scholarly journals Role of endoscopy in diagnosis and treatment of gallstone disease complicated by the pathology of the extrahepatic bilary tract (literature review)

2020 ◽  
Vol 46 (1) ◽  
pp. 65-71
Author(s):  
G. E. Samoilenko ◽  
R. P. Klimanskyi ◽  
S. O. Zharikov ◽  
V. V. Makhnik
Keyword(s):  
Biliary Tract ◽  
Gallstone Disease ◽  
Diagnostic Testing ◽  
Intraoperative Ultrasound ◽  
Postoperative Mortality ◽  
Surgical Care ◽  
Percutaneous Transhepatic Cholangiography ◽  
Two Stage ◽  
One Stage ◽  
Complex Approach

The article presents current literature data of domestic and foreign authors on the main problems of endoscopic diagnostics and complex approach to treatment of gallstone disease complicated by pathology of the extrahepatic biliary tract. Efficiency of one-stage and two-stage methods of surgical treatment of cholelithiasis and the possibility of their practical application are considered. Complex approach for minimally invasive bile duct interventions with cholecystoccholedocholitiase, which can be conditionally divided into laparoscopic, mini-access, endoscopic by duodenoscope, cholangioscopy, ultrasound-controlled biliary intervention, is analyzed. Methods of diagnostic testing that can be divided into preoperative and intraoperative, non-invasive and invasive used in patients with cholecystoccholedocholitiase, namely fibrogastroduodenoscopy, endoscopic retrograde cholangiopancreatography, percutaneous-transhepatic cholangiography, diagnostic laparoscopy, intraoperative cholangiography, intraoperative ultrasound, angiography. New concepts of providing surgical care to patients with this pathology are presented, which include one-stage performance of cholecystectomy with priority use of intraoperative antegrade endoscopic papillosphincterotomy, and retrograde litho-extraction under duodenoscope control, in comparison with the two-stage tactics of correction of cholelithiasis with pathology of extrahepatic biliary tract, when the first stage includes its decompression, rehabilitation, and the second — cholecystectomy. Statistical data of complications arising during diagnostic and therapeutic manipulations in patients with cholelithiasis complicated by pathology of the extrahepatic biliary tract are presented. Number of cases of postoperative mortality depending on the severity of complications of cholelithiasis is also considered.

scholarly journals ALGORITHM OF SURGICAL CARE IN COMPLICATED COLORECTAL CANCER

2019 ◽  
Vol 18 (1) ◽  
pp. 66-73 ◽  
Author(s):  
A. V. Shabunin ◽  
Z. A. Bagateliya
Keyword(s):  
Colorectal Cancer ◽  
Bowel Resection ◽  
Bowel Perforation ◽  
Colonic Obstruction ◽  
Postoperative Mortality ◽  
Surgical Care ◽  
Two Stage ◽  
Elective Resection ◽  
One Stage ◽  
Malignant Colonic Obstruction

AIM: to standardize surgical care for the malignant colonic obstruction. PATIENTS AND METHODS: the retrospective cohort study included 797 patients with complicated colorectal cancer. Malignant colonic obstruction was diagnosed in 572 patients: 247 of them were treated in 2011-2013 (I group); 325 - in 2014-2017 (II). Urgent bowel resection was performed more often in I group (one-stage treatment), fecal diversion or stent- in II (two-stage treatment). Seventy-seven patients with tumor bleeding were included as well: 62 of them were treated conservatively or underwent endoscopic coagulation or arterial embolization (III group); 15 patients - underwent urgent bowel resection (IV). All of 148 patients with bowel perforation were underwent urgent surgery: resection was performed in 115 patients (V), suturing the perforation site-in 15 (VI), extraperitoneal drainage of the abscess - in18 (VII). Elective bowel resection was performed in 241 patients (186 - from I-II group, 40 - from III, 15 - from VI-VII) after 0.1-6 months. The comparative analysis of the early and late results of one- and two-stage treatment was carried out with assessment of the 3-year cumulative survival. RESULTS: postoperative mortality was significantly lower in elective resection groups compared with urgent resection groups: 3.6% vs 29.2% (II vs I); 5.0% vs 20.0% (III vs IV); 0.0% vs 35,7% (VI-VII vs V). The survival rate was higher in elective resection groups than in urgent ones: 0.809 vs 0.680 (II vs I), 0.8882vs 0.3571 (III vs IV), 0.8615 vs 0.4257 (VI-VII vs V). CONCLUSION: multi-stage approach for complicated colorectal cancer is more effective than one-stage.

Pathological syndromes of decompression of the biliary tract.

2021 ◽  
Author(s):  
Saadat Magomedova
Keyword(s):  
Biliary Tract ◽  
Treatment Algorithm ◽  
Main Group ◽  
Control Group ◽  
Electrolyte Balance ◽  
Two Stage ◽  
One Stage ◽  
Pathological Conditions ◽  
Tumor Origin

Summary. The circle of pathological conditions that develop in the post-decompression phase of BT with OX is indicated, and an effective pathognomonic conditioned treatment algorithm for patients has been developed. The results of examination and treatment of 216 patients with OX who underwent various options for BT decompression were analyzed. OX of tumor origin was observed in 112 (51.8%) patients, benign - in 104 (48.2%). The main group was -112, the control group - 104. Two-stage tactics were undertaken in 133 (61.6%) cases, 83 (38.4%) were operated on in one stage. The accelerated decompression syndrome developed in 31 (14.3%) cases (in the control -26, main-5). Violations of the water-electrolyte balance occurred in 32 (46.4%) patients with complete external abduction of bile. Digestive remodeling syndrome was present in 44 (33.1%) patients.

A systematic review and meta-analysis on the management of concomitant abdominal aortic aneurysms and renal tumours

Vascular ◽  
2021 ◽  
pp. 170853812110268
Author(s):  
Katerina Lawrie ◽  
Adam Whitley ◽  
Peter Balaz
Keyword(s):  
Endovascular Procedures ◽  
Meta Analysis ◽  
Postoperative Mortality ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Two Stage ◽  
One Stage ◽  
Abdominal Aortic ◽  
Renal Tumours ◽  
Aneurysm Repair

Objectives The treatment of concomitant abdominal aortic aneurysms and renal tumours is controversial. The aim of this study was to ascertain which of the following three strategies, one-stage open aneurysm repair and nephrectomy, two-stage open aneurysm repair and nephrectomy or two-stage endovascular aneurysm repair and nephrectomy, is the best approach. Methods systematic review and meta-analysis of articles published between January 1992 and April 2021 describing the treatment of concomitant abdominal aortic aneurysms and renal tumours. Results A total of 1168 records were identified. After the selection process, 12 studies with data on 89 patients were included. Sixty-two patients underwent one-stage open procedures, 18 patients underwent two-stage open procedures and nine underwent two-stage endovascular procedures. The overall postoperative mortality was 0.82% (95% CI, 0.00–4.61). The postoperative mortality for one-stage open procedures was 3.09% (95% CI, 0.00–10.11). No deaths occurred in the postoperative period open two-stage procedures or two-stage endovascular procedures. The weighted postoperative morbidity for all procedures was 23.86% (95% CI, 12.64–35.08) and for open one-stage procedures was 37.40% (95% CI, 14.33–60.47). Data concerning postoperative complications of two-stage open procedures were extractable from only one patient in whom no complications were reported. Two postoperative complications were reported after two-stage endovascular procedures from a total of six patients with extractable postoperative data. We were unable to perform meta-analysis on long-term outcomes as the data were reported non-uniformly. Conclusion There is currently no evidence to suggest that any procedure is associated with better outcomes. However, a one-stage open approach was the most commonly used option, favoured as it avoids delaying treatment of either of the conditions. Two-stage open procedures were preferred in cases where the surgical risk of a one-stage procedure was higher than the potential benefit. For such cases, two-stage endovascular repair is becoming more popular as a less invasive approach.

Molecular genetic background of haemophilia A patients with discrepancy between one-stage and two-stage factor VIII assays

2010 ◽  
Vol 30 (S 01) ◽  
pp. S153-S155
Author(s):  
D. Delev ◽  
S. Pahl ◽  
J. Driesen ◽  
H. Brondke ◽  
J. Oldenburg ◽  
...  
Keyword(s):  
Factor Viii ◽  
Genetic Background ◽  
Molecular Genetic ◽  
Haemophilia A ◽  
Two Stage ◽  
One Stage

Plasma Factor V Activation Is Prevented by Activated Protein C in the Presence of Phospholipid Vesicles, Not Platelets

1993 ◽  
Vol 69 (02) ◽  
pp. 124-129 ◽  
Author(s):  
Susan Solymoss ◽  
Kim Thi Phu Nguyen
Keyword(s):  
Western Blotting ◽  
Protein C ◽  
Thrombin Generation ◽  
Blood Platelets ◽  
Activated Protein C ◽  
Phospholipid Vesicles ◽  
Factor V ◽  
Two Stage ◽  
One Stage ◽  
Plasma Factor

SummaryActivated protein C (APC) is a vitamin K dependent anticoagulant which catalyzes the inactivation of factor Va and VIIIa, in a reaction modulated by phospholipid membrane surface, or blood platelets. APC prevents thrombin generation at a much lower concentration when added to recalcified plasma and phospholipid vesicles, than recalcified plasma and platelets. This observation was attributed to a platelet associated APC inhibitor. We have performed serial thrombin, factor V one stage and two stage assays and Western blotting of dilute recalcified plasma containing either phospholipid vesicles or platelets and APC. More thrombin was formed at a given APC concentration with platelets than phospholipid. One stage factor V values increased to higher levels with platelets and APC than phospholipid and APC. Two stage factor V values decreased substantially with platelets and 5 nM APC but remained unchanged with phospholipid and 5 nM APC. Western blotting of plasma factor V confirmed factor V activation in the presence of platelets and APC, but lack of factor V activation with phospholipid and APC. Inclusion of platelets or platelet membrane with phospholipid enhanced rather than inhibited APC catalyzed plasma factor V inactivation. Platelet activation further enhanced factor V activation and inactivation at any given APC concentration.Plasma thrombin generation in the presence of platelets and APC is related to ongoing factor V activation. No inhibition of APC inactivation of FVa occurs in the presence of platelets.

Two-Stage Procedure for the Quantitative Determination of Autoprothrombin III Concentration and Some Applications

1967 ◽  
Vol 18 (01/02) ◽  
pp. 198-210 ◽  
Author(s):  
Ronald S Reno ◽  
Walter H Seegers
Keyword(s):  
Prothrombin Time ◽  
Factor Vii ◽  
Two Stage ◽  
Pronounced Increase ◽  
One Stage ◽  
Assay Procedure ◽  
Bovine Plasma ◽  
The One ◽  
Autoprothrombin C

SummaryA two-stage assay procedure was developed for the determination of the autoprothrombin C titre which can be developed from prothrombin or autoprothrombin III containing solutions. The proenzyme is activated by Russell’s viper venom and the autoprothrombin C activity that appears is measured by its ability to shorten the partial thromboplastin time of bovine plasma.Using the assay, the autoprothrombin C titre was determined in the plasma of several species, as well as the percentage of it remaining in the serum from blood clotted in glass test tubes. Much autoprothrombin III remains in human serum. With sufficient thromboplastin it was completely utilized. Plasma from selected patients with coagulation disorders was assayed and only Stuart plasma was abnormal. In so-called factor VII, IX, and P.T.A. deficiency the autoprothrombin C titre and thrombin titre that could be developed was normal. In one case (prethrombin irregularity) practically no thrombin titre developed but the amount of autoprothrombin C which generated was in the normal range.Dogs were treated with Dicumarol and the autoprothrombin C titre that could be developed from their plasmas decreased until only traces could be detected. This coincided with a lowering of the thrombin titre that could be developed and a prolongation of the one-stage prothrombin time. While the Dicumarol was acting, the dogs were given an infusion of purified bovine prothrombin and the levels of autoprothrombin C, thrombin and one-stage prothrombin time were followed for several hours. The tests became normal immediately after the infusion and then went back to preinfusion levels over a period of 24 hrs.In other dogs the effect of Dicumarol was reversed by giving vitamin K1 intravenously. The effect of the vitamin was noticed as early as 20 min after administration.In response to vitamin K the most pronounced increase was with that portion of the prothrombin molecule which yields thrombin. The proportion of that protein with respect to the precursor of autoprothrombin C increased during the first hour and then started to go down and after 3 hrs was equal to the proportion normally found in plasma.

Standardization of Factor VIII – IV. Establishment of the 3rd International Standard for Factor VIII: C Concentrate

1983 ◽  
Vol 50 (03) ◽  
pp. 697-702 ◽  
Author(s):  
T W Barrowcliffe ◽  
A D Curtis ◽  
D P Thomas
Keyword(s):  
Factor Viii ◽  
High Purity ◽  
Collaborative Study ◽  
World Health ◽  
Current Standard ◽  
Two Stage ◽  
International Standard ◽  
One Stage ◽  
The One ◽  
Health Organization

SummaryAn international collaborative study was carried out to establish a replacement for the current (2nd) international standard for Factor VIII: C, concentrate. Twenty-six laboratories took part, of which 17 performed one-stage assays, three performed two-stage assays and six used both methods. The proposed new standard, an intermediate purity concentrate, was assayed against the current standard, against a high-purity concentrate and against an International Reference Plasma, coded 80/511, previously calibrated against fresh normal plasma.Assays of the proposed new standard against the current standard gave a mean potency of 3.89 iu/ampoule, with good agreement between laboratories and between one-stage and two- stage assays. There was also no difference between assay methods in the comparison of high-purity and intermediate purity concentrates. In the comparison of the proposed standard with the plasma reference preparation, the overall mean potency was 4.03 iu/ampoule, but there were substantial differences between laboratories, and the two-stage method gave significantly higher results than the one stage method. Of the technical variables in the one-stage method, only the activation time with one reagent appeared to have any influence on the results of this comparison of concentrate against plasma.Accelerated degradation studies showed that the proposed standard is very stable. With the agreement of the participants, the material, in ampoules coded 80/556, has been established by the World Health Organization as the 3rd International Standard for Factor VIII :C, Concentrate, with an assigned potency of 3.9 iu/ampoule.

Sign in / Sign up

Export Citation Format

Share Document