RESUMO
BACKGROUND: In 1,577 laparoscopic cholecystectomies, 111 due to acute and 1,466 due to chronic cholecystitis, the incidence of intraoperative gallbladder rupture and its relationship with abdominal wound infections were evaluated. METHODS: A sampling test for binomial proportions and a binomial approximation test for discrete data were employed for statistical analysis. Gallbladder accidental opening took place in 250 (19%) out of the 1,466 chronic and in 44 (40%) out of the 111 acute cholecystitis, disclosing a statistically significant difference (p < 0.01). Postoperatively, there were 32 (2%) surgical wound infections, 17 (1.3%) in the absence of gallbladder injury and 15 (5%) when gallbladder injury was observed, likewise showing a statistically significant difference (p < 0.05). RESULTS: It should be pointed out that all 32 wound infections involved the umbilical incision, of which 3 with chronic suppuration required reintervention where remnants of stones were found in the parietal route. The seven with symptomatic abdominal fluid resolved without specific treatment. As regards the seven intraabdominal infections, two remitted with antibiotics and five required percutaneous drainage. There was no significant correlation between the presence of cavity fluid abdominal collections or infections and bile spillage. CONCLUSION: Gallbladder injury proved more frequent in laparoscopic cholecystectomies performed due to acute cholecystitis, while bile spillage increased the incidence of umbilical wound infection, particularly in the presence of remnants of stones, but there was no correlative increase in the incidence of intraabdominal collections or infections.
Assuntos
Colecistectomia Laparoscópica/efeitos adversos , Vesícula Biliar/lesões , Infecção da Ferida Cirúrgica , Doença Aguda , Colecistite/cirurgia , Colelitíase/cirurgia , Doença Crônica , Humanos , Estudos Retrospectivos , Fatores de RiscoRESUMO
Se presenta la experiencias de 137 canalizaciones venosas por puncion subclavia en 70 pacientes, indicados en alimentacion parenteral, insuficiencia renal cronica en hemodialisis e inclusive en pacientes ventilados o con broncopatias bilaterales. No se observaron complicaciones mayores que en estadisticas con casos mas seleccionados (un caso de sepsis por cateter). Se comparan detalles tecnicos de permanencia y contraindicaciones con las de otros autores. Se enfatiza la necesidad de una tecnica precisa y mantenimiento cuidadoso de los cateteres sumados a un entrenamiento adecuado para evitar complicaciones
Assuntos
Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Masculino , Feminino , Cateterismo , Veia SubcláviaRESUMO
Se presenta la experiencias de 137 canalizaciones venosas por puncion subclavia en 70 pacientes, indicados en alimentacion parenteral, insuficiencia renal cronica en hemodialisis e inclusive en pacientes ventilados o con broncopatias bilaterales. No se observaron complicaciones mayores que en estadisticas con casos mas seleccionados (un caso de sepsis por cateter). Se comparan detalles tecnicos de permanencia y contraindicaciones con las de otros autores. Se enfatiza la necesidad de una tecnica precisa y mantenimiento cuidadoso de los cateteres sumados a un entrenamiento adecuado para evitar complicaciones
