CBD Repair Over T-tube or Primary Repair

2019 ◽  
Author(s):  
Keyword(s):  
Primary Repair ◽  
T Tube

scholarly journals Outcomes following Boerhaave’ syndrome

2013 ◽  
Vol 95 (8) ◽  
pp. 557-560 ◽  
Author(s):  
CL Connelly ◽  
PJ Lamb ◽  
S Paterson-Brown
Keyword(s):  
Hospital Stay ◽  
Primary Repair ◽  
Length Of Hospital Stay ◽  
Good Survival ◽  
Boerhaave’S Syndrome ◽  
Direct Closure ◽  
Tube Drainage ◽  
T Tube ◽  
Boerhaave's Syndrome ◽  
The Mean

Introduction Boerhaave’s syndrome is associated with high mortality and morbidity. This study aimed to assess outcome following treatment in a specialist upper gastrointestinal surgical unit. Methods Patients were identified from a prospectively collected database (Lothian Surgical Audit) and their records reviewed. Primary outcomes were mortality and serious morbidity. Secondary outcomes included time to theatre, operation undertaken and length of hospital stay. Results Twenty patients with Boerhaave’s syndrome were identified between 1997 and 2011. Four patients (20%) died in hospital. The mean time to theatre from symptom onset was 2.4 days. This was 7.3 days in the patients who died compared with 1.5 days in survivors. Five patients underwent primary repair of rupture, eleven underwent direct closure over a T-tube and one rupture was irreparable. Three patients were managed non-operatively and all survived. Outcomes were similar for the different surgical groups. There was one death following primary closure (20%) and two after T-tube drainage (18%). The mean length of hospital stay was 35.7 days after T-tube drainage and 20.5 days after primary repair. The 3 patients with small, self-contained leaks had a mean length of stay of 5.7 days. Conclusions Aggressive surgical management with direct repair is associated with good survival in patients with Boerhaave’s syndrome. Delayed time to theatre is associated with increased mortality. Patients with small, contained leaks without signs of sepsis can be managed non-operatively with a good outcome.

scholarly journals Treatment of Iatrogenic Cervical Esophageal Transection following Thyroidectomy: A Case Report and Review of Literature

2021 ◽  
Author(s):  
Kai-Yun Hsueh ◽  
En-Kuei Tang
Keyword(s):  
Surgical Intervention ◽  
Primary Repair ◽  
Rare Condition ◽  
Review Of Literature ◽  
Fatal Complication ◽  
Case Presentation ◽  
T Tube ◽  
Mediastinal Abscess ◽  
Prompt Diagnosis ◽  
Gastric Pull Up

Abstract Background: iatrogenic cervical esophageal transection after thyroidectomy is an extremely rare condition that requires prompt diagnosis and surgical intervention.Case presentation: we reported a rare case of iatrogenic cervical esophageal transection following thyroidectomy for thyroid carcinoma in a 54-year-old woman. Primary repair was not achievable because of loss of a long segment of the cervical esophagus. A modified diversion was performed by inserting a T-tube into the remnant esophagus, followed by gastrostomy and jejunostomy. The next day, mediastinal abscess was detected on chest computed tomography; therefore, thoracoscopic mediastinotomy was performed, with placement of two drains. After 6 months, thoracoscopic esophagectomy, alimentary reconstruction with gastric pull-up, and cervical esophagogastrostomy anastomosis were performed. The patient was discharged on postoperative day 18, without complications.Conclusions: iatrogenic cervical esophageal transection following thyroidectomy is a rare but fatal complication. It can be successfully managed with a series of treatments, including modified diversion procedure, prompt drainage of mediastinitis, alimentary reconstruction with gastric pull-up, and cervical esophagogastrostomy anastomosis.

Laparoscopic common bile duct exploration for choledocholithiasis (primary repair vs T-tube drainage)

2020 ◽  
Vol 39 (2) ◽  
pp. 317
Author(s):  
Mahmoud Hasabelnabi ◽  
AbdelmoniemI El-Khateeb ◽  
GamalA Makhlouf ◽  
AhmedS Aboulhassen ◽  
BashirA Fadel ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Primary Repair ◽  
Common Bile Duct Exploration ◽  
Tube Drainage ◽  
T Tube

scholarly journals Comparative Study between Primary Closure and T-tube Drainage after Open Choledochotomy

2017 ◽  
Vol 29 (1) ◽  
pp. 15-18
Author(s):  
Md Asaduzzaman ◽  
Md Golam Mostofa Mia ◽  
SM Abdullah ◽  
Md Shofiqul Islam ◽  
Mohammad Abu Hanif ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Wound Infection ◽  
Primary Closure ◽  
Primary Repair ◽  
Bile Leakage ◽  
Tube Insertion ◽  
College Hospital ◽  
Tube Drainage ◽  
T Tube ◽  
Closure Group

Common Bile Duct (CBD) exploration for choledocholithiasis is usually closed after T-tube insertion. However, complications of T-tube insertion limit its use. In the present study, we wanted to compare outcomes between primary repair of choledochotomy and traditional T-tube insertion. Thirty patients with CBD stones admitted at Tangail Medical College Hospital, Tangail, from January 2010 to December 2015, were included in this study. The patients were randomly divided into two groups: T-tube drainage group and primary closure group. Intraoperative findings and postoperative complications were recorded and analyzed. There was no mortality and retained stones in both groups. Two of 15 patients in the Ttube group and four of 15 patients in primary closure group suffered from minor bile leakage. There was no major bile leakage in the T-tube group but one patient in the primary closure group had major bile leakage, which was treated conservatively without surgical or endoscopic intervention. Wound infection was seen in two patients in the T-tube group and one patient in the primary closure group. In follow up assessment, there was no intra-abdominal collection in both groups. Overall postoperative complications include biliary complications, wound infection and intraabdominal collections, were seen in four patients in the T-tube group and six patients in primary closure group; that was not statistically significant. Primary (Para) closure of CBD after open choledochotomy is feasible and is as safe as T-tube insertion. In effect, primary closure avoids T-tube insertion and disadvantages associated with the use of T-tube. Primary closure can be recommended for selected patients with choledocholithiasis.Medicine Today 2017 Vol.29(1): 15-18

Surgical management of early and late esophageal perforation

2018 ◽  
Vol 26 (9) ◽  
pp. 685-689 ◽  
Author(s):  
Seyed Hossein Fattahi Masoom ◽  
Marziyeh Nouri Dalouee ◽  
Asieh Sadat Fattahi ◽  
Saeedeh Hajebi Khaniki
Keyword(s):  
Esophageal Perforation ◽  
Primary Repair ◽  
Esophageal Resection ◽  
Late Presentation ◽  
Early Group ◽  
Acceptable Result ◽  
T Tube ◽  
Time Of Presentation ◽  
Complications And Mortality ◽  
Late Group

Introduction Esophageal perforation is a rare and life-threating problem with a 10%–40% mortality rate. Early diagnosis and treatment are important for prevention of complications. Strategies for treatment of esophageal perforation have been controversial for many years, especially in cases of late presentation. Methods We prospectively studied 27 patients (12 male, 17 female, mean age 42.7 ± 17.8 years) who presented with esophageal perforation from 1996 to 2015, and evaluated the results of surgical treatment. The patients were divided into 3 groups according to time of presentation: early (<24 h), intermediate (24–72 h), and late (>72 h). We also considered the etiology and site of esophageal perforation, complications, and mortality. Results Surgery was performed in 5 patients in the early group, 7 in the moderate group, and 15 in the late group. Primary repair was carried out in 5 cases, primary repair and reinforcement with a flap in 10, esophageal resection and reconstruction in 8, and a T-tube stent was used in 4. Four patients developed a fistula postoperatively, and there was one death due to respiratory failure. No relationship was found between complications and the cause of perforation, time of presentation, or type of treatment. Conclusion In patients without sepsis, primary repair can be an option even in those presenting late after esophageal perforation, with an acceptable result.

544: Can a Complete Primary Repair Approach be Applied to Cloacal Exstrophy?

2004 ◽  
Vol 171 (4S) ◽  
pp. 145-145
Author(s):  
Richard S. Lee ◽  
Richard W. Grady ◽  
Byron D. Joyner ◽  
Pasquale Casale ◽  
Michael E. Mitchell
Keyword(s):  
Primary Repair ◽  
Cloacal Exstrophy

Feasability of a valveless RV-PA connection in primary repair of common arterial trunk

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
E Kusmenkov ◽  
J Hörer ◽  
J Cleuziou ◽  
J Kasnar-Samprec ◽  
M Vogt ◽  
...  
Keyword(s):  
Primary Repair ◽  
Common Arterial Trunk ◽  
Arterial Trunk

Esophageal Atresia and Associated Duodenal Atresia: A Cohort Study and Review of the Literature

2020 ◽  
Author(s):  
Maria Enrica Miscia ◽  
Giuseppe Lauriti ◽  
Dacia Di Renzo ◽  
Angela Riccio ◽  
Gabriele Lisi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Esophageal Atresia ◽  
Primary Repair ◽  
English Literature ◽  
Delayed Diagnosis ◽  
Case Series ◽  
Primary Treatment ◽  
Duodenal Atresia ◽  
Staged Approach ◽  
Missed Diagnosis

Abstract Introduction Esophageal atresia (EA) is associated with duodenal atresia (DA) in 3 to 6% of cases. The management of this association is controversial and literature is scarce on the topic. Materials and Methods We aimed to (1) review the patients with EA + DA treated at our institution and (2) systematically review the English literature, including case series of three or more patients. Results Cohort study: Five of seventy-four patients with EA had an associated DA (6.8%). Four of five cases (80%) underwent primary repair of both atresia, one of them with gastrostomy placement (25%). One of five cases (20%) had a delayed diagnosis of DA. No mortality has occurred. Systematic Review: Six of six-hundred forty-five abstract screened were included (78 patients). Twenty-four of sixty-eight (35.3%) underwent primary correction of EA + DA, and 36/68 (52.9%) underwent staged correction. Nine of thirty-six (25%) had a missed diagnosis of DA. Thirty-six of sixty-eight underwent gastrostomy placement. Complications were observed in 14/36 patients (38.9 ± 8.2%). Overall mortality reported was 41.0 ± 30.1% (32/78 patients), in particular its incidence was 41.7 ± 27.0% after a primary treatment and 37.0 ± 44.1% following a staged approach. Conclusion The management of associated EA and DA remains controversial. It seems that the staged or primary correction does not affect the mortality. Surgeons should not overlook DA when correcting an EA.

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