Upper gastrointestinal surgery

2014 ◽  
Author(s):  
James Wood
Keyword(s):  
Gastrointestinal Surgery ◽  
Clinical Findings ◽  
Junior Doctors ◽  
Ulcer Disease ◽  
Upper Gi ◽  
Life Threatening ◽  
The Impact ◽  
Upper Gi Malignancy ◽  
Symptoms And Signs ◽  
Upper Gastrointestinal

Diseases of the upper gastrointestinal tract (GI) have changed a great deal both in their aetiology and presentations as well as their manage­ment in the last three decades. Modern students and junior doctors need to understand the range of upper GI conditions which now present, especially the increasing issues of upper GI malignancy and the impact of morbid obesity on medical and surgical practice. Old text books full of operations for benign peptic ulcer disease have been replaced with texts on the constantly advancing treatment of oesophagogastric cancer and operations for obesity management. Symptoms and signs in upper GI disease are often subtle and non-specific so a sound knowledge of clinical findings and the choices for appropriate investigations are extremely important and are covered in this chapter. Lastly, some of the most urgent and life-threatening surgical emergen­cies can occur due to upper GI disease and the management of these conditions is a vital area of knowledge for all junior doctors.

Intra-abdominal Trocar-Free Vacuum Liver Retractor for Upper-Gastrointestinal Surgery

2017 ◽  
Vol 24 (2) ◽  
pp. 186-191 ◽  
Author(s):  
Christian Benzing ◽  
Helmut Weiss ◽  
Felix Krenzien ◽  
Matthias Biebl ◽  
Johann Pratschke ◽  
...  
Keyword(s):  
Gastrointestinal Surgery ◽  
Obese Patients ◽  
Liver Retraction ◽  
Upper Gi ◽  
Single Port Surgery ◽  
Clinical Series ◽  
Liver Retractor ◽  
Study Population ◽  
Male Patients ◽  
Upper Gastrointestinal

Background. In laparoscopic upper-gastrointestinal (GI) surgery, an adequate retraction of the liver is crucial. Especially in single-port surgery and obese patients, problems may occur during liver retraction. The current study seeks to evaluate the efficacy and safety of the LiVac trocar-free liver retractor in laparoscopic upper-GI surgery. Methods. The present study is a nonrandomized dual-center clinical series describing our preliminary results using the LiVac system for liver retraction. The primary end points of the present study included the effectiveness and safety of the LiVac device as well as complications and documentation of problems with the device during surgery. Results. The device was used in 11 patients for simple and complex laparoscopic procedures. The mean age of the study population was 59.6 years (SD = 20.6; range = 30-84). There were 6 female and 5 male patients with a mean body mass index (BMI) of 31.9 kg/m2 (SD = 8.1; range = 26.0-45.3). The efficacy of the device was excellent in all cases, reducing the number of trocars needed. There were no device-related complications. Conclusion. The LiVac liver retractor is easy to use and provides a good exposure of the operative field in upper-GI laparoscopic surgery, even in obese patients with a high BMI.

scholarly journals Systematic review with meta-analysis: age-related malignancy detection rates at upper gastrointestinal endoscopy

2020 ◽  
Vol 13 ◽  
pp. 175628482095922
Author(s):  
Judith J. de Jong ◽  
Marten A. Lantinga ◽  
Ina M. E. Thijs ◽  
Philip R. de Reuver ◽  
Joost P. H. Drenth
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Detection Rates ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Age Related ◽  
Upper Gi Endoscopy ◽  
Age Limits ◽  
Upper Gi Malignancy ◽  
Upper Gastrointestinal

Background: Age is an important and objective risk factor for upper gastrointestinal (GI) malignancy. The accuracy of various age limits to detect upper GI malignancy is unclear. Determination of this accuracy may aid in the decision to refer symptomatic patients for upper GI endoscopy. The aim of this analysis was to synthesize data on upper GI malignancy detection rates for various age limits worldwide through meta-analysis. Methods: We searched MEDLINE, EMBASE, and Web of Science in November 2018. Selection criteria included studies addressing malignant findings at upper GI endoscopy in a symptomatic population reporting age at time of diagnosis. Meta-analyses were conducted to derive continent-specific cancer detection rates. Results: A total of 33 studies including 346,641 patients across 21 countries fulfilled the inclusion criteria. To detect >80% of malignant cases all symptomatic patients over 40 years of age should be investigated in Africa, over 50 years of age in South America and Asia, and over 55 years of age in North America and Europe. Conclusion: This systematic review and meta-analysis provides data on intercontinental variation in age at time of upper GI malignancy diagnosis in symptomatic patients referred for upper GI endoscopy. Guideline recommendations for age-based selection should be tailored to local age-related detection rates.

scholarly journals Chronic splenic artery occlusion with gastric wall arterial ectasia, an unusual cause of massive upper gastrointestinal hemorrhage

2021 ◽  
pp. 20200194
Author(s):  
Hassan Al-Balas ◽  
Zeyad A. Metwalli ◽  
David M. Sada
Keyword(s):  
Splenic Artery ◽  
Gastric Wall ◽  
Left Gastric Artery ◽  
Artery Occlusion ◽  
Gastric Fundus ◽  
Gastric Artery ◽  
Upper Gi ◽  
Life Threatening ◽  
Upper Gastrointestinal ◽  
Artery Branch

Life-threatening upper gastrointestinal (GI) hemorrhage can occur as a result of bleeding from a variety of arterial and venous sources. We present an unusual cause of life-threatening upper GI hemorrhage arising from ectatic gastric wall arterial branches in a 49-year-old male with previously unrecognized chronic splenic artery thrombosis. The patient developed a recurrence of bleeding despite coil embolization of an accessory left gastric artery branch supplying the gastric fundus suspected to be the site of active bleeding. The patient subsequently underwent splenectomy and surgical ligation of a bleeding gastric artery branch. This case emphasizes the importance of recognizing this unusual cause of upper GI hemorrhage for proper management and prevention of recurrence. Informed consent was obtained from the patient for publication of the case report including accompanying images.

scholarly journals Endoscopic study of upper gastrointestinal mucosal lesion in chronic renal failure

2017 ◽  
Vol 5 (4) ◽  
pp. 1316
Author(s):  
Manoj Gupta ◽  
Atul Shende
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Mucosal Lesion ◽  
Ulcer Disease ◽  
Upper Gi ◽  
Gastrointestinal Lesions ◽  
Duration Of Disease ◽  
Upper Gastrointestinal

Background: Chronic renal failure is a syndrome complex results from progressive and irreversible destruction of nephrons regardless of cause. This diagnosis implies that GFR is known to have been reduced for atleast 3 to 6 months. To study the clinical manifestations and assess the type and prevalence of upper gastrointestinal lesions and to correlate the clinical and biochemical parameters with upper GI mucosal lesion in chronic renal failure patients.Methods: Fifty CRF patients from nephrology and Medicine OPD, admitted in the department of Medicine, M.Y. Hospital, Indore, during January 2002 to April 2003 were studied. A detailed History, clinical examination, Urine Examination, renal Function test, U.S.G. was done and then upper GI Endoscopy was performed.Results: Thirty-six males and fourteen females (n=50) were studied. Most common age group was 41-50 years; commonest GI symptom was Anorexia (100%) and Nausea was present in (94%) of patients and GI bleed was seen in (8%). The common upper GI lesion were gastritis (28%), Oesophagitis (16%) and Duodenitis (12%). No patients had Gastric or Duodenal Ulcers. Majority of patients had creatinine clearance between 5-10 ml /min and most of the patients had duration of disease between 11-20 months.Conclusions: Gastrointestinal symptoms are very frequent in CRF patients. There is a high incidence of inflammatory charges of gastrointestinal mucosa in patients of CRF and chronic uremic patients are not at high risk of developing ulcer disease. There is no correlation of these gastrointestinal symptoms and inflammatory changes with age, sex, severity and duration of disease.

Upper gastrointestinal surgery

2012 ◽  
Author(s):  
Matthew D. Gardiner ◽  
Neil R. Borley
Keyword(s):  
Gallstone Disease ◽  
Gastrointestinal Surgery ◽  
Surgical Patients ◽  
Basic Principles ◽  
Gastrointestinal Physiology ◽  
Ulcer Disease ◽  
Relevant Case ◽  
Gastric Neoplasia ◽  
Upper Gastrointestinal ◽  
Case Based

This chapter begins by discussing the basic principles of gastrointestinal physiology and nutrition in surgical patients, before focusing on the key areas of knowledge, namely gastro-oesophageal reflux disease and gastritis, peptic ulcer disease, gallstone disease, oesophageal neoplasia, gastric neoplasia, pancreatico-biliary neoplasia, and liver and spleen disorders. The chapter concludes with relevant case-based discussions.

scholarly journals Upper gastro-intestinal bleeding: Aetiology and demographic profile based on endoscopic examination at Dhulikhel Hospital, Kathmandu University Hospital

1970 ◽  
Vol 8 (2) ◽  
pp. 208-211 ◽  
Author(s):  
RB Gurung ◽  
G Joshi ◽  
N Gautam ◽  
P Pant ◽  
B Pokhrel ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Endoscopic Examination ◽  
Oesophageal Varices ◽  
Gi Bleeding ◽  
Ulcer Disease ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Upper Gastrointestinal

Background: The upper gastrointestinal bleeding (UGIB) is defined as bleeding within the intraluminal gastrointestinal tract from any location between the upper oesophagus to the duodenum at the ligament of Treitz. It is one of the important medical emergencies worldwide. Objective: The objective of this study is to study the aetiology of upper gastrointestinal bleeding based on endoscopic examination findings in patients of various demographic characteristics. Materials and methods: This is a retrospective observational study. The endoscopic record book from 2007 January to 2009 October was reviewed for all the cases who underwent oesophago-gastro-duodenoscopic examination for upper GI bleeding. The clinico-epidemiological data of all the patients was reviewed and analyzed in concert with the aetiology of bleeding. Results: A total of 90 patients (58 males, 32 females; mean age 45.32+ 18.47 years) of upper gastrointestinal bleeding was studied and analyzed in terms of aetiology of bleeding and demographic profile. Among the ethnic groups, Aryan 46 (51%) was the most common ethnic group to have upper GI bleeding followed by Newars 24 (27%), Mongolians 16 (18%), Dalits 3 (3%) and others 1 (1%). Out of 90 patients, 47( 52.2%) cases was less than 45 years of age, 30(33.3%) of 46 to 65 age ; and 13(14.4 %) more than 65 years of age. Gastric ulcer 23(25.6%) was the most common endoscopic finding, followed by oesophageal varices 14 (15.6%), acute erosive/haemorrhagic gastropathy 11 (12.2%), duodenal ulcer 9(10%), growth 7(7.8%), vascular lesions 3(3.3%), Mallory-Weiss tear 1(1.1%), fundal varices 1(1.1%) and, no cause was identified in 21(23.3%) cases. The peptic ulcer bleeding was the most common finding in Aryan 22(47.9%), whereas oesophageal varices and growth were more common in Newar 7(29.2%) and 3 (12.5%) respectively. Conclusion: Peptic ulcer disease is the most common cause of upper GI bleeding which was most commonly found in Aryan population; followed by oesophageal varices and growth as second and third most common causes and were more prevalent in Newar and Mongolian people. Key words: Endoscopy; Peptic ulcer disease; Upper GI bleeding; Varices DOI: 10.3126/kumj.v8i2.3560 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 208-211

scholarly journals Minimally Invasive Oncologic Upper Gastrointestinal Surgery can be Performed Safely on all Weekdays: A Nationwide Cohort Study

2021 ◽  
Author(s):  
Daan M. Voeten ◽  
Arthur K. E. Elfrink ◽  
Suzanne S. Gisbertz ◽  
Jelle P. Ruurda ◽  
Richard van Hillegersberg ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Esophageal Cancer ◽  
Cohort Study ◽  
Minimally Invasive ◽  
Surgical Outcomes ◽  
Gastrointestinal Surgery ◽  
Short Term ◽  
Esophagogastric Surgery ◽  
The Impact ◽  
Upper Gastrointestinal

Abstract Background Existing literature suggests deteriorating surgical outcome of esophagogastric surgery as the week progresses. However, these studies were conducted in the pre-centralization and pre-minimally invasive era. In addition, they failed to correct for fixed weekdays of esophagogastric cancer surgery among hospitals. This study aimed to describe the impact of weekday of minimally invasive upper gastrointestinal surgery on short-term surgical outcomes. Methods All patients registered in the Dutch Upper Gastrointestinal Cancer Audit who underwent curative minimally invasive esophageal or gastric carcinoma surgery in 2015–2019, were included in this nationwide cohort study. Using multilevel multivariable logistic regression, the impact of weekday of surgery on 14 short-term surgical outcomes was investigated. To correct for interhospital variance in fixed weekday(s) of surgery multilevel analyses was used. Results were adjusted for patient, tumor, and treatment characteristics using multivariable logistic regression analyses. Results This study included 4,102 patients undergoing minimally invasive upper gastrointestinal surgery (2,968 esophageal cancer and 1,134 gastric cancer patients). Weekday of surgery did not impact postoperative complications, severe postoperative complications, surgical/technical complications, medical complications, anastomotic leakage, complicated postoperative course, failure to rescue, surgical radicality, lymph node yield, 30-day/in-hospital mortality, reinterventions, length of ICU stay, 30-day readmission, and textbook outcome after neither esophageal cancer nor gastric cancer surgery. Conclusions Minimally invasive esophagogastric surgery can be performed safely on all weekdays with respect to short-term surgical outcomes, which is important information for operation room scheduling.

scholarly journals Endoscopic ‘suction room’ to treat complex enteral stump leaks after upper gastrointestinal surgery

2021 ◽  
Vol 09 (03) ◽  
pp. E371-E377
Author(s):  
Massimiliano Mutignani ◽  
Lorenzo Dioscoridi ◽  
Ludovica Venezia ◽  
Alberto Larghi ◽  
Francesco Pugliese ◽  
...  
Keyword(s):  
Clinical Success ◽  
Gastrointestinal Surgery ◽  
Tube Placement ◽  
Pancreatic Stent ◽  
Suction Tube ◽  
Enteral Stent ◽  
Life Threatening ◽  
Endoscopic Methods ◽  
Upper Gastrointestinal

AbstractLeaks/dehiscence of the enteral stump associated with infected peri-enteric collections after upper gastrointestinal surgery are a life-threatening adverse event, not usually endoscopically treatable.We describe a new endoscopic approach to treat complex entero-cutaneous fistulas (CECF) by creating a “suction room” through placement of multiple stents (enteral, biliary and/or pancreatic) and a large nose-enteral suction tube inside the enteral stent maintained on a continuous negative aspiration suction.Between January 2016 and December 2019, six consecutive patients referred to our unit with CECF of the enteral stump after failed redo surgeries underwent creation of a “suction room.” In five patients, enteral, biliary and pancreatic stents were positioned before a nose-to-stent or nose-to-collection large 18 Fr tube placement. In one patient, a pancreatic stent was not placed. Technical and clinical success were achieved in all patients. Mean and median times of aspiration were 49 and 27 days, respectively, with a mean hospital stay of 56 days after the endoscopic procedure. Stents were successfully removed. Mean post-procedural follow-up was 17.3 months.Endoscopic creation of the “suction room” offers the unique possibility of treating complex entero-cutaneous fistulas in surgically altered sites, which are difficult to manage with standard endoscopic methods.

scholarly journals Impact of Protocol-Based Guidelines on the Management and Outcome of Acute Upper Gastrointestinal Hemorrhage in a District General Hospital

2003 ◽  
Vol 17 (2) ◽  
pp. 97-100 ◽  
Author(s):  
RM Anwar ◽  
A Dhanji ◽  
A Fish ◽  
S Singh
Keyword(s):  
High Risk ◽  
Risk Group ◽  
District General Hospital ◽  
Endoscopic Examination ◽  
High Risk Group ◽  
Second Phase ◽  
Upper Gi ◽  
Risk Scoring ◽  
The Impact ◽  
Upper Gastrointestinal

A prospective audit of acute upper gastrointestinal (GI) hemorrhage was conducted between January and September 2000 at Frimley Park Hospital to determine the impact of introducing an upper GI bleeding protocol based on Rockall’s initial risk scoring system. Fifty-seven patients and 52 patients were in the pre- and postprotocol phases of the study respectively. Fifty per cent (28) of the patients in the first phase and 40% (21) of the patients in the second phase belonged to the high risk group. In the preprotocol phase, endoscopy was performed in 86% (49) of cases with 60% of patients having an esophogastroduodenoscopy within 24 h. Thirty-three per cent of the high risk group failed to have an endoscopic examination within 24 h. Only two of 57 patients required surgery and the mortality was 14%. In the postprotocol phase, endoscopy was performed in 79% (42) of patients and 68% (36) patients had endoscopy within 24 h. Only four of 21 patients belonging to the high risk group had their endoscopy after 24 h of the admission. Patients were better monitored and mortality was reduced to 7.5%. Reduction of mortality from upper GI hemorrhage followed the introduction of an agreed protocol based on risk scoring.

Sign in / Sign up

Export Citation Format

Share Document