Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 26
Filter
1.
Cir. Esp. (Ed. impr.) ; 93(1): 39-41, ene. 2015. ilus
Article in Spanish | IBECS | ID: ibc-131365

ABSTRACT

La aceptación definitiva de un órgano como válido depende del equipo quirúrgico que realiza la extracción multiorgánica, que tendrá de enfrentarse en muchas situaciones a dificultades inesperadas. Las características demográficas de los donantes han cambiado, se aceptan donantes de órganos que hace no muchos años considerábamos subóptimos, lo que implica muchas veces una técnica quirúrgica difícil y una toma de decisión acerca de la validez del órgano u órganos muy arriesgada. Se propone un método alternativo a la canulación de la aorta abdominal cuando se evidencie enfermedad de la aorta infra-renal durante la realización de la extracción multiorgánica. Se realiza la canulación de la aorta torácica descendente retrocardíaca con una perfusión anterógrada, esta técnica permite aumentar el número de órganos a trasplantar


The definitive acceptance of an organ as valid for transplant depends on the surgical team performing the multiorgan recovery; and unexpected difficulties can occur. The demographic characteristics of donors has changed, and some accepted donors can present difficulties in surgical technique and risky decisions on the validity of the retrieved organ or organs. An alternative method to the cannulation of the abdominal aorta is proposed when there is evidence of disease in the infrarenal aorta during the multiorgan procurement. The retrocardiac descending thoracic aorta is cannulated using an antegrade perfusion; this technique allows an increase in organ recovery


Subject(s)
Tissue and Organ Procurement/methods , Aorta, Thoracic , Catheterization, Peripheral/methods , Atherosclerosis/diagnosis , Organ Transplantation/methods
2.
Cir Esp ; 93(1): 39-41, 2015 Jan.
Article in English, Spanish | MEDLINE | ID: mdl-25139555

ABSTRACT

The definitive acceptance of an organ as valid for transplant depends on the surgical team performing the multiorgan recovery; and unexpected difficulties can occur. The demographic characteristics of donors has changed, and some accepted donors can present difficulties in surgical technique and risky decisions on the validity of the retrieved organ or organs. An alternative method to the cannulation of the abdominal aorta is proposed when there is evidence of disease in the infrarenal aorta during the multiorgan procurement. The retrocardiac descending thoracic aorta is cannulated using an antegrade perfusion; this technique allows an increase in organ recovery.


Subject(s)
Aorta, Thoracic , Tissue and Organ Harvesting/methods , Abdominal Cavity , Catheterization , Humans , Perfusion/methods , Vascular Surgical Procedures/methods
7.
Cir. Esp. (Ed. impr.) ; 91(10): 651-658, dic. 2013. ilus, tab
Article in Spanish | IBECS | ID: ibc-118079

ABSTRACT

Objetivo Evaluar la morbimortalidad postoperatoria de la resección pancreática.Material y métodosEstudio observacional prospectivo que incluye 117 pacientes intervenidos quirúrgicamente de forma consecutiva por presentar tumoración pancreática o periampular. En 61 de ellos se hizo pancreatectomía cefálica; en 15, pancreatectomía total; en uno, enucleación y en 40, resección corporocaudal.ResultadosLa morbilidad global fue de 48,7% (59% para la pancreatectomía cefálica, 35% para la resección corporocaudal y 46,7% para la pancreatectomía total). Las complicaciones más frecuentes fueron las colecciones y abscesos intraabdominales, con un 15,38% y las complicaciones médicas, con un 13,68%. La incidencia de fístula pancreática fue de 9,83%, para la pancreatectomía cefálica y de 10% para la resección corporocaudal. La incidencia de reintervención fue de 14,53%. La mortalidad global fue de 5,12% (6,56% para la pancreatectomía cefálica, 2,5% para la resección corporocaudal y 6,67% para la pancreatectomía total). La presencia de complicaciones postoperatorias, la necesidad de reintervención y la edad superior a 70 años correlacionaron significativamente con la mortalidad.DiscusiónLa resección pancreática tiene una morbilidad alta. La mortalidad es baja y está prácticamente limitada a los pacientes mayores de 70 años (AU)


Aim Assess the postoperative morbidity rates in pancreatic resection.Material and methodProspective observational study which includes 117 patients who underwent surgery consecutively due to pancreatic or periampullary tumours. In 61 of the patients, cephalic pancreatectomy was carried out; 15 underwent total pancreatectomy; one underwent enucleation and 40 underwent distal pancreatectomy.ResultsOverall morbidity was 48.7% (59% for cephalic pancreatectomy, 35% for distal pancreatectomy and 46.7% for total pancreatectomy). The most frequent complications were intra-abdominal abscesses and collections (15.38%) and medical complications (13.68%). The incidence of pancreatic fistula was 9.83% for cephalic pancreatectomy and 10% for distal pancreatectomy. The reintervention incidence was 14.53%. Overall mortality was 5.12% (6.56% for cephalic pancreatectomy, 2.5% for distal pancreatectomy and 6.67% for total pancreatectomy). The presence of postoperative complications, the need for reintervention and the fact of being over 70 years of age correlated significantly with mortality.DiscussionPancreatic resection has high morbidity rates. Mortality is low and is practically limited to patients older than 70 years. (AU)


Subject(s)
Humans , Pancreatectomy/statistics & numerical data , Postoperative Complications/epidemiology , Pancreatic Neoplasms/surgery , Indicators of Morbidity and Mortality , Prospective Studies
9.
Cir Esp ; 91(10): 651-8, 2013 Dec.
Article in Spanish | MEDLINE | ID: mdl-23541704

ABSTRACT

AIM: Assess the postoperative morbidity rates in pancreatic resection. MATERIAL AND METHOD: Prospective observational study which includes 117 patients who underwent surgery consecutively due to pancreatic or periampullary tumours. In 61 of the patients, cephalic pancreatectomy was carried out; 15 underwent total pancreatectomy; one underwent enucleation and 40 underwent distal pancreatectomy. RESULTS: Overall morbidity was 48.7% (59% for cephalic pancreatectomy, 35% for distal pancreatectomy and 46.7% for total pancreatectomy). The most frequent complications were intra-abdominal abscesses and collections (15.38%) and medical complications (13.68%). The incidence of pancreatic fistula was 9.83% for cephalic pancreatectomy and 10% for distal pancreatectomy. The reintervention incidence was 14.53%. Overall mortality was 5.12% (6.56% for cephalic pancreatectomy, 2.5% for distal pancreatectomy and 6.67% for total pancreatectomy). The presence of postoperative complications, the need for reintervention and the fact of being over 70 years of age correlated significantly with mortality. DISCUSSION: Pancreatic resection has high morbidity rates. Mortality is low and is practically limited to patients older than 70 years.


Subject(s)
Pancreatectomy/adverse effects , Pancreatectomy/mortality , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Prospective Studies
14.
Cir Esp ; 84(1): 20-7, 2008 Jul.
Article in Spanish | MEDLINE | ID: mdl-18590671

ABSTRACT

OBJECTIVES: The aim of this study is to present an analysis of 30 patients with major bile duct injuries in a single hospital centre. MATERIAL AND METHOD: From January 2001 to December 2006, a prospective database was kept of all patients with a bile duct injury (BDI) following laparoscopic cholecystectomy (LC). Patients' charts were reviewed to analyse perioperative surgical management. RESULTS: Over 6 years, 30 patients were treated for a major BDI. Patient demographics were not notable for 16 women (53%) and 14 men (47%) with a mean age of 58.9 years. Twenty of them sustained their BDI at another hospital. The mean interval from the time of BDI to referral was 17.4 days. A total of 30 patients underwent definitive biliary reconstruction, including 17 hepaticojejunostomies (56.7%), 8 end-to-end repairs (20%), 2 choledochoduodenostomies (6.7%), 3 liver transplantations (10%), 1 hepatectomy and 1 Whipple (3.3%). There were 2 deaths in the postoperative period (6.7%). Thirteen (43.3%) sustained at least 1 postoperative complication. The most common complications were cholangitis (20%), and intra-abdominal abscess/biloma (23.3%). The mean postoperative length of stay was 17.46 days. CONCLUSIONS: Bile duct injury is a serious complication that affects mostly individuals with benign disease. Various subsequent procedures (surgical and/or endoscopic) are almost always necessary for its correction, with a high socioeconomic cost that imposes great suffering on the patients and their relatives. Clearly, all efforts should be made to prevent such accidents.


Subject(s)
Bile Ducts/injuries , Bile Ducts/surgery , Intraoperative Complications/surgery , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prospective Studies
15.
Cir. Esp. (Ed. impr.) ; 84(1): 20-27, jul. 2008. ilus, tab
Article in Es | IBECS | ID: ibc-65755

ABSTRACT

Objetivos. Presentar una serie de 30 pacientes intervenidos en nuestro hospital como consecuencia de una lesión de la vía biliar. Material y método. Se han estudiado de forma prospectiva todos los datos preoperatorios y postoperatorios de los pacientes tratados en nuestro hospital entre enero de 2001 y diciembre de 2006. Resultados. Durante un período de 6 años han sido intervenidos 30 pacientes como consecuencia de una lesión iatrogénica de la vía biliar; 14 (53%) pacientes eran varones y 16 (47%), mujeres, con una media de edad de 58,9 años. Las cirugías en que se produjeron las lesiones fueron: hepatectomía en 1 (3,3%) paciente, gastrectomía en 1 (3,3%), colecistectomía laparoscópica en 19 (63,4%) pacientes, de éstos, se reconvirtió a cirugía abierta en 5 y colecistectomía abierta de entrada en 9 (30%); 20 de los pacientes procedían de otros hospitales y fueron remitidos a nuestro hospital como centro de referencia regional. El tiempo medio transcurrido desde que se produce la lesión hasta que los pacientes son intervenidos en nuestro centro es de 17,4 días. La reparación de la vía biliar se realizó mediante hepatoyeyunostomía en 17 (56,7%) pacientes, coledocoplastia y Kehr en 8 (20%), coledocoduodenostomía en 2 (6,7%), trasplante hepático en 3 (10%), hepatectomía en 1 (3,3%) y duodenopancreatectomía cefálica en 1 (3,3%). Fallecieron 2 (6,7%) pacientes en el postoperatorio a consecuencia de una sepsis abdominal; 13 (43,3%) pacientes sufrieron al menos una complicación: biloma en 5 (16,7%), coleperitoneo en 1 (3,3%), hemoperitoneo en 1 (3,3%) y colangitis en 6 (20%). La estancia media postoperatoria fue de 17,46 días. Conclusiones. Las lesiones iatrogénicas de la vía biliar son complicaciones muy serias que suelen producirse en pacientes con una enfermedad benigna. Hay diferentes técnicas quirúrgicas y endoscópicas para su tratamiento con un importantísimo coste para el paciente y la sociedad. Sin duda el mejor tratamiento es evitar que se produzcan este tipo de lesiones (AU)


Objectives. The aim of this study is to present an analysis of 30 patients with major bile duct injuries in a single hospital centre. Material and method. From January 2001 to December 2006, a prospective database was kept of all patients with a bile duct injury (BDI) following laparoscopic cholecystectomy (LC). Patients’ charts were reviewed to analyse perioperative surgical management. Results. Over 6 years, 30 patients were treated for a major BDI. Patient demographics were not notable for 16 women (53%) and 14 men (47%) with a mean age of 58.9 years. Twenty of them sustained their BDI at another hospital. The mean interval from the time of BDI to referral was 17.4 days. A total of 30 patients underwent definitive biliary reconstruction, including 17 hepaticojejunostomies (56.7%), 8 end-to-end repairs (20%), 2 choledochoduodenostomies (6.7%), 3 liver transplantations (10%), 1 hepatectomy and 1 Whipple (3.3%). There were 2 deaths in the postoperative period (6.7%). Thirteen (43.3%) sustained at least 1 postoperative complication. The most common complications were cholangitis (20%), and intra-abdominal abscess/biloma (23.3%). The mean postoperative length of stay was 17.46 days. Conclusions. Bile duct injury is a serious complication that affects mostly individuals with benign disease. Various subsequent procedures (surgical and/or endoscopic) are almost always necessary for its correction, with a high socioeconomic cost that imposes great suffering on the patients and their relatives. Clearly, all efforts should be made to prevent such accidents (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Adult , Aged , Biliary Tract/injuries , Biliary Tract/pathology , Biliary Tract Surgical Procedures/methods , Intraoperative Complications/diagnosis , Intraoperative Complications/epidemiology , Intraoperative Complications/surgery , Jejunostomy/methods , Liver Transplantation/methods , Sepsis/complications , Analysis of Variance , Iatrogenic Disease , Prospective Studies , Hepatectomy/adverse effects , Gastrectomy/adverse effects , Cholecystectomy/adverse effects
SELECTION OF CITATIONS
SEARCH DETAIL
...