MINIMALLY-INVASIVE TECHNOLOGIES IN THE TREATMENT OF CHOLEDOCHOLITHIASIS COMPLICATED BY CHOLANGITIS AND BILIARY SEPSIS

Minimally-invasive endoscopic technologies are used in the treatment of patients with choledocholithiasis with complicated cholangitis and biliary sepsis. 56 patients were treated for the period 2014–2018, aged 65,5 ± 15,18 years. ERCP was performed in 31 (55,3%) patients, in 13 (23,2%) – surgical intervention was performed without contrast of extrahepatic bile ducts. Papillotomy in 52 cases (96,4%) was performed by string papilloma and in 4 (7,1%) – by needle. In all cases, subtotal papilloprotectomy was performed, supplemented by balloon sphincteroplasty. In the I group, the patients included patients with acute cholangitis clinic, in group II patients with clinic of biliary sepsis, in the III group patients with purulent cholangitis clinic, biliary sepsis and septic shock.In the 1st and 2nd groups of patients, mortality was not observed. In the 3rd group, 3 patients died (37,5%). The rest of the patients are discharged from the hospital in a satisfactory condition. A decrease in the level of markers of hepatitis cytolysis (AlAT, AsAT, GGTP, L-FABP) was observe during surgical procedures without ERCP, indicating the toxic effect of contrast on the liver parenchyma. L-FABP is a highly informative marker for hepatocyte cytolysis and can be used as a criterion for hepatic insufficiency and prognosis of biliary sepsis. The high efficiency of transpacillary endoscopic surgical techniques in the treatment of cholangitis and biliary sepsis was noted. Keywords: cholecholithiasis, purulent cholangitis, biliary sepsis, septic shock, endoscopic retrograde pancreatic cholangiography, endoscopic papillomotorotomy.

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Minimally-invasive technologies in the treatment of choledocholithiasis complicated by purulent cholangitis

Journal of Education, Health and Sport ◽

10.12775/jehs.2021.11.02.030 ◽

2021 ◽

Vol 11 (2) ◽

pp. 317-334

Author(s):

I. Deikalo ◽

D. Osadchuk ◽

O. Karel ◽

M. Handzhalas

Keyword(s):

High Efficiency ◽

Acute Cholangitis ◽

Surgical Techniques ◽

Liver Parenchyma ◽

Minimal Invasive ◽

Satisfactory Condition ◽

Biliary Sepsis ◽

Extrahepatic Bile Ducts ◽

Group 3 ◽

Sepsis And Septic Shock

Minimal invasive endoscopic technologies are used in the treatment of patients with choledocholithiasis with complicated cholangitis and biliary sepsis. 56 patients were treated for the period 2014 - 2018, aged 65.5 ± 15.18 years. ERCP was performed in 31 (55,3%) patients, in 13 (23,2%) - surgical intervention was performed without contrast of extrahepatic bile ducts. Papillotomy in 52 cases (96,4%) was performed by string papilloma and in 4 (7,1%) - by needle. In all cases, subtotal papilloprotectomy was performed [1], supplemented by balloon sphincteroplasty. In the I group, the patients included patients with acute cholangitis clinic, in group II patients with clinic of biliary sepsis, in the III group patients with purulent cholangitis clinic, biliary sepsis and septic shock. In the 1st and 2nd groups of patients, mortality was not observed. In the 3rd group, 3 patients died (37,5%). The rest of the patients are discharged from the hospital in a satisfactory condition. A decrease in the level of markers of hepatitis cytolysis (AlAT, AsAT, GGTP, L-FABP) was observed during surgical procedures without ERCP, indicating the toxic effect of contrast on the liver parenchyma. L-FABP is a highly informative marker for hepatocyte cytolysis and can be used as a criterion for hepatic insufficiency and prognosis of biliary sepsis. The high efficiency of transpacillary endoscopic surgical techniques in the treatment of cholangitis and biliary sepsis was noted.

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Minimally-invasive technologies in the treatment of choledocholithiasis complicated by biliary pancreatitis

Journal of Education, Health and Sport ◽

10.12775/jehs.2021.11.03.028 ◽

2021 ◽

Vol 11 (3) ◽

pp. 294-309

Author(s):

I. Deikalo ◽

D. Osadchuk ◽

O. Karel ◽

M. Handzhalas

Keyword(s):

High Efficiency ◽

Surgical Techniques ◽

Liver Parenchyma ◽

Minimal Invasive ◽

Biliary Pancreatitis ◽

Satisfactory Condition ◽

Biliary Sepsis ◽

Extrahepatic Bile Ducts ◽

Group 3 ◽

Sepsis And Septic Shock

Minimal invasive endoscopic technologies are used in the treatment of patients with biliary pancreatitis with complicated cholangitis and biliary sepsis. 56 patients were treated for the period 2014 - 2018, aged 65.5 ± 15.18 years. ERCP was performed in 31 (55,3%) patients, in 13 (23,2%) - surgical intervention was performed without contrast of extrahepatic bile ducts. Papillotomy in 52 cases (96,4%) was performed by string papilloma and in 4 (7,1%) - by needle. In all cases, subtotal papilloprotectomy was performed [1], supplemented by balloon sphincteroplasty. In the I group, the patients included patients with biliary pancreatitis clinic, in group II patients with clinic of biliary sepsis, in the III group patients with purulent cholangitis clinic, biliary sepsis and septic shock. In the 1st and 2nd groups of patients, mortality was not observed. In the 3rd group, 3 patients died (37,5%). The rest of the patients are discharged from the hospital in a satisfactory condition. A decrease in the level of markers of hepatitis cytolysis (AlAT, AsAT, GGTP, L-FABP) was observed during surgical procedures without ERCP, indicating the toxic effect of contrast on the liver parenchyma. L-FABP is a highly informative marker for hepatocyte cytolysis and can be used as a criterion for hepatic insufficiency and prognosis of biliary sepsis. The high efficiency of transpacillary endoscopic surgical techniques in the treatment of biliary pancreatitis and biliary sepsis was noted.

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Use of endoscopic transorbital and endonasal approaches for 360° circumferential access to orbital tumors

Journal of Neurosurgery ◽

10.3171/2020.6.jns20890 ◽

2020 ◽

pp. 1-10

Author(s):

Chiman Jeon ◽

Sang Duk Hong ◽

Kyung In Woo ◽

Ho Jun Seol ◽

Do-Hyun Nam ◽

...

Keyword(s):

Optic Nerve ◽

Minimally Invasive ◽

Surgical Techniques ◽

Cystic Teratoma ◽

Subtotal Resection ◽

Zone Model ◽

Team Approach ◽

Orbital Tumors ◽

Total Resection ◽

Endoscopic Transorbital

OBJECTIVEOrbital tumors are often surgically challenging because they require an extensive fronto-temporo-orbital zygomatic approach (FTOZ) and a multidisciplinary team approach to provide the best outcomes. Recently, minimally invasive endoscopic techniques via a transorbital superior eyelid approach (ETOA) or endoscopic endonasal approach (EEA) have been proposed as viable alternatives to transcranial approaches for orbital tumors. In this study, the authors investigated the feasibility of 360° circumferential access to orbital tumors via both ETOA and EEA.METHODSBetween April 2014 and June 2019, 16 patients with orbital tumors underwent either ETOA or EEA at the authors’ institution. Based on the neuro-topographic “four-zone model” of the orbit with its tumor epicenter around the optic nerve in the coronal plane, ETOA (n = 10, 62.5%) was performed for tumors located predominantly superolateral to the nerve and EEA (n = 6, 37.5%) for those located predominantly inferomedial to the nerve. Eight patients (50%) presented with intraconal tumors and 8 (50%) with extraconal ones. The orbital tumors included orbital schwannoma (n = 6), cavernous hemangioma (n = 2), olfactory groove meningioma (n = 1), sphenoorbital meningioma (n = 1), chondrosarcoma (n = 1), trigeminal schwannoma (n = 1), metastatic osteosarcoma (n = 1), mature cystic teratoma (n = 1), sebaceous carcinoma (n = 1), and ethmoid sinus osteoma (n = 1). The clinical outcomes and details of surgical techniques were reviewed.RESULTSGross-total resection was achieved in 12 patients (75%), near-total resection in 3 (18.8%), and subtotal resection in 1 (6.2%). Eight (88.9%) of the 9 patients with preoperative proptosis showed improvement after surgery, and 4 (66.7%) of the 6 patients with visual symptoms demonstrated improvement. Four (40%) of the 10 patients treated with ETOA experienced partial third nerve palsy immediately after surgery (3 transient and 1 persistent). There have been no postoperative CSF leaks or infections in this series.CONCLUSIONSWithout transcranial approaches requiring temporalis muscle dissection and orbitozygomatic osteotomy, the selection of ETOA or EEA based on a concept of a four-zone model with its epicenter around the optic nerve successfully provides a minimally invasive 360° circumferential access to the entire orbit with acceptable morbidity.

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Minimally Invasive Surgical Techniques in Management of Intra-articular Fracture Calcaneus

Zagazig University Medical Journal ◽

10.21608/zumj.2020.24425.1758 ◽

2020 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

sami sadek ◽

khalid Abd Elrahman ◽

Yousuf Khira ◽

el sayed soudy

Keyword(s):

Minimally Invasive ◽

Surgical Techniques ◽

Articular Fracture ◽

Minimally Invasive Surgical

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Revisional Techniques for Secondary Cleft Lip Deformities

Seminars in Plastic Surgery ◽

10.1055/s-0041-1728673 ◽

2021 ◽

Vol 35 (02) ◽

pp. 065-071

Author(s):

Shayan M. Sarrami ◽

Anna J. Skochdopole ◽

Andrew M. Ferry ◽

Edward P. Buchanan ◽

Larry H. Hollier ◽

...

Keyword(s):

Minimally Invasive ◽

Early Life ◽

Cleft Lip ◽

Primary Repair ◽

Surgical Techniques ◽

Minimally Invasive Techniques ◽

Adjacent Tissue ◽

Tissue Transfer ◽

Invasive Techniques

AbstractSecondary deformities of repaired cleft lips are an unfortunate complication despite the meticulous approach of modern primary procedures. Most of these surgeries take place in the patient's early life and must be strategically planned to provide optimal cosmesis with minimal interventions. Depending on the level of severity, treatment of the secondary deformities ranges from noninvasive or minimally invasive techniques to complete revision cheiloplasty. Many novel topical, injectable, and laser therapies have allotted physicians more technical flexibility in treating superficial distortions. Nonetheless, surgical techniques such as diamond excision and adjacent tissue transfer remain popular and useful reconstructive modalities. Deformities involving the orbicularis oris must be completely taken down to allow full access to the muscle. Complete revision cheiloplasty requires recreation of the cleft defect and reconstruction similar to the primary repair. Due to the myriad of presentations of these secondary deformities, familiarity with the various treatments available is imperative for any cleft surgeon.

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