
Rubinkiewicz, Mateusz
Matłok, Maciej
Migaczewski, Marcin
Budzyński, Piotr
Budzyński, Andrzej
Powiązania:: https://bibliotekanauki.pl/articles/1394419.pdf
Data publikacji:: 2015
Wydawca:: Index Copernicus International
Tematy:: laparoscopic cholecystectomy
resident education
conversion of operator
Opis:: The aim of the study was to assess safety of elective laparoscopic cholecystectomy (LC) performed by residents that are undergoing training in general surgery. Material and methods. A retrospective analysis was conducted on 330 patients operated electively due to cholelithiasis. Patients with acute cholecystitis, choledocholithiasis, undergoing cholecystectomy as a part of more extensive operation and patients with gall-bladder cancer were excluded. Group 1 included patients operated by resident, group 2 – by specialist. Duration of operation, mean blood loss, number of major complications, number of conversions to the open technique and conversions of the operator, reoperations and length of hospital stay were analyzed. Results. Mean operative time overall was 81 min (25 – 170, SD±28.6) and 71 min (30-210, SD±29.1) in groups 1 and 2 respectively (p=0.00009). Mean blood loss in group 1 was 45±68.2 ml and in group 2 – 41±73.4 ml (p=0.23). Six major complications has occurred (1.81%) – 2 (2%) in group 1 and 4 (1.7%) in group 2. 18 cases (15.5%) of conversion of the operator occurred in group 1, and 6 cases (2.6%) of conversion of the operator happened in group 2. Average LOS was 1.9 days in group 1 and 2.3 days in group 2 (p=0.03979). Conlcusions. Elective LC performed by a supervised resident is a safe procedure. Tactics of “conversion of operator” allowed to prevent major complications. Longer LC by residents is natural during the learning curve. Modifications of residency program in the field of laparoscopy may increase its accessibility.
Źródło:: Polish Journal of Surgery; 2015, 87, 9; 429-433
0032-373X
2299-2847
Pojawia się w:: Polish Journal of Surgery
Dostawca treści:: Biblioteka Nauki

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Tytuł:: Laparoscopic cholecystectomy in the treatment of gallbladder polypoid lesions – 15 years of experience
Autorzy:: Matłok, Maciej
Migaczewski, Marcin
Major, Piotr
Pędziwiatr, Michał
Budzyński, Piotr
Winiarski, Marek
Ostachowski, Mateusz
Budzyński, Andrzej
Rembiasz, Kazimierz
Powiązania:: https://bibliotekanauki.pl/articles/1396486.pdf
Data publikacji:: 2013-11-01
Wydawca:: Index Copernicus International
Tematy:: gall-bladder polyps
laparoscopic cholecystectomy
gall-bladder cancer
gall-bladder ultrasound
Opis:: Due to the constant increase of public health awareness and widespread “cancerophobia”, the progressively larger number of incidentally diagnosed gall-bladder polyps became the source of anxiety, which leads patients and physicians to undertake therapeutic decisions, despite the absence of symptoms. The majority of gall-bladder polyps are benign. It is estimated that only 3 to 5% of polyps are malignant. Currently, there is lack of randomized control trials based on which the clear-cut criteria of qualification of patients with gall-bladder polyps for surgical procedure can be created. The aim of the study was to analyze gall-bladder polyps in patients who underwent laparoscopic cholecystectomy in the 2nd Department of General Surgery, Jagiellonian University Collegium Medicum. Material and methods. The retrospective study was conducted on 5369 patients who underwent laparoscopic cholecystectomy in the 2nd Department of General Surgery, Jagiellonian University Collegium Medicum with special attention to 152 (2.8%) patients in whom gall-bladder polyps were diagnosed preoperatively. Qualification criteria for surgery, surgical treatment results, and histopathological examination results were also analyzed. Results. Amongst the 5369 patients qualified for laparoscopic cholecystectomy, 152 (2.8%) were diagnosed with gall-bladder polyps during the preoperative ultrasound examinations. Postoperative histopathological examinations of 41 (27%) patients confirmed the presence of gall-bladder polyps. In 102 (67%) patients, only gall-stones were diagnosed without previously described polyps during the ultrasound examination. Analysis of the histopathological examination results revealed the presence of benign lesions in 35 (23.35%) patients. In 5 (3%) patients the presence of an adenoma, and in one (0.65%) the presence of adenocarcinoma were confirmed. Conclusions. Based on the conducted study and previous personal experience in the treatment of patients with gall-bladder polyps, we believe that due to the potential risk of neoplastic transformation, patients with polyps larger than 10 mm in diameter and polyps of proven rapid growth should be qualified for laparoscopic cholecystectomy. Indications for surgical treatment also seem reasonable in case of patients with present polyps and coexisting right upper quadrant pain, even though the above-mentioned is connected with gall-bladder deposits.
Źródło:: Polish Journal of Surgery; 2013, 85, 11; 625-629
0032-373X
2299-2847
Pojawia się w:: Polish Journal of Surgery
Dostawca treści:: Biblioteka Nauki

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Tytuł:: Randomized Clinical Trial to Compare the Effects of Preoperative Oral Carbohydrate Loading versus Placebo on Insulin Resistance and Cortisol Level after Laparoscopic Cholecystectomy
Autorzy:: Pędziwiatr, Michał
Pisarska, Magdalena
Matłok, Maciej
Major, Piotr
Kisielewski, Michał
Wierdak, Mateusz
Natkaniec, Michał
Budzyński, Piotr
Rubinkiewicz, Mateusz
Budzyński, Andrzej
Powiązania:: https://bibliotekanauki.pl/articles/1394369.pdf
Data publikacji:: 2015
Wydawca:: Index Copernicus International
Tematy:: laparoscopic cholecystectomy
insulin resistance
preoperative carbohydrate loading
perioperative care
Opis:: Postoperative insulin resistance, used as a marker of stress response, is clearly an adverse event. It may induce postoperative hyperglycemia, which according to some authors can increase the risk of postoperative complications. One of the elements of modern perioperative care is preoperative administration of oral carbohydrate loading (CHO-loading), which shortens preoperative fasting and reduces insulin resistance. The aim of the study is to establish the influence of CHO-loading on the level of insulin resistance and cortisol in patients undergoing elective laparoscopic cholecystectomy. Material and methods. Patients were randomly allocated to one of 2 groups. The intervention group included 20 patients who received CHO-loading (400 ml Nutricia pre-op®) 2 hours prior surgery. The control group received a placebo (clear water). In every patient blood samples were taken 2 hours prior to surgery, immediately after surgery, and on the 1st postoperative day. Levels and changes in glucose, cortisol and insulin resistance were analyzed in both groups. Results. Although there were differences in the levels of cortisol, insulin, and insulin resistance, no statistically significant differences were observed between groups in every measurement. The length of stay and postoperative complications were comparable in both groups. Conclusions. We believe that CHO-loading is not clinically justified in case of laparoscopic cholecystectomy. No effect on the levels of glucose, insulin resistance and cortisol was observed. Even though such procedure is safe, in our opinion there is no clinical benefit from CHO-loading prior to laparoscopic cholecystectomy.
Źródło:: Polish Journal of Surgery; 2015, 87, 8; 402-408
0032-373X
2299-2847
Pojawia się w:: Polish Journal of Surgery
Dostawca treści:: Biblioteka Nauki

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