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Wyświetlanie 1-3 z 3
Tytuł:
Learning curve for laparoscopic Roux-en-Y gastric bypass based on the experience of a newly created bariatric center
Autorzy:
Dworak, Jadwiga
Wysocki, Michał
Rzepa, Anna
Pędziwiatr, Michał
Radkowiak, Dorota
Budzyński, Andrzej
Major, Piotr
Powiązania:
https://bibliotekanauki.pl/articles/1391721.pdf
Data publikacji:
2020
Wydawca:
Index Copernicus International
Tematy:
bariatric center
clinical competence
laparoscopic Roux-en-Y gastric bypass
learning curve
perioperative complications
surgical training
Opis:
Introduction: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most common treatments for morbid obesity. The learning curve for this procedure is 50–75 cases for an independent surgeon, and it is considered the most important factor in decreasing complications and mortality. We present our experience and learning curve with LRYGB for a newly established bariatric center in Poland. Material and methods: A prospectively collected database containing 285 LRYGB procedures performed in the II Department of General Surgery of the Jagiellonian University MC in Krakow between 06.2010 and 03.2019 was retrospectively reviewed. Patients were divided into groups of 30 (G1–G10) in the order of the procedures performed by each surgeon. The study analyzed the course of the operation and patient hospitalization, comparing those groups. Learning curve for the newly created bariatric center was established. Results: Operative time in G1–G3 differed significantly from G4–G10 (P < 0.0001). The stabilization point was the 90th procedure. Perioperative complications were observed in 36 (12.63%) patients. Perioperative complications, intraoperative difficulties and adverse events did not differ importantly among groups. Liberal use of “conversions of the operator” from a surgeon to a senior surgeon provides reasonable safety and prevents complications. Conclusions: The institutional learning process stabilization point for LRYGB in a newly established bariatric center is around the 90th operation. LRYGB can be a safe procedure from the very beginning in newly established bariatric centers. Specific bariatric training with active proctoring by an experienced surgeon in a bariatric centre can improve the laparoscopic gastric bypass outcome during the learning curve.
Źródło:
Polish Journal of Surgery; 2020, 92, 4; 23-30
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
The usefulness of the Mannheim Peritonitis index score in assessing the condition of patients treated for peritonitis
Autorzy:
Budzyński, Piotr
Dworak, Jadwiga
Natkaniec, Michał
Pędziwiatr, Michał
Major, Piotr
Migaczewski, Marcin
Matłok, Maciej
Budzyński, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1395648.pdf
Data publikacji:
2015-06-01
Wydawca:
Index Copernicus International
Tematy:
peritonitis
mortality
Mannheim Peritonitis Index (MPI)
Opis:
The aim of the study was to verify the Mannheim Peritonitis Index (MPI) suitability to determine the probability of death among patients in Polish population operated due to peritonitis and to assess the possibility of using the Index to determine the risk of postoperative complications, relaparotomy and need for postoperative hospitalization in intensive care unit. Material and methods. Retrospective analysis covered 168 patients (M: F = 83: 85, mean age = 48.45 years, SD ± 22.2) treated for peritonitis. The MPI score was calculated for each patient. According to MPI results, patients were divided to the appropriate groups (<21, 21‑29, > 29) and within analyzed. The statistical analysis used Chi-square, Mann Withney U and Kolmogorov-Smirnov test. The best cut-off point for MPI was calculated on the basis of ROC analisys. Results. Mortality in the study group was 13.1%. In groups <21, 21‑29 and > 29 points according to MPI mortality was 1.75%, 28.13% and 50% respectively, the difference was statistically significant (p = 0.0124). Significant differences were observed in mortality depending on the diagnosis. Based on the ROC curve the cut-off point was identified as 32 with an accuracy of 85.9% and AUC = 81%. There has been a significant correlation between the MPI count and and the occurrence of: cardio-respiratory failure, acidosis, electrolyte imbalance, surgical wound complications, the need for treatment in the intensive care unit after surgery. Conclusions. The MPI is a simple and effective predictor of death among patients operated due to peritonitis. It can also provide assistance in assessing the risk of postoperative complications and the need for treatment in the intensive care unit.
Źródło:
Polish Journal of Surgery; 2015, 87, 6; 301-306
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
A periampullary duodenal diverticula in patient with choledocholithiasis – single endoscopic center experience
Autorzy:
Major, Piotr
Dembiński, Marcin
Winiarski, Marek
Pędziwiatr, Michał
Rubinkiewicz, Mateusz
Stanek, Maciej
Dworak, Jadwiga
Pisarska, Magdalena
Rembiasz, Kazimierz
Budzyński, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1393717.pdf
Data publikacji:
2016
Wydawca:
Index Copernicus International
Tematy:
choledocholithiasis
digestive system endoscopic surgery
diverticulum
endoscopic retrograde cholangiopancreatography
prevalence
Opis:
The reported prevalence of periampullary duodenal diverticula varies between 9 and 32.8%. The aim of the study was to evaluate the prevalence of periampullary diverticula in the studied population and establish whether their presence influence the risk of choledocholithiasis and the risk of Endoscopic Retrograde Cholangio Pancreatography (ERCP) related complications. Material and methods. The study group of 3788 patients who underwent ERCP between 1996 and 2016at the 2nd Department of General Surgery Jagiellonian University Medical College in Kraków were analyzed. The group comprised of 2464 women (mean age 61.7 years) and 1324 men (mean age 61.8 years). The patients were divided into two groups. Group A included patients in whom there were no periampullary diverticula detected. Group B included patients in whom the opening of the bile duct was in the vicinity of a duodenal diverticulum. Results. There were 3332 patients included in group A (2154 women and 1178 men) and 456 patients in group B (310 women and 146 men). The prevalence of periampullary duodenal diverticula in the analyzed group was 12.8%. The presence of stones or biliary sludge was diagnosed in 1542 patients (47.6%) in group A and 290 patients (68.1%) in group B. Recurrence of choledocholithiasis occurred in 4.5% of patients (70/1542) in group A and 10.3% of patients (30/290) in group B. Complications occurred in a total of 76 patients in group A (2.3%) and 22 patients in group B (4.8%). Conclusions. The presence of choledocholithiasis and the risk of ERCP related complications are significantly higher in the group with duodenal diverticula.
Źródło:
Polish Journal of Surgery; 2016, 88, 6; 576-586
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
    Wyświetlanie 1-3 z 3

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