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Tytuł:
Costs of elective vs emergency cholecystectomy in diabetic patients
Autorzy:
Łącka, Monika
Spychalski, Piotr
Obłój, Paweł
Łaski, Dariusz
Rostkowska, Olga
Wieszczy, Paulina
Kobiela, Jarosław
Powiązania:
https://bibliotekanauki.pl/articles/1196132.pdf
Data publikacji:
2020-12-03
Wydawca:
Gdański Uniwersytet Medyczny
Tematy:
diabetes
elective cholecystectomy
emergency cholecystectomy
costs of hospitalization
Opis:
Introduction: Hospitalization costs of diabetic patients are estimated to be higher than non-diabetic. Literature on the topic is however limited. The aim of this study was to compare the costs of elective and emergency cholecystectomy of diabetic and non-diabetic patients. Material and methods: A retrospective analysis involved diabetic versus non-diabetic age- and sex-matched patients who underwent emergency and elective cholecystectomy at a single center in Poland between 2016-2019. Results: The total costs of an elective cholecystectomy were 739.31 ± 423.07 USD for diabetic patients and 797.14 ± 772.24 USD for non-diabetic patients (p = 0.51). Whereas emergency cholecystectomy total costs were 3950.72 ± 2856.83 USD (diabetic patients) and 2464.31 ± 1718.21 USD (non-diabetic patients) (p = 0.04). The difference in total costs between elective cholecystectomy vs emergency cholecystectomy in both groups (diabetic vs non-diabetic patients) was statistically significant (p < 0.01 vs p < 0.05 respectively). Conclusions: In this study we demonstrated that emergency cholecystectomy is associated with a significant increase in hospitalization costs, particularly in diabetic patients. This suggests that early qualification of diabetic patients for an elective cholecystectomy could be beneficial for both diabetic patients and public health insurers.
Źródło:
European Journal of Translational and Clinical Medicine; 2020, 3, 2; 37-43
2657-3148
2657-3156
Pojawia się w:
European Journal of Translational and Clinical Medicine
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Evaluation of patient feedback following laparoscopic cholecystectomy based on information described in the informed consent form developed by the Association of Polish Sur
Autorzy:
Misiak, Piotr
Jabłoński, Sławomir
Lazarek, Jerry
Malinowska, Katarzyna
Santorek-Strumiłło, Edyta
Terlecki, Artur
Powiązania:
https://bibliotekanauki.pl/articles/1394302.pdf
Data publikacji:
2015
Wydawca:
Index Copernicus International
Tematy:
laparoscopic cholecystectomy
informed consent
Opis:
The cholecystectomy procedure is the most routinely performed intervention in general surgery. The current international gold standard is via the laparoscopic approach. It is a safe, minimally-invasive procedure; however, it is associated with complications in 1% of cases. The aim of the study was to analyze patient feedback, by means of a survey, to determine how much knowledge patients possessed about their disease state and proposed surgical intervention, based primarily on information contained within the informed consent form developed by the Association of Polish Surgeons. Material and methods. This study involved the participation of 51 patients who underwent laparoscopic cholecystectomy, indicated by a diagnosis of gallstones, in the years 2014 and 2015. Results. Despite having signed the informed consent form, there was considerable variation among the responses given to the survey by the 51 patients in this study. Some patients’ responses were tangential to the questions asked; many patients did not respond to any of the sub points. Conclusions. Given that this study is based on a small sample size of patients, it must be presumed that the process by which the patient declares his or her informed consent requires further consideration with respect to the means by which it is obtained. The authors of this study thus recommend that multimedia resources be harnessed as part of the process of obtaining the informed consent of patients prior to surgical intervention.
Źródło:
Polish Journal of Surgery; 2015, 87, 11; 558-564
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Cholelithiasis in Home Parenteral Nutrition (Hpn) Patients – Complications of the Clinical Nutrition: Diagnosis, Treatment, Prevention
Autorzy:
Ławiński, Michał
Jachnis, Aneta
Ukleja, Anna
Pertkiewicz, Marek
Powiązania:
https://bibliotekanauki.pl/articles/1395736.pdf
Data publikacji:
2014-03-01
Wydawca:
Index Copernicus International
Tematy:
HPN
cholelithiasis
cholecystectomy
Opis:
Long-term home parenteral nutrition (HPN) is an important factor for cholelithiasis. An individualized nutrition program, trophic enteral nutrition and ultrasound bile ducts monitoring is a necessity in those patients. The aim of the study was to evaluate the usefulness of prophylactic cholecystectomy in patients with asymptomatic cholelithiasis requiring HPN. Material and methods. 292 chronic HPN patients were analyzed in the period from 2005 to 2012. Patients were divided into four groups: A - without cholelithiasis, B - with asymptomatic cholelithiasis, C - urgent cholecystectomy because of cholecystisis caused by gallstones, D - cholecystectomy in patients without cholelithiasis performed during an operation to restore the continuity of the digestive tract. The patients were additionally divided depending on the extent of resection of the small intestine and colon. Results. 36.9% of chronic HPN patients had cholelithiasis confirmed using ultrasonographic examination. Cholecystectomy due to acute cholecystitis symptoms was performed in 14.4% of the patients. The remaining 22.6% patients had asymptomatic cholelithiasis. Prophylactic cholecystectomy was performed in 5.5% patients with no signs of cholelcystisis during the planned operation to restore the continuity of the digestive tract. Conclusions. Cholelithiasis in chronic HPN patients is a frequent phenomenon. It seems useful to perform prophylactic cholecystectomy during primary subtotal resection of the small intestine, because the risk of cholelithiasis in this group of patients is very high.
Źródło:
Polish Journal of Surgery; 2014, 86, 3; 111-115
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Postcholecystectomy bile duct injuries: evolution of surgical treatment
Autorzy:
Šileikis, Audrius
Žulpaitė, Rūta
Šileikytė, Auksė
Lukšta, Martynas
Powiązania:
https://bibliotekanauki.pl/articles/1392375.pdf
Data publikacji:
2019
Wydawca:
Index Copernicus International
Tematy:
Complications
laparoscopic cholecystectomy
bile duct injury
Opis:
Introduction: Bile duct injuries (BDIs) still occur during laparoscopic cholecystectomy. Although management of such complications is challenging, a collaboration of a multidisciplinary team and development of treatment methods and materials often lead to successful treatment. Materials and methods: Medical records of 67 patients who have experienced bile duct injuries after laparoscopic cholecystectomy were retrospectively reviewed. All injuries were classified according to the European Association for Endoscopic Surgery ATOM classification and investigated by the manifestation of the injury, surgical repair technique, early and late complications. Results: In 28 (41.8 %) patients with partial divisions, the surgical treatment of BDI was completed with endoscopic retrograde cholangiopancreatography (ERCP) and stenting while in 14 (20.1%) cases, the defect of bile duct was closed by suture. End-to-end ductal anastomosis was performed for 6 (13.4%) patients with complete division while 19 (28.3%) patients underwent hepaticojejunostomy. We followed up 58 (92.1%) of 63 patients. The mean follow-up duration was 25.7 (3 - 123) months. Twenty-three (39.7%) patients were found to have structures. Discussion: Intraoperative detection and management of BDIs are crucial to achieving good results. The routine intraoperative cholangiography and possibilities of repair by initial surgeons in peripheral hospitals remain controversial. Stenting with a covered self-expanding metal stent is promising for the patients with partial divisions of bile ducts. Initial hepaticojejunostomy is often a preferred treatment for transected bile ducts because of a lower rate of anastomosis strictures. However, an end-to-end anastomosis is more physiological, and endoscopy allows successful management of the strictures, we suggest choosing this treatment when possible Recommendation for paperwork content: Classifying bile duct injuries according to the new ATOM classification may be useful in choosing the most appropriate treatment in each case.
Źródło:
Polish Journal of Surgery; 2019, 91, 1; 14-21
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
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:
Gall-Bladder and Hepatoduodenal Ligament Lymphangioma – Case Report and Literature Review
Autorzy:
Nazarewski, Łukasz
Patkowski, Waldemar
Pacho, Ryszard
Marczewska, Maja
Krawczyk, Marek
Powiązania:
https://bibliotekanauki.pl/articles/1396019.pdf
Data publikacji:
2013-01-01
Wydawca:
Index Copernicus International
Tematy:
lymphangioma
gall-bladder
cholecystectomy
lymphatic vessels
Opis:
Lymphangiomas are rare benign lesions of the lymphatic vessels that are most commonly diagnosed in childhood. Intraperitoneal localization is unusual as, typically, they are located in the head and neck areas. In general, abdominal lymphangiomas seem to be asymptomatic, however, patients may occasionally suffer from acute abdominal symptoms, due to intestinal obstruction or peritonitis. The study presented a case of a 41-year-old female patient, clinically asymptomatic, who was accidentally diagnosed with a multiseptated cystic lesion of the right liver lobe surrounding the gall-bladder fossa in a routine ultrasound examination. Further examinations including computed tomography and magnetic resonance (MR) aroused suspicion of a polycystic lesion of the gall-bladder and hepatoduodenal ligament. The cystic lesion of the gall-bladder and hepatoduodenal ligament filled with lymphatic fluid was diagnosed intraoperatively. Simultaneous cholecystectomy and radical resection of the cystic lesion was undertaken. The histopathological examination revealed the presence of a lymphangioma. Additionally, the authors of the study reviewed literature data concerning gall-bladder lymphangiomas.
Źródło:
Polish Journal of Surgery; 2013, 85, 1; 39-43
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Surgical treatment of acute cholecystitis in obese patients
Autorzy:
Kebkalo, Andrey
Tkachuk, Olha
Reyti, Andrian
Chanturidze, Archil
Pashunskyi, Yaroslav
Powiązania:
https://bibliotekanauki.pl/articles/1391898.pdf
Data publikacji:
2020
Wydawca:
Index Copernicus International
Tematy:
acute cholecystitis
obesity
laparoscopic cholecystectomy
Opis:
Introduction: In today’s technological climate, science and medicine have entered a new era. At the level of technological progress, we have identified millennia of “new” problems and diseases. If earlier diseases had a certain individuality then, in the third millennium, we face compliance and synergistic influence of diseases. Obesity is a problem of the third millennium. It is known that obesity is the main factor in the development of various chronic diseases [1–3]. With excess weight and obesity, bile is oversaturated with cholesterol, resulting in an increase of its lipogenicity index. As a result, frequency of gallstone disease increases; findings from this study document an increase of disease frequency as high as 50% to 60% [4]. In 20% of patients, housing concerns are combined with obesity [5]. Thus, obesity is one of the factors in the development of cholelithiasis and cholecystitis [6]. The presence of acute cholecystitis represents the most difficult situation for patients with gallstones. When obesity is also present, the patient’s risk of surgical complications increases due to altered homeostasis and reduced reserve capacity [7]. A retrospective study of this issue [8] posed a number of questions about the possibility of influencing the course of disease in the preoperative period as well as the improvement and impact of surgical technicalities in patients with acute cholecystitis and obesity. Addressing these and additional questions is the main goal of this study. Aim: The aim of the study was to study and select the optimal method of surgery in patients with acute cholecystitis and obesity. Materials and methods: In our study, a prospective analysis was used. We analyzed 67 cases with diagnosis of acute cholecystitis and obesity; all were treated at Kyiv Regional Clinical Hospital in the period from September 2018 to March 2020. Patients with acute cholecystitis and obesity received either traditional or modified laparoscopic cholecystectomy. Results: Retrospective analysis indicates traditional laparoscopic cholecystectomy is technically difficult and costly in patients with acute cholecystitis and obesity. A modified laparoscopic cholecystectomy has been proposed to improve and enhance surgery in patients with acute cholecystitis and obesity. Surgical duration was shortened by 9.01 ± 0.41 minutes (p = 0.001; αα= 0.05) when a modified laparoscopic cholecystectomy was performed. Conclusions: Performing a modified laparoscopic cholecystectomy reduced the duration of surgery by 9.01 ± 0.41 minutes (p = 0.001; α = 0.05), prevents development of metabolic acidosis pH 7.39 ± 0.03 vs 7.30 ± 0.005 = 0.001; αα= 0.05, pCO2 5.05 ± 0.36 vs 6.03 ± 0.38 (p = 0.02; αα= 0.05), reducing the risk of hypercoagulation. Modified laparoscopic cholecystectomy (LHE) is effective in II and III degrees of obesity (p = 0.001; α = 0.05).
Źródło:
Polish Journal of Surgery; 2020, 92, 5; 37-42
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Clinical relationship between histopathological necrotic/partial necrotic findings and disease condition of gallbladder mucoceles in dogs
Autorzy:
Itoh, H.
Igari, K.
Tani, K.
Sunahara, H.
Nemoto, Y.
Nakaichi, M.
Iseri, T.
Horikirizono, H.
Itamoto, K.
Powiązania:
https://bibliotekanauki.pl/articles/16539152.pdf
Data publikacji:
2022
Wydawca:
Polska Akademia Nauk. Czasopisma i Monografie PAN
Tematy:
canine
cholecystectomy
gallbladder mucoceles
necrosis
gangrenous cholecystitis
Opis:
Gallbladder mucocele (GM) is a common extrahepatic biliary disease recognized in dogs and is defined as the expansion and extension of the gallbladder by an accumulation of semi-solid bile or bile acid. Histopathological diagnosis of necrotizing cholecystitis and transmural coagulative necrosis of the gallbladder wall shows poor prognosis. Conversely, histopathological diagnosis with partial necrotic findings is often achieved. We hypothesized that histopathological partial necrosis of the gallbladder wall is the primary lesion of necrotic cholecystitis or transmural ischemic necrosis. Therefore, we investigated the relationship between histopathological necrosis/ partial necrosis findings and their clinical conditions. We retrospectively analyzed 55 dogs diagnosed with GM that had undergone cholecystectomy at the Yamaguchi University Animal Medical Center. The group with histopathological necrosis/partial necrosis of the gallbladder wall showed elevated levels of preoperative white blood cells, alanine transaminase, alkaline phosphatase, γ-glutamyltransferase, total bilirubin, and C-reactive protein compared to the non-necrotic group. Partial necrosis of the gallbladder wall may affect the progression of the disease and hematological abnormalities. Additionally, all death cases until 2 weeks were included in the histopathological necrosis/partial necrosis group. In this study, we found that poor prognosis factors were associated with partial necrosis of the gallbladder wall. Furthermore, these cases of partial necrosis showed elevated levels of blood test parameters. These results suggest that necrosis of the gallbladder wall is associated with poor prognosis and poor pathophysiological conditions.
Źródło:
Polish Journal of Veterinary Sciences; 2022, 25, 2; 223-229
1505-1773
Pojawia się w:
Polish Journal of Veterinary Sciences
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Iatrogenic bile duct injuries – clinical problems
Autorzy:
Głuszek, Stanisław
Kot, Marta
Bałchanowski, Norbert
Matykiewicz, Jarosław
Kuchinka, Jakub
Kozieł, Dorota
Wawrzycka, Iwona
Powiązania:
https://bibliotekanauki.pl/articles/1395690.pdf
Data publikacji:
2014-01-01
Wydawca:
Index Copernicus International
Tematy:
laparoscopic surgery
cholecystectomy
iatrogenic bile duct injury
Opis:
Laparoscopic cholecystectomy is one of the most frequently performed surgical procedures in surgical wards. Iatrogenic bile duct injuries (IBDI) incurred during the procedures are among postoperative complications that are most difficult to treat. The risk of bile duct injury is 0.2-0.4%, and their consequences are unpleasant both for the surgeon and for the patient. The aim of the study was analysis of iatrogenic bile duct injuries and methods of their repair,taking into consideration the circumstances, under which the injuries occur. Material and methods. The study group consisted of 16 patients who had suffered IBDI during surgery. The analysed parameters included sex, age, indications for surgery, the setting of the surgical procedure and the type of bile duct injury. Additionally, the time of injury diagnosis, type of repair and treatment outcome were assessed. The IBDI analysis used the EAES classification of injuries. The time of IBDI repair was defined as immediate, early or late,depending on the time that had passed from the injury. The analysis included complications seen after bile duct repair. Results. The study group consisted of 10 women and 6 men, aged 29-84. Patients underwent 6 classic cholecystectomies, 8 laparoscopic cholecystectomies, one gastrotomy to remove oesophageal prosthesis and one laparotomy due to peptic ulcer. IBDI was diagnosed intraoperatively in 4 patients. In 12 patients IBDI was diagnosed within 1-7 days. The diagnosis was based on endoscopic retrograde cholangiopancreatography and the results of biochemistry tests. According to the EAES classification, the injuries were of type 1 (4 patients), type 2 (8 patients), type 5 (3 patients) and type 6 (1 patients). Reconstruction procedures were performed during the same anaesthesia session in 3 patients, and in the early period in 13 patients. The main procedure was Roux-en-Y anastomosis (12 patients), with the remaining including bile-duct suturing over a T-tube (3 patients) and underpinning of an accessory bile duct in the pocket left after gallbladder removal (1 patient). The most common reconstruction complications included bile leak (3 patients), recurrent cholangitis (3 patients) and bile duct stricture (2 patients). Mortality in the study group was 12.5%. Conclusions. The procedures of laparoscopic and classic cholecystectomy are associated with a risk of IBDI, especially in the presence of inflammatory state of the gall-bladder. IBDI is a complex complication: its treatment poses a challenge for the operating surgeon, and even the most careful treatment adversely affects the patient’s lifedue to complications.
Źródło:
Polish Journal of Surgery; 2014, 86, 1; 17-25
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Cancer of the gallbladder – own experience
Autorzy:
Gryko, M.
Dawidziuk, T.
Sawicka, E.
Cepowicz, D.
Kamocki, Zb.
Masiulaniec, P.
Kędra, B.
Powiązania:
https://bibliotekanauki.pl/articles/1916507.pdf
Data publikacji:
2014
Wydawca:
Uniwersytet Medyczny w Białymstoku
Tematy:
gallbladder cancer
survival
surgery
gallstones
cholecystectomy
Opis:
Gallbladder cancer is a relatively rare cancer of the gastrointestinal tract, most commonly detected (approximately 95% of cases) in the most advanced clinical stage IV and burdened with high mortality rate. This is mainly due to the nonspecific symptoms in the early stages of the disease. The remaining cases of gallbladder cancer are usually detected after surgery due to gallstone disease. Gallstones, their size and pancreatic juice reflux into the gallbladder are risk factors in the development of gallbladder cancer. In this paper the authors carried out a retrospective research based on an evaluation of a group of 38 patients treated surgically due to the gallbladder cancer in the years 2005-2012 in the Second Department of General and Gastroenterological Surgery in Białystok Medical University Hospital. In this group there were 29 women and 9 men, in age between 48-86 years. Although women suffered from gallbladder cancer more often than men, their survival rate was significantly better after the surgery. The research showed some benefits of extended surgical procedures even in patients with advanced stages of the disease, while the effectiveness of surgical treatment depends mainly on the possibility of radical resection of the primary lesion and, eventually, the resection of lymph nodes and other infiltrated tissues.
Źródło:
Progress in Health Sciences; 2014, 4, 1; 153-157
2083-1617
Pojawia się w:
Progress in Health Sciences
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Gall-Bladder Duplication - Case Report
Autorzy:
Koszman, Bogusław
Powiązania:
https://bibliotekanauki.pl/articles/1395844.pdf
Data publikacji:
2014-12-18
Wydawca:
Index Copernicus International
Tematy:
digestive system abnormalities
gall-bladder
cholecystectomy
Opis:
Gall-bladder duplication is a rare anatomical variation, which can affect safe performance of cholecystectomy and be a cause of persistent symptoms and a need for reoperation in case of accessory gall-bladder omission. A case of successfully performed elective laparoscopic cholecystectomy in a patient with duplicated gall-bladder accidentally intraoperatively disclosed is presented. The identified anomaly was classified according to the Harlaftis Classification of Multiple Gall-bladders. Attention was drawn to the uneffectivenes of ultrasound scanning in multiple gall-bladders preoperative detecting, and presence of other non-biliary anatomical variation in the same individual as well.
Źródło:
Polish Journal of Surgery; 2014, 86, 9; 433-435
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Iatrogenic Bile Duct Injury. A Significant Surgical Problem. Assessment of Treatment Outcomes in the Departments Own Material
Autorzy:
Bobkiewicz, Adam
Krokowicz, łukasz
Banasiewicz, Tomasz
Kościński, Tomasz
Borejsza-Wysocki, Maciej
Ledwosiński, Witold
Drews, Michał
Powiązania:
https://bibliotekanauki.pl/articles/1396002.pdf
Data publikacji:
2015-03-01
Wydawca:
Index Copernicus International
Tematy:
iatrogenic bile duct injuries
cholecystectomy
complications
Opis:
Iatrogenic bile duct injuries (BDI) are still a challenging diagnostic and therapeutic problem. With the introduction of the laparoscopic technique for the treatment of cholecystolithiasis, the incidence of iatrogenic BDI increased. The aim of the study was a retrospective analysis of 69 patients treated at the department due to iatrogenic BDI in the years 2004-2014. Material and methods. In this paper, we presented the results of a retrospective analysis of 69 patients treated at the Department due to iatrogenic BDI in the years 2004-2014. The data were analysed in terms of age, sex, type of biliary injury, clinical symptoms, the type of repair surgery, the time between the primary surgery and the BDI management, postoperative complications and duration of hospital stay. Results. 82.6% of BDI occurred during laparoscopic cholecystectomy, 8.7% occurred during open cholecystectomy, whereas 6 cases of BDI resulted from surgeries conducted for other indications. In order to assess the degree of BDI, Bismuth and Neuhaus classifications were used (for open and laparoscopic cholecystectomy respectively). 84.1% of patients with confirmed BDI, were transferred to the Department from other hospitals. The average time between the primary surgery and reoperation was 6.2 days (SD 4). The most common clinical symptom was biliary fistula observed in 78.3% of patients. In 28 patients, unsuccessful attempts to manage BDI were made prior to the admission to the Department in other centres. The repair procedure was mainly conducted by laparotomy (82.6%) and by the endoscopic approach (15.9%). Hepaticojejunostomy was the most common type of reconstruction following BDI (34.7%). Conclusions. The increase in the rate of iatrogenic bile duct injury remains a challenging surgical problem. The management of BDI should be multidisciplinary treatment. Referring patients with both suspected and confirmed iatrogenic BDI to tertiary centres allows more effective treatment to be implemented.
Źródło:
Polish Journal of Surgery; 2014, 86, 12; 576-583
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Simultaneous TAPP (transabdominal pre-peritoneal technique) for inguinal hernia and cholecystectomy – a feasible and safe procedure
Autorzy:
Lehmann, Andrzej
Piątkowski, Jacek
Nowak, Mariusz
Jackowski, Marek
Pawlak, Maciej
Witzling, Mieczysław
Śmietański, Maciej
Powiązania:
https://bibliotekanauki.pl/articles/1395705.pdf
Data publikacji:
2014-02-01
Wydawca:
Index Copernicus International
Tematy:
TAPP
transabdominal pre-peritoneal technique
laparoscopic cholecystectomy
simultaneous
Opis:
Inguinal hernia repair and cholecystectomy are amongst the most common surgical procedures performed worldwide. In the recent decades, early disease detection has notably increased due to easily accessible ultrasound. The aim of the study was to assess the safety and the possibility of performing a simultaneous hernia repair and cholecystectomy using the laparoscopic approach. Material and methods. Eight patients (M=100%) with inguinal hernia (3 with bilateral hernia) and cholelithiasis were included in the study. The presence of gallstones was confirmed by imaging. Mean age of the patients was 61.75 years (ranging from 47-72). Simultaneous laparoscopic cholecystectomy and transabdominal pre-peritoneal hernia repair was performed in all patients. Postoperative complications were analyzed to assess the safety and feasibility of the procedure. Results. Mean operating time was 55 minutes (ranging from 30-60) and average length of stay was 3.625 days (ranging from 2-7). In order to perform a cholecystectomy, 1-2 additional trocars were used. No intra-operative complications were observed. At a follow-up visit on postoperative day 7, a small hematoma (10 ml of blood was punctured) in the right groin was noted in one patient. Another patient developed fever postoperatively, treated conservatively with antibiotics. Conclusions. Simultaneous TAPP and cholecystectomy proved to be a safe and feasible procedure. Acceptable operating time and hospital stay, as well as lack of influence on the length of convalescence, may present an interesting alternative to two separate procedures
Źródło:
Polish Journal of Surgery; 2014, 86, 2; 73-76
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Retroperitoneal abscess with retained gall-stones as a late complication of laparoscopic cholecystectomy
Autorzy:
Kamiński, Mateusz
Nowicki, Michał
Powiązania:
https://bibliotekanauki.pl/articles/1394061.pdf
Data publikacji:
2016
Wydawca:
Index Copernicus International
Tematy:
cholelithiasis
laparoscopic cholecystectomy
retroperitoneal abscess
late complications
Opis:
Laparoscopic cholecystectomy is the golden standard, considering treatment of cholelithiasis. During the laparoscopic procedure one may often observe damage to the gall-bladder wall, as well as presence of gall-stones in the peritoneal cavity, as compared to classical surgery. These gall-stones may be associated with the occurrence of various complications following surgery. The study presented a rare case of a retroperitoneal abscess, as a consequence of retained gall-stones, in a female patient who was subject to laparoscopic cholecystectomy two years earlier.
Źródło:
Polish Journal of Surgery; 2016, 88, 1; 38-40
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
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
Artykuł
Tytuł:
Laparoscopic cholecystectomy in a patient with total situs inversus – case report
Autorzy:
Stojcev, Zoran
Duszewski, Michał
Bobowicz, Maciej
Galla, Wojciech
Maliszewski, Daniel
Powiązania:
https://bibliotekanauki.pl/articles/1396117.pdf
Data publikacji:
2013-03-01
Wydawca:
Index Copernicus International
Tematy:
total situs inversus
cholecystectomy
laparoscopy
operative technique
Opis:
For many years, laparoscopic cholecystectomy remains the method of choice for both the treatment of symptomatic cholelithiasis, and chronic and acute cholecystitis (1). The experience of the surgeon grows with each laparoscopic procedure, which enables to operate in case of difficult anatomical conditions and associated anatomical variants. The aim of the study was to present a case of a 47-year old male patient with total situs inversus and several months history of recurrent left epigastric pain, radiating to the left scapula, being accompanied by nausea and vomiting. The study presented the operative technique of laparoscopic cholecystectomy and postoperative period data. In conclusion, laparoscopic cholecystectomy in a patient with total situs inversus is possible and safe, providing relevant precautions. The main issues certainly include a good and feasible plan of the operation, discussion concerning the possible intraoperative and postoperative complications, a good plan considering the localization of the trocars, as well as an experienced surgical team. One should also not forget that early conversion to classical cholecystectomy is not considered as failure, but might prevent accidental damage of the biliary ducts and long-term complications.
Źródło:
Polish Journal of Surgery; 2013, 85, 3; 141-144
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
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
Artykuł
Tytuł:
Primary pure squamous cell carcinoma of the gall bladder – a case report of rare and aggressive entity with adverse prognosis
Autorzy:
Bargotya, Mona
Mehta, Ankita
Das, Payel
Sachan, Ashish
Powiązania:
https://bibliotekanauki.pl/articles/454981.pdf
Data publikacji:
2020-03-30
Wydawca:
Uniwersytet Rzeszowski. Wydawnictwo Uniwersytetu Rzeszowskiego
Tematy:
adenocarcinoma
cholecystectomy
gall bladder
pure squamous cell carcinoma
Opis:
Introduction. The most common malignancy of the biliary tract is gall bladder carcinoma and the main subtype according to the histological classification is Adenocarcinoma. Pure squamous cell carcinoma of the gall bladder is very rare entity accounting for only 1.1-3.7% of the gall bladder carcinomas.It is highly malignant with poor prognosis due to high proliferative rate and local invasiveness to the adjacent organs. The patients are usually diagnosed at an advanced stage with a bulky tumor owing to its aggressive behavior. Aim. In this paper, we describe a female patient with primary pure squamous cell carcinoma of the gall bladder. Description of the case. A 42-year old female patient presented with chief complaints of pain in abdomen associated with nausea and vomiting and gradually progressive jaundice since 02 months. Contrast Enhancing Computed Tomography (CECT) abdomen showed an enhancing mass lesion in gall bladder involving adjacent organs for which she underwent extended cholecystectomy with pancreaticoduodenectomy. Conclusion. Diagnosis as well as the management of this exceptionally rare type of tumour is undoubtedly challenging because of non-specific clinical as well as imaging findings. This case report is an attempt to add to the literary evidence for better pathological as well as clinical understanding of this rare and aggressive entity thereby providing additional material for the early diagnosis as well as the development of effective targeted therapies which will certainly help in increasing the lifespan of these patients.
Źródło:
European Journal of Clinical and Experimental Medicine; 2020, 1; 59-63
2544-2406
2544-1361
Pojawia się w:
European Journal of Clinical and Experimental Medicine
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:
Polymeric locking clips [Hem-o-lok] versus Metallic clips in elective Laparoscopic Cholecystectomy: a retrospective study of 1496 patients
Autorzy:
Madhavan, Shibumon
Pandey, Anshuman
Masood, Shakeel
Kumar, Suneed
Chauhan, Smita
Kumar, Dinesh
Jha, Sneha
Powiązania:
https://bibliotekanauki.pl/articles/1391545.pdf
Data publikacji:
2021
Wydawca:
Index Copernicus International
Tematy:
Hem-o-lok clip
laparoscopic cholecystectomy
metallic clip
wide cystic duct
Opis:
Background Laparoscopic cholecystectomy is one of the most commonly performed operation. Various methods for securing the cystic artery and cystic duct are described in literature. We aim to compare intra-operative and early post-operative outcomes of laparoscopic cholecystectomy using polymeric locking Hem-o-lok clips versus metallic ligaclips . Patients and Methods Retrospective study of prospectively maintained single institutional data including all consecutive patients who underwent elective laparoscopic cholecystectomy from 2013 to 2018. Patients in whom metallic ligaclips were used were grouped as Group I and those with Hem-o-Lok were grouped as Group II. The early post-operative outcomes of the two groups were compared. Results Total 1496 patients were included in the study; 836 patients in Group I and 660 in Group II. Study included 29.1% males and 70.9% females with mean age of 43.6 years. Hem-o-lok clip was better in securing wide cystic duct compared to metallic clips. Metallic clip failed to secure 8 out of 44 wide cystic duct compared to 0 out 70 with Hem-o-lok clips (p=0.002). The post-operative outcomes of both groups were comparable. There were no cystic duct leak, post- operative bleeding or major bile duct injuries in either group. Conclusion Use of Hem-o-lok clip is safe in laparoscopic cholecystectomy due to ease of application and security. Hem-o-lok is more useful in patients with thick and wide cystic duct which are difficult to secure with metallic clips with low risk of leak. Key words: Laparoscopic Cholecystectomy, Hem-o-lok clip, Metallic clip, Wide cystic duct
Źródło:
Polish Journal of Surgery; 2021, 93, 3; 10-16
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Reprinted with permission of editor-in-chief of Annals of Surgery: Annals of Surgery: Vol. 266, nr 5, November 2017; 703 - 705: Modern Surgeons: Still Masters of Their Trade or Just Operators of Medical Equipment?
Autorzy:
Krawczyk, Marek
Powiązania:
https://bibliotekanauki.pl/articles/1392874.pdf
Data publikacji:
2018
Wydawca:
Index Copernicus International
Tematy:
vascular surgery
cholecystectomy
ultrasonography
bile ducts
liver transplantation
pancreas
laparoscopy
Opis:
My surgical education began at a time when Poland formed part of the communist bloc and was isolated from the world, or in today’s Terms – it remained behind the Iron Curtain. This was true of all areas of life, including medicine. When after 40 years of work, I look back at my professional career; I wonder whether I owe my proficiency in surgery to my experience and dexterity or, like many others, to technological progress. Two of the great Polish surgeons were my mentors and teachers. Professor Zdzisław Łapiński was the one I met first. He was a manual genius and an unusual operational strategist. Granted, he had one character defect, but nobody’s perfect after all. In 1975, I defended my dissertation. I was convinced that I should continue my education at a center abroad, preferably within a postdoctoral scholarship. Professor Łapiński wanted me to learn everything about surgery from him. I decided otherwise, and in 1978 with his tacit agreement, I obtained a Humboldt Fellowship and went to Heidelberg, to the department headed by none other than Professor Fritz Linder.1 I started my research for the habilitation thesis at the Experimentelle Chirurgie Abteilung of his Department.
Źródło:
Polish Journal of Surgery; 2018, 90, 2; 1-4
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Ultrasound measurement of the gallbladder wall thickness in the assessment of the risk of conversion from elective laparoscopic cholecystectomy to open surgery — Olkusz county experience
Autorzy:
Kania, Dariusz
Powiązania:
https://bibliotekanauki.pl/articles/1393735.pdf
Data publikacji:
2016
Wydawca:
Index Copernicus International
Tematy:
laparoscopic cholecystectomy
conversion
gall-bladder wall thickness
gall-bladder ultrasound
Opis:
The aim of the study was to assess the risk of intraoperative difficulties, conversion and biliaryintestinal fistula during laparoscopic cholecystectomy on the basis of an ultrasound-measured gallbladder wall thickness. Material and methods. A prospective study was conducted in 50 patients undergoing laparoscopic cholecystectomy for chronic gallstone-induced cholecystitis. To calculate the relationships between categorical variables, a chi-square (χ2 ) independence test was used, and the results were interpreted for the significance threshold of α = 0.05. Results. The relationship between the gall-bladder wall thickness and the occurrence of intraoperative difficulties in the analysed set is deterministic (AUC = 1), and the wall thickness of ≥ 5 mm allows to predict their occurrence as soon as at the stage of diagnostic evaluation (p < 0.001). In addition, the ultrasound-measured GB wall thickness is a good predictor of conversion (AUC = 0.976; 95% CI 0.444–0.975; p < 0.001) and biliary-intestinal fistula (AUC = 0.935; 95% CI 0.121–0.738; p = 0.001). Conclusions. The results allow prediction of technically difficult laparoscopic cholecystectomies in patients with CCh, and selection of the right surgical team helps to reduce the number of conversions and possible complications. In addition, bearing in mind the above results in everyday practice should facilitate planning and increase effectiveness in the operating room.
Źródło:
Polish Journal of Surgery; 2016, 88, 6; 587-607
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Patient with metastatic breast cancer presenting as acute cholecystitis with one-year survival on hormonotherapy
Autorzy:
Zamkowski, Mateusz
Kąkol, Michał
Makarewicz, Wojciech
Ropel, Jerzy
Bobowicz, Maciej
Powiązania:
https://bibliotekanauki.pl/articles/1392993.pdf
Data publikacji:
2017
Wydawca:
Index Copernicus International
Tematy:
breast neoplasm
advanced cancer
metastatic disease
Acute cholecystitis
gallbladder
laparoscopic cholecystectomy
Opis:
Breast cancer has high metastatic potential with distant metastases involving mainly lungs, liver and bones. Less frequently it gives distant spread to other organs. Herein we would like to present a very rare case of an acute cholecystitis which turned out to be a metastatic breast cancer in previously healthy woman. A female patient, 64-years old, presented to the emergency department with symptoms of biliary colic and acute abdomen. During the emergency cholecystectomy, we diagnosed the gallbladder empyema with thickened wall. There were also multiple metastatic nodules in the peritoneal cavity and an excessive amount of free fluid. The emergency physicians diagnosing female patient with the acute abdominal symptoms and a breast cancer history might suspect malignant spread into abdominal organs including gallbladder. On the other hand, acute cholecystitis symptoms might be the first symptoms of metastatic process in the gallbladder from the unknown primary source, which may be breast.
Źródło:
Polish Journal of Surgery; 2017, 89, 4; 46-49
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
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
Artykuł
Tytuł:
Health risk to medical personnel of surgical smoke produced during laparoscopic surgery
Autorzy:
Dobrogowski, Miłosz
Wesolowski, Wiktor
Kucharska, Małgorzata
Paduszyńska, Katarzyna
Dworzyńska, Agnieszka
Szymczak, Wiesław
Sapota, Andrzej
Pomorski, Lech
Powiązania:
https://bibliotekanauki.pl/articles/2177163.pdf
Data publikacji:
2015-07-29
Wydawca:
Instytut Medycyny Pracy im. prof. dra Jerzego Nofera w Łodzi
Tematy:
smoke
exposure
volatile organic compounds
dioxins
health risk
laparoscopic cholecystectomy
pyrolysis
Opis:
Objectives During laparoscopic cholecystectomy, the removal of the gall bladder, pyrolysis occurs in the peritoneal cavity. Chemical substances which are formed during this process escape into the operating room through trocars in the form of surgical smoke. The aim of this study was to identify and quantitatively measure a number of selected chemical substances found in surgical smoke and to assess the risk they carry to medical personnel. Material and Methods The study was performed at the Maria Skłodowska-Curie Memorial Provincial Specialist Hospital in Zgierz between 2011 and 2013. Air samples were collected in the operating room during laparoscopic cholecystectomy. Results A complete qualitative and quantitative analysis of the air samples showed a number of chemical substances present, such as aldehydes, benzene, toluene, ethylbenzene, xylene, ozone, dioxins and others. Conclusions The concentrations of these substances were much lower than the hygienic standards allowed by the European Union Maximum Acceptable Concentration (MAC). The calculated risk of developing cancer as a result of exposure to surgical smoke during laparoscopic cholecystectomy is negligible. Yet it should be kept in mind that repeated exposure to a cocktail of these substances increases the possibility of developing adverse effects. Many of these compounds are toxic, and may possibly be carcinogenic, mutagenic or genotoxic. Therefore, it is necessary to remove surgical smoke from the operating room in order to protect medical personnel.
Źródło:
International Journal of Occupational Medicine and Environmental Health; 2015, 28, 5; 831-840
1232-1087
1896-494X
Pojawia się w:
International Journal of Occupational Medicine and Environmental Health
Dostawca treści:
Biblioteka Nauki
Artykuł
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