ABSTRACT
Patients undergoing cholecystectomy were randomly divided into two groups. The effects of a single injection of one gram of cefazoline given thirty minutes before operation to 30 patients were compared with those obtained in a second group of 29 untreated cases. The efficiency of the second generation cephalosporins in preventing postoperative complications of this type was confirmed. Prophylactic administration of this antibiotic therapy before uncomplicated biliary tract surgery can significantly reduce the incidence of postoperative parietal infections and therefore the duration of hospitalization.
Subject(s)
Bacterial Infections/prevention & control , Bile Duct Diseases/prevention & control , Cefazolin/therapeutic use , Cholecystectomy/adverse effects , Premedication , Adult , Aged , Double-Blind Method , Female , Humans , Male , Middle AgedABSTRACT
Ten patients treated for pancreatic fistulas have been reviewed. They all received a nutritional support via a jejunal tube in association with an external drainage of the fistulous tract. Enteral hyperalimentation do not stimulate external pancreatic secretion and all fistulas closed up spontaneously within three months (mean 55 days) without major complications. In one case fistula reappeared two months later and needed surgical procedure.
Subject(s)
Pancreatic Fistula/therapy , Adolescent , Adult , Drainage , Enteral Nutrition , Humans , Jejunum , Male , Middle Aged , Pancreatic Juice/metabolism , Pancreatitis/therapy , Parenteral Nutrition, Total , Therapeutic IrrigationABSTRACT
The pressure variations registered in the common bile duct, after injection of phenoperidine (0,033 mg/kg) during sixteen anaesthesias performed for cholecystectomy, showed no significant modifications. In one case a spasm of the common bile duct was observed before analgesic administration which induced no change in the biliary pressure, an inhalation of amyl nitrite made it possible to affirm the functional character of the anomaly. The analgesic anaesthesia using phenoperidine, method chosen for high-risk patients, is compatible with bile duct surgery without risk of bringing about unnecessary surgical procedures.
Subject(s)
Cholecystectomy , Common Bile Duct/physiology , Phenoperidine/pharmacology , Adult , Aged , Amyl Nitrite/pharmacology , Common Bile Duct/drug effects , Female , Humans , Intraoperative Period , Male , Middle Aged , PressureABSTRACT
In a series of twenty similar patients, having a healthy small intestine and having undergone elective surgery, two protocols of alimentation were studied. Beginning from the 8th post-operative hour, enteral alimentation is carried out by means of access to the jejunum and continued for ten days. The volume of liquid in the alimentary canal is progressively increased allowing the intravenous route to be stopped on average after 3,9 days. The high amount of the nitrogen and calory supply limits the post-operative nitrogen catabolism and rapidly restores a positive nitrogen balance. In other respects the weight loss is less than 2%, the biological constants are stable and no serious complications are linked with this technique. The early use of GI tract deals with the alimentational and electrolyte needs of the post-operative patient and diminishes the risks of iatrogenic complications of long term intravenous infusions. Relying on experimental data proving the absence of cessation of peristalsis of the small intestine in the immediate post-operative period and also the continuation of its capacity for absorption, this work demonstrates the possibility of early enteral alimentation. A better knowledge of the indications and contra-indications of this technique of feeding, of its methods of administration, and of the capabilities of absorption of the alimentary canal, must extend its indications to the high risk operative patients.
Subject(s)
Digestive System Surgical Procedures , Enteral Nutrition/methods , Intubation, Gastrointestinal/methods , Adult , Aged , Biliary Tract Diseases/surgery , Catheterization , Enteral Nutrition/adverse effects , Esophageal Diseases/surgery , Female , Food, Formulated , Humans , Jejunum , Male , Middle Aged , Pancreatic Diseases/surgery , Postoperative Care , Time FactorsABSTRACT
About one case, we describe our technology. The main avantage of the method is to reduce strongly septic complications resulting from intravenous feeding. It can be used as soon as the gastrointestinal tract is functional without any risk and it is the most effective means of providing nutrition for an extended period.
Subject(s)
Enteral Nutrition/methods , Ileum , Aged , Blood Proteins/analysis , Cholesterol/analysis , Female , Humans , Injections , Intestine, Small/surgery , Methods , Nutritional Physiological Phenomena , Potassium/blood , Sodium/bloodABSTRACT
Among fifty cases hepatic hydatid cysts, we have observed four serious complications during operation. These complications appeared at the time of the puncture of the cysts with a severe shock in three cases. Anaphylactic etiology can be suspected but not proved without specific tests. Because the severity of these accidents (one death), anesthesiologist must be aware of the possibility of such complications: it is important to recognize anaphylactic reactions during surgical procedure to institute immediately a treatment to restore both circulatory competency and cardiac out put. Vasopressors with both alpha and beta properties are most useful under the conditions of massive peripheral vasodilatation and bronchospasm which occur in anaphylaxis.
