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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 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:
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:
Zanik powłok brzusznych po zabiegach operacyjnych
Abdominal integument atrophy after operative procedures
Autorzy:
Smereczyński, Andrzej
Kołaczyk, Katarzyna
Lubiński, Jan
Bojko, Stefan
Gałdyńska, Maria
Bernatowicz, Elżbieta
Powiązania:
https://bibliotekanauki.pl/articles/1061355.pdf
Data publikacji:
2012
Wydawca:
Medical Communications
Tematy:
abdominal integument atrophy
appendectomy
cholecystectomy
laparotomy
nephrectomy
ultrasound
appendektomia
badanie ultrasonograficzne
cholecystektomia
laparotomia
nefrektomia
zanik powłok brzusznych
Opis:
The aim of the study was to analyze clinical material concerning postoperative atrophy of abdominal integument. Material and methods: The evaluated group consisted of 29 patients with sonographically revealed atrophy of the abdominal wall. Those changes were observed after various surgical procedures: mainly after long, anterolateral laparotomies or several classical operations. Ultrasound examinations up to the year 2000 were performed with analog apparatus, in the latter years only with digital apparatus with linear transducers (7–12 MHz) and sometimes convex type conducers (3–5 MHz). The location, size and intestine stratified wall structure were evaluated. In each case the integument thickness was measured in millimeters in the site of the greatest atrophy and it was compared with the integument thickness from the side that had not been operated which enabled the calculation of the percentage reduction of integument in the area of the scar. Results: In 3 patients who underwent several laparotomies there was a total reduction of muscular mass in the operated area. In these cases we stated only skin and slightly echogenic subcutaneous strand; probably corresponding to fibrous tissue – the thickness of integument in this area was in the range from 3 to 8 mm. In the remaining 26 patients the integument atrophy on the scar level included muscles in a greater extent and covered an extensive area after classical urological procedures on the upper urinary tract: after nephrectomy and even ureter stone evacuation or kidney cyst excision by means of classical anterolateral approach with the integument incision on the length of almost 20 cm. Reduction in the integument thickness was observed on the smaller area after classical cholecystectomies, appendectomies and other surgical procedures with the incision across the integument. The integument atrophy in the operated sites expressed in absolute numbers was in the range of 7–20 mm (average 14 mm). These values are markedly lower than the comparative integument thickness on the not operated side: 17–52 mm (average 25.4 mm). The percentage value of the integument thickness reduction oscillated in the range of 32–67% (average 44.2%). In most cases the atrophy involved all layers of the abdominal wall, what demonstrated as regional prominence of the integument, mimicking the presence of hernia. Conclusions: Ultrasonography allows precise evaluation of the size and extent of atrophy as well as depiction of other lesions simulating that effect. Establishing the correct diagnosis should prevent the unnecessary reconstructions of the abdominal integument.
Celem pracy była analiza materiału klinicznego dotyczącego zaniku powłok brzusznych po zabiegach operacyjnych. Materiał i metoda: Zgromadzono grupę 29 chorych z wykazanym ultrasonograficznym zanikiem powłok brzusznych. Zmiany te obserwowano po różnych procedurach operacyjnych, najczęściej po długich nacięciach laparotomijnych przednio‑bocznych lub kilkukrotnych operacjach klasycznych. Badania ultrasonograficzne wykonano do 2000 roku na aparatach analogowych, a w następnych latach wyłącznie aparatami cyfrowymi, z głowicami linowymi (7–12 MHz) i niekiedy głowicami typu konweks (3–5 MHz). Określano lokalizację, rozległość, warstwową budowę ściany jelita. W każdym przypadku mierzono grubość powłok w milimetrach w miejscu największego zaniku i porównywano ją z grubością powłok po stronie nieoperowanej, co pozwalało na obliczenie procentowej redukcji powłok w okolicy blizny. Wyniki: U 3 pacjentów po kilku laparotomiach doszło do całkowitej redukcji masy mięśniowej w miejscu operacji. W tych przypadkach stwierdzano jedynie skórę i lekko echogeniczne pasmo podskórne, prawdopodobnie odpowiadające zwłókniałym tkankom – grubość powłok w tym miejscu wahała się od 3 do 8 mm. U pozostałych 26 pacjentów zanik powłok na poziomie blizny pooperacyjnej dotyczył w największym stopniu mięśni i obejmował rozległy obszar po klasycznych zabiegach urologicznych na górnych drogach moczowych: po usunięciu nerki, a nawet po ewakuacji złogu z moczowodu lub wycięciu torbieli nerki z dostępu klasycznego przednio‑bocznego z nacięciem powłok na długości prawie 20 cm. Na mniejszym obszarze obserwowano redukcję grubości powłok po klasycznych cholecystektomiach, appendektomiach i innych operacjach z nacięciem powłok na całej grubości. Zanik powłok w miejscach operacji wyrażał się w liczbach bezwzględnych w zakresie 7–20 mm (średnio 14 mm). Wartości te są wyraźnie mniejsze od porównawczej grubości powłok po stronie nieoperowanej: 17–52 mm (średnio 25,4 mm). Procentowa wielkość redukcji grubości powłok wahała się w granicach 32–67% (średnio 44,2%). W większości przypadków zanik obejmował wszystkie warstwy ściany brzucha, co manifestowało się uwypukleniem powłok w tym rejonie pozorującym istnienie przepukliny. Wnioski: Ultrasonografia pozwala z dużą precyzją określić stopień zaniku, jego rozległość oraz zmiany, które mogą pozorować taki efekt. Ustalenie właściwego rozpoznania powinno zapobiec zbędnej rekonstrukcji powłok brzusznych.
Źródło:
Journal of Ultrasonography; 2012, 12, 50; 262-268
2451-070X
Pojawia się w:
Journal of Ultrasonography
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:
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:
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:
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:
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:
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:
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:
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:
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:
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
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