ABSTRACT
PURPOSE: Bile duct injury (BDI) represents the most serious complication of laparoscopic cholecystectomy (LC). The aim of this retrospective single-institution study was to evaluate the real incidence of BDI during laparoscopic and open cholecystectomy (OC) in a tertiary academic center in Athens, Greece. METHODS: Between January 1991 and December 2001, 3637 patients underwent cholecystectomy in our department; as LC in 2079 patients (LC group) and as OC in 1558 patients (OC group). All the LCs were performed or supervised by five staff surgeons and all the OCs were performed or supervised by another five staff surgeons. RESULTS: There were 13 BDIs associated with LC (0.62%) and 6 associated with OC (0.38%) (P = 0.317). There was one death associated with BDI after LC. Only two (15.4%) of the BDIs associated with LC occurred within the proposed learning curve limit of 50 LCs per individual surgeon. CONCLUSION: Laparoscopic cholecystectomy is safe and is not associated with a higher incidence of BDI than OC. Moreover, we did not find that the learning curve for LC affected BDI occurrence.
Subject(s)
Bile Duct Diseases/etiology , Bile Ducts/injuries , Cholecystectomy, Laparoscopic/adverse effects , Intraoperative Complications/epidemiology , Laparotomy/adverse effects , Adult , Age Distribution , Aged , Bile Duct Diseases/epidemiology , Bile Duct Diseases/surgery , Cholecystectomy/adverse effects , Cholecystectomy/methods , Cholecystectomy/mortality , Cholecystectomy, Laparoscopic/methods , Cholecystectomy, Laparoscopic/mortality , Cohort Studies , Female , Follow-Up Studies , Gallstones/diagnosis , Gallstones/surgery , Humans , Incidence , Intraoperative Complications/diagnosis , Laparotomy/methods , Laparotomy/mortality , Male , Middle Aged , Reoperation , Retrospective Studies , Risk Assessment , Sex Distribution , Survival RateABSTRACT
Splenic abscesses are rare among abdominal abscesses. We present a case of splenic abscess due to Staphylococcus aureus in a beta-thalassemia major patient. Such a complication may not be coincidental, as beta-thalassemia major patients have an increased susceptibility to infection, which is attributable to a number of immune abnormalities.
Subject(s)
Abscess/complications , Splenic Diseases/complications , Staphylococcal Infections/complications , Staphylococcus aureus/isolation & purification , beta-Thalassemia/complications , Abscess/diagnostic imaging , Abscess/microbiology , Adult , Humans , Male , Splenic Diseases/diagnostic imaging , Splenic Diseases/surgery , Staphylococcal Infections/diagnostic imaging , Staphylococcal Infections/surgery , UltrasonographyABSTRACT
BACKGROUND: Both tissue c-erbB-2 expression and serum levels the shed protein have been shown to correlate with tumour stage in a range of adenocarcinomas. This study measured serum and urinary c-erbB-2 levels in patients with gastric cancer, assessing their role in cancer-specific survival and the effects of resectional surgery. PATIENTS AND METHODS: Serum and urinary c-erbB-2 concentrations were measured with commercial enzyme-linked immunosorbent assay in 41 healthy controls and in 54 gastric cancer patients. Serum and urinary c-erbB-2 levels in cancer patients were determined before and 7 days following tumour surgery. RESULTS: Preoperative serum and urinary c-erbB-2 levels in gastric cancer patients were significantly higher than those in controls although there were no significant associations between these levels and tumour pathology. Serum c-erbB-2 levels decreased significantly after radical resection of the primary tumour and were an independent prognostic factor for survival, whereas there were no changes in urinary c-erbB-2 levels after surgery or an association with patient survival. CONCLUSION: Gastric cancer patients show higher serum and urinary c-erbB-2 levels compared to healthy controls. Preoperative serum c-erbB-2 concentration decreases significantly after radical resection of the primary tumour and is an independent prognostic factor for patient survival.
