ABSTRACT
The authors present an original reconstruction technique after pancreaticoduodenectomy, with anastomosis between the pancreatic stump and the posterior wall of the stomach, using two Roux-en-Y loops to separate the hepaticojejunostomy from the pancreaticogastrostomy and gastrojejunostomy in order to reduce postoperative complications and mortality. Eighteen consecutive patients underwent the procedure. There was no mortality and no pancreaticogastrostomy leaks occurred. Two (11.1%) gastric bleeds occurred in the first two cases. Twelve cases (66.6%) presented alimentary emesis on postoperative day 5 or 6 after food intake. Three patients (16.6%) had postoperative diarrhea. There were no complications calling for reoperation. The mean hospital stay was 14.4 days. No significant late complications were observed. The procedure is easy and safe with no mortality and with one of the lowest complication rates in the literature.
Subject(s)
Carcinoma/surgery , Pancreatic Neoplasms/surgery , Pancreaticoduodenectomy , Adenocarcinoma/surgery , Aged , Ampulla of Vater , Anastomosis, Roux-en-Y , Carcinoma, Papillary/surgery , Common Bile Duct Neoplasms/surgery , Female , Humans , Jejunum/surgery , Male , Middle Aged , Pancreas/surgery , Postoperative Complications , Stomach/surgeryABSTRACT
The authors present their experience about diagnosis and therapy of Spigelian hernia in five cases observed. Clinical examination is the foundation of the diagnosis and radiological findings (ultrasonography, colonic X-rays, CT and NMR) permit to exclude other pathologies which concern differential diagnosis. They suggest prosthetic repair, similar to the therapy of groin hernias, using a tension-free technique. This method of treatment avoids relapses and does not alter the functionality of muscular and aponeurotic apparatus.
Subject(s)
Abdominal Muscles/surgery , Hernia, Ventral/surgery , Aged , Female , Humans , Male , Middle AgedABSTRACT
Personal experience is reported in the use of peritoneal lavage in closed abdominal trauma to provide rapid, definitive diagnosis of haemoperitoneum. The techniques to be employed in order to obtain accurate diagnosis without any of the complications reported in the literature are specified and the advantages of the technique in resolving diagnostic uncertainties are analysed.
Subject(s)
Abdominal Injuries/diagnosis , Peritoneal Lavage , Abdominal Injuries/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Hemoperitoneum/diagnosis , Humans , Laparotomy , Male , Middle AgedABSTRACT
In a prospective randomized trial on 77 patients undergoing elective colorectal surgery, cefoxitin and cephalothin were given as systemic antibiotic prophylaxis. Postoperative sepsis occurred in 2/40 (5%) of those given cefoxitin compared to 9/37 (24.3%) of those given cephalothin. The reduction in the infection rate in the group treated by cefoxitin was statistically significant (p less than 0.02). Specific drug toxicity was not evidenced except for transient skin rashes in two patients of both groups.
