Assuntos
Tamponamento Cardíaco/diagnóstico , Hérnia Hiatal/diagnóstico , Obstrução Intestinal/diagnóstico , Peritonite/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Tamponamento Cardíaco/terapia , Diagnóstico Diferencial , Tratamento de Emergência , Feminino , Humanos , Obstrução Intestinal/cirurgia , Laparotomia , Índice de Gravidade de Doença , SucçãoRESUMO
The authors present their personal experience of three cases of bronchial fistulae post pneumonectomy or lobectomy. Surgical treatment was not done directly on the bronchial stump but by thoracoplasty. This approach to the thoracic chest gets good results on condition that stabilization in reexpansion of residual parenchyma and drainage of bronchial secretions is carried out.
Assuntos
Fístula Brônquica/cirurgia , Fístula/cirurgia , Doenças Pleurais/cirurgia , Pneumonectomia/efeitos adversos , Deiscência da Ferida Operatória/cirurgia , Toracoplastia/métodos , Fístula Brônquica/etiologia , Fístula/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/etiologia , Reoperação/métodos , Deiscência da Ferida Operatória/complicaçõesRESUMO
Simplified parietal cell vagotomies (Taylor's and Hill-Barker's procedures) were proposed more than a decade ago to make the operation easier and faster. Efficacy and safety have proven to be as good as with proximal gastric vagotomy. The Hill-Barker operation is particularly simplified by the laparoscopic approach, which enables the procedure to be performed very precisely. The limited trauma of minimally invasive vagotomy has increased the interest in peptic ulcer surgery, especially for patients with chronic duodenal ulcer disease who cannot or do not want to take long-term continuous medication, or who are resistant to it. We describe our technique of performing the laparoscopic Hill-Barker procedure. Our initial results with eleven patients show no operative mortality and minimal morbidity with early discharge and ulcer of all patients. Of the 9 cases which are evaluable, 8 are pain-free and one had an ulcer recurrence after incomplete vagotomy.
Assuntos
Úlcera Duodenal/cirurgia , Laparoscópios , Vagotomia Gástrica Proximal/instrumentação , Vagotomia Troncular/instrumentação , Seguimentos , Humanos , Microcirurgia/instrumentação , Equipamentos Cirúrgicos , Instrumentos CirúrgicosRESUMO
On account of dissatisfaction with the two-staged approach to stones in the common bile duct, and the risks associated with endoscopic papillotomy, one-stage laparoscopic duct exploration was commenced. The initial experienced with 20 cases is presented. In 13 cases the transcystic approach to the main duct was not successful, so a choledochotomy was performed, and closed without biliary drainage. The postoperative course was similar to laparoscopic cholecystectomy and was uncomplicated in all patients. The follow-up examination of 12 patients demonstrated a mild stenosis of the main duct in our first case; however, this resolved spontaneously within six months. When indicated, the laparoscopic "ideal" choledochotomy with fibroscopic exploration gives very good early and long term results.