scholarly journals Hybrid management of acute severe necrotizing biliary pancreatitis complicated by abdominal sepsis and necrotic and fl uid collections in the abdominal cavity

2020 ◽  
Vol 174 (2) ◽  
pp. 99-104
Author(s):  
D. V. Mizgirev ◽  
A. M. Epshtein ◽  
S. S Pozdeev ◽  
V. N. Pozdeev ◽  
L. A. Neledova ◽  
...  

The article presents a clinical case of successful hybrid minimally invasive treatment of acute severe biliary necrotizing pancreatitis complicated by acute infected necrotic and fluid collections, abdominal sepsis. Endoscopic transgastric sequestrectomy in combination with polypositional percutaneous drainage and staged sanitation and drainage interventions allowed to avoid the traditional surgical treatment.

Author(s):  
N. Yu. Kokhanenko ◽  
A. V. Glebova ◽  
O. G. Vavilova ◽  
A. A. Kashintsev ◽  
S. A. Kaliuzhnyi ◽  
...  

A clinical case of successful surgical treatment of a patient with chronic pancreatitis, complicated by suppuration of a postnecrotic cyst and the formation of a cysto-gastric fistula. As a result of the conservative and minimally invasive treatment, the pseudocyst was drained, and the cystogastric fistula was closed. The staged treatment was completed by resection of the head of the pancreas with the formation of an anastomosis.


2018 ◽  
Vol 55 (suppl 1) ◽  
pp. 52-55 ◽  
Author(s):  
Thiago Ferreira de SOUZA ◽  
Eduardo GRECCO ◽  
Luiz Gustavo de QUADROS ◽  
Yael Duarte de ALBUQUERQUE ◽  
Fernanda Oliveira AZÔR ◽  
...  

ABSTRACT BACKGROUND: New endoscopic treatments for gastroesophageal reflux (GERD) are developed every year and are indicated in cases that are refractory to conventional therapies as well as after surgical treatment failure. OBJECTIVE: To present the first cases of endoscopic therapy for GERD performed in Brazil. METHODS: Use of radiofrequency with the Stretta procedure in symptomatic volunteers diagnosed with GERD. RESULTS The technique was performed in three patients after they were included in the study protocol. No patient had complications, and all patients were discharged on the same day, either without medication or taking it sporadically for symptom control. CONCLUSION: Endoscopic treatment for GERD using radiofrequency was effective in the cases presented herein with no technical complications.


2021 ◽  
pp. 31-38
Author(s):  
Natal’ya Fedosova ◽  
Andrey Abramenkov ◽  
Igor Ezhov

An analysis of the results of surgical treatment of patients with Dupuytren’s contracture using tactics of minimally invasive percutaneous aponeurotomy and open aponeurectomy is presented. Dupuytren’s contracture (CD) is a chronic disease characterized by cicatricial degeneration of the palmar aponeurosis with a predominant lesion of the working population. The need to quickly restore the function of the upper limb in the postoperative period in patients with CD leads to the need to develop new and modernize the existing minimally invasive tactics of surgical treatment, allowing to minimize the duration of treatment and the risks of various complications.


Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 121-124
Author(s):  
Costantino Eretta ◽  
Alessia Ferrarese ◽  
Elisabetta Moggia ◽  
Elisa Francone ◽  
Carlo Sagnelli ◽  
...  

AbstractLymphedema is a chronic disease with a progressively ingravescent evolvement and an appearance of recurrent complications of acute lymphangitic type; in nature it is mostly erysipeloid and responsible for a further rapid increase in the volume and consistency of edema. The purpose of this work is to present our experience in the minimally invasive treatment for recurrence of lymphedema; adapting techniques performed in the past which included large fasciotomy with devastating results cosmetically; but these techniques have been proposed again by the use of endoscopic equipment borrowed from the advanced laparoscopy surgery, which allows a monoskin access of about one cm.


2020 ◽  
pp. 85-88 ◽  
Author(s):  
V. V. Mishchenko ◽  
P. I. Pustovoit ◽  
R. Yu. Vododyuk ◽  
V. V. Velichko ◽  
V. V. Goryachy

Summary. The problem of hemorrhagic complications of destructive pancreatitis is relevant. The aim of the study was to study the frequency and sources of hemorrhagic complications in patients with pancreatic necrosis, to evaluate the tactics of diagnosis and the effectiveness of methods to stop bleeding. Materials and methods. A study of the results of treatment of 40 patients with acute necrotizing pancreatitis was conducted. Results and its discussion. In 67.5 % of patients with acute necrotizing pancreatitis, hemorrhagic complications in the form of arrosive bleeding were observed. A method of endovascular occlusion of vessels using Gianturco spirals or stent grafts to stop arrosive bleeding in acute necrotizing pancreatitis has been introduced in the clinic. In 37.0 % of cases, repeated signs of arrosive bleeding were observed. In acute necrotizing pancreatitis complicated by arrosive bleeding, mortality was 44.4 %. Conclusions. The main cause of hemorrhagic complications in acute necrotic pancreatitis is acute necrotic changes, during infection of which arrosia of adjacent vessels occurs. The predominant tactic in case of bleeding from the retroperitoneal space against the background of minimally invasive treatment is clamping of drains, endovascular hemostasis using Gianturco spirals or stent grafts and the use of hemostatic soluble gauze (hemostop). Mortality in the development of arrosive bleeding in acute necrotic pancreatitis is 44.4 %.


Author(s):  
F. V. Galimzyanov ◽  
T. M. Bogomyagkova ◽  
M. I. Prudkov ◽  
M. A. Lazareva

Aim of investigation: improvement the results of treatment in patients with diffuse postoperative peritonitis complicated with severe abdominal sepsis. Materials and methods. The present investigation is performed in 132 patients. According to the way of treatment the patients were divided into 2 groups: the first (control) group included 56 patients with diffuse postoperative peritonitis, severe abdominal sepsis who got complex treatment, sanations and abdominal cavity drainage according to “clinical indications”. The second (main) group included 76 patients with diffuse postoperative peritonitis, severe abdominal sepsis who got complex treatment and a surgical treatment algorithm which we have worked out. The patients were in severe condition with marked multiple organ failure, with equal risk of lethality in both groups. Surgical methods included laparotomy, relaparotomy, sanations, abdominal cavity drainage, mini-laparotomy. Results: application of the elaborated algorithm for surgical treatment of patients with diffuse postoperative peritonitis and severe abdominal sepsis made it possible to improve the results of treatment. Intensive ward stay was 1.4 times less accordingly, 10.0 ± 1.4 days and 14.0 ± 1.9 days (p < 0.1). Hospital stay was 3.3 days less accordingly, 29.0 ± 0.9 days and 32.3 ± 1.2 days (p < 0.05). Lethality was 2.5 times less as compared with abdominal cavity sanations according to “clinical indications”, accordingly 21.1 and 51.8 % (p < 0.01).


2019 ◽  
Vol 12 (1) ◽  
pp. 29-37
Author(s):  
Denis Vladimirovich Mizgirev ◽  
Valeriy Vladimirovich Kremlev ◽  
Lyudmila Aleksandrovna Neledova ◽  
Victor Nikolaevich Pozdeev ◽  
Anastasiya Andriyanovna Katysheva ◽  
...  

Relevance. There is a discussion about the prevalence of early or late mortality and the main causes of death in different phases of acute pancreatitis. Analysis of mortality is important for the determination of ways to improve the results of treatment of pancreatic necrosis. Aim of the research is analysis of the structure, timing characteristics and causes of deaths in pancreatic necrosis, the effect of the configuration of parapancreatitis and surgical tactics on the outcome of the disease. Materials and methods. Retrospective single-center study of lethal outcomes in acute pancreatitis was performed, the structure of mortality, cases of discrepancies in diagnoses, the timing of the onset and causes of deaths of patients were studied. The lethal outcomes were compared in the operated patients, the frequency of the mesentery root involvement, the indications and the timing of the interventions were assessed. Results. The ratio of early and late mortality was 45,2% to 54,8%, respectively. The main causes of early mortality – endotoxin shock and multi-organ failure, late one – infectious complications. In 9,6% of the patients, the diagnosis was made only with an autopsy. The prognostic value of the SOFA and SAPS II scales is characterized as low. The tactics of surgical treatment has changed in favour of minimally invasive surgery. The average conversion time for ineffective percutaneous procedures was 21,4 days. The involvement of mesentery in parapancreatitis was often accompanied by a breakthrough of the abscess into the abdominal cavity. Conclusion. The surgical component of the reduction in mortality is the rejection of unreasonable surgical interventions, the earlier conversion to "traditional" operations in case of ineffective minimally invasive treatment and the allocation of "central" localization of parapancreatitis as a serious prognostic factor of the course of severe pancreatitis.


2021 ◽  
Vol 14 (5) ◽  
pp. e238961
Author(s):  
Parvez Mohi Ud Din Dar ◽  
Shivanand Gamanagatti ◽  
Pratyusha Priyadarshini ◽  
Subodh Kumar

Chylothorax is generally seen due to iatrogenic injury to the thoracic duct during thoracic or neck surgery. It can also be encountered secondary to chest trauma either blunt or penetrating. Percutaneous thoracic duct embolisation is an alternative to surgical treatment and is considered an effective and safe minimally invasive treatment option for chylothorax with a success rate of about 80%. We present a case of blunt trauma to the chest with chylothorax, which was successfully managed with transvenous retrograde thoracic duct embolisation.


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