scholarly journals Resección endoscópica bajo visión coledocoscópica de pólipo biliar. Reporte de un caso

2021 ◽  
Vol 51 (2) ◽  
Author(s):  
Aníbal Soler ◽  
Gonzalo Palmili ◽  
Eduardo Cassone ◽  
Aníbal Silva
Keyword(s):  
Preoperative Diagnosis ◽  
Biliary Fistula ◽  
Benign Pathology ◽  
Trained Personnel ◽  
Biliary Pathology ◽  
Inflammatory Pseudotumors ◽  
Surgery Department ◽  
Spyglass Ds ◽  
The Cost ◽  
Specific Technology

Inflammatory pseudotumors of the biliary tract represent an infrequent biliary pathology, with few cases reported in literature. In radiological or surgical explorations, these tumors are usually diagnosed as unsuspected findings. They represent a challenge in preoperative diagnosis, due to the cost of specific technology such as Spyglass DS (Boston Scientific) and the need of trained personnel for its correct use. This means that most patients are usually treated with major resections with wrong preoperative diagnosis of cholangiocarcinoma, missing a chance of an endoscopic solution while adding unnecessary morbidity and mortality in benign pathology. We present a case that underwent endoscopic resection by ERCP under direct choledochoscopic view for Kehr’s biliary fístula in the General Surgery Department of a central hospital.

scholarly journals Mirizzi syndrome grades III and IV: surgical treatment

2016 ◽  
Vol 43 (4) ◽  
pp. 243-247 ◽  
Author(s):  
RONALD REVERDITO ◽  
ANDRÉ DE MORICZ ◽  
TÉRCIO DE CAMPOS ◽  
ADHEMAR MONTEIRO PACHECO JÚNIOR ◽  
RODRIGO ALTENFELDER SILVA
Keyword(s):  
Surgical Treatment ◽  
Preoperative Diagnosis ◽  
Anastomotic Stricture ◽  
Cross Sectional Study ◽  
Biliary Fistula ◽  
Mirizzi Syndrome ◽  
Cross Sectional ◽  
Biliodigestive Anastomosis ◽  
Type Iv

ABSTRACT Objective : to evaluate the epidemiology and outcomes of surgical treatment of patients with Mirizzi Syndrome (MS) grades III and IV, the most advanced according to Csendes classification. Methods : we conducted a retrospective, cross-sectional study by reviewing records of thirteen patients with grades III and IV MS operated from December 2001 to September 2013, among the 3,691 cholecystectomies performed in the period. Results : the incidence of MS was 0.6% (23 cases) and grades III and IV amounted to 0.35% of this number. There was a predominance of type IV (12 cases). The preoperative diagnosis was possible in 53.8% of cases. The preferred approach was biliary-digestive derivation (10 cases), and "T" tube drainage with suture of the bile duct was the choice in three special occasions. Three patients had biliary fistula resolved with clinical management, and one coliperitoneum case required reoperation. In the outpatient follow-up of patients who underwent biliodigestive anastomosis (eight), 50% are asymptomatic, 25% had anastomotic stricture and 25% lost follow-up. The mean follow-up was 41.8 months. Conclusion : MS in advanced degrees has low incidence, preoperative diagnosis in only half of cases, and has the biliodigestive anastomosis as the best conduct, but not without morbidity.

scholarly journals Histopathological Aspects Described in Patients with Hepatic Hydatidosis

2016 ◽  
Vol 54 (1) ◽  
pp. 47-53
Author(s):  
Daniela E. Mihăilă ◽  
M.C. Niţu ◽  
T.D. Potecă
Keyword(s):  
General Surgery ◽  
Liver Parenchyma ◽  
Cystic Mass ◽  
Cytokeratin 19 ◽  
Hepatic Hydatidosis ◽  
Benign Pathology ◽  
Before And After ◽  
Immunohistochemical Techniques ◽  
Surgery Department

Introduction. Hydatidosis is a parasitic disease with tumour-like development of a cystic mass. This has specific endemic areas, Romania being amongst them. Our hospital has national addressability and the collaboration between the Departments of Parasitology, General Surgery and Pathology ensures optimal multidisciplinary approach to cases of therapeutic and diagnostic standpoint. The study aims to test the hypothesis that the gallbladder is a hydatid reservoir, to identify signs of biliary fistulas in the pericyst and liver parenchyma; to identify inflammation elements in the pericyst and the gallbladder. Material and methods. The study is a retrospective observational one, carried out between 2011-2014, on a total of 35 patients operated for hepatic hydatidosis in the General Surgery Department of “Colentina” Clinical Hospital. All the selected patients had sent to the Pathology Department: gallbladder, cyst and pericyst. Statistical analysis of the data was performed using SPSS package Statistics 19. Results. The main results of the study revealed no evidence to confirm the hypothesis that the gallbladder is a hydatid reservoir. Out of the 35 cases, in 16 we observed the tendency to include hepatic biliary ducts in the pericyst or the formation of new canals which lead to the formation of biliary fistulas. Using immunohistochemical techniques with mark of CK19 (cytokeratin 19), have been observed the pattern of fistulization and modification of local architecture through the formation of the pericyst, in 16/35 (45.7%) of cases. Conclusion. Although it is a benign pathology, the evolution of hepatic hydatidosis can lead to severe complications and a low quality of life for the patient, both before and after surgery. Better knowledge of the pathology behind the local evolution of the disease can influence the therapeutic approach.

scholarly journals Evaluation of outcome of early appendectomy in appendicular lump

2020 ◽  
Vol 8 (1) ◽  
pp. 7
Author(s):  
A. S. M. Rezbanul Haque ◽  
Bablu Kumar Saha ◽  
M. Mahfuzul Haque ◽  
M. Abdus Sattar ◽  
Upendra Nath Ray ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Recovery Period ◽  
Medical College ◽  
Group I ◽  
Perforated Appendix ◽  
Early Exploration ◽  
The Mean ◽  
Group Ii ◽  
Surgery Department ◽  
The Cost

Background: Appendicular lump is a well-known sequalae of acute appendicitis encountered in 2-6% of patients. Successful management of appendicular lump is controversial with different approaches. This study aims to evaluate the outcome of early appendectomy in an appendicular lump.Methods: A total of 210 patients were admitted in surgery and pediatric surgery department of Rangpur medical college and hospital with the diagnosis of acute appendicitis and its sequalae over two years.Results: In this study, sixty patients were included who were presented with an appendicular lump. Maximum patients (50%) were found in the age group of 21-30 years. Males (66.67%) were more affected. Eighty percent of patients were coming from below-average socio-economic conditions. In group I, early appendicectomy had done and outcomes were satisfactory and favorable. In group II, eighteen patients were operated who were admitted at 6 to 8 days after an attack of acute appendicitis, and twelve patients were continued the conservative treatment. In group II, who had done surgery, among them, fourteen patients (77.78%) were found an appendicular abscess, and four patients (22.22%) were found perforated appendix per-operatively. In group I, the mean recovery period was less and they had minimum complications. In group II, the mean recovery period was more and they had more complications.Conclusions: Based on these findings, it can be concluded that early exploration in appendicular lump patients confirm the diagnosis, cures the problem, reduces the cost of management, and shortens the convalescence period and hospital stay with reasonably satisfactory outcomes.

scholarly journals Association of metabolic syndrome with complicated gall stone disease: our experience

2019 ◽  
Vol 6 (7) ◽  
pp. 2543
Author(s):  
Narender Kumar ◽  
Somendra Bansal ◽  
Shalu Gupta ◽  
Bhanwar Lal Yadav ◽  
Pradeep Verma ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
General Surgery ◽  
Prospective Observational Study ◽  
Gall Stone ◽  
Daily Practice ◽  
Stone Disease ◽  
P Value ◽  
Gall Stone Disease ◽  
Biliary Pathology ◽  
Surgery Department

Background: Gall stone disease is the most common biliary pathology and frequently encountered in our daily practice. Patients with gall stone that experienced at least one attack of acute cholecystitis is defined as complicated gall stone disease (CGSD). Aim of this study was to find out the association between complicated gall stone disease and the metabolic syndrome.Methods: This prospective, observational study was done from 1st March 2017 to 30th November 2018 in department of general surgery, SMS hospital Jaipur. All patients with cholelithiasis admitted in general surgery department were included. Metabolic syndrome was defined by adult treatment panel III (ATP III) criteria. All patients were divided in two groups: complicated gall stone disease (CGSD) and uncomplicated gall stone disease (UGSD).Results: Mean age was 47.2 years in CGSD group and 46.7 year in UGSD group. Female to male ratio was 8.2:1 in CGSD group and 4:1 in UGSD. Metabolic syndrome was presented in 64 patients (58.2%) of CGSD group and 24 patients (21.8%) of UGSD patients, which was statistically significant (OR 4.986, CI 2.763-8.995, p value <0.001). Five components of metabolic syndrome were compared in both CGSD group and UGSD group. Lower serum HDL-C level and hyperglycemias was statistically significant in CGSD group as compared to UGSD group.Conclusions: Metabolic syndrome can be use to predict complicated gall stone disease. Hyperglycaemia and lower HDL-C associated with CGSD. One should be aware about possible metabolic syndrome background when dealing with gall stone disease patients.

scholarly journals 251. Implementation of the Sōna Coccidioides Antibody Lateral Flow Assay in the Clinical Laboratory Proves to Reduce Cost and Decrease Turnaround Time When Compared with Send out Immunodiffusion and Complement Fixation Testing

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S141-S141
Author(s):  
Wesley J Candelaria
Keyword(s):  
Complement Fixation ◽  
Clinical Laboratory ◽  
Turnaround Time ◽  
Lateral Flow ◽  
Lateral Flow Assay ◽  
Inexpensive Method ◽  
Diagnostic Challenge ◽  
Valley Fever ◽  
Trained Personnel ◽  
The Cost

Abstract Background Coccidioidomycosis (Valley fever) is an airborne, invasive fungal infection endemic to Arizona, California, Mexico, and Central and South America. The dominant method of diagnosis is serology, which includes complement fixation (CF), immunodiffusion (ID), and enzyme immunoassay (EIA). These serological assays require highly trained personnel and are time consuming, with turnaround times (TAT) that range anywhere from 5 days to 2+ weeks. Due to costs of send outs and long TAT, Valley fever presents a diagnostic challenge to physicians and laboratorians. IMMY developed the sōna Coccidioides Antibody Lateral Flow Assay (LFA), a rapid and simple diagnostic assay that detects anti-Coccidioides antibodies in patient serum in 30 minutes. Methods We tested the sōna Coccidioides antibody LFA using 315 patient specimens and compared cost-analysis and TAT to a send out reference lab’s ID and CF assays. Results In this study, we found that after implementing the sōna Coccidioides Antibody LFA as a screening test, the cost of send-outs reduced by 84%, and the cost of all testing reduced by 68%. The TAT for sending out testing averaged 5–10 days, whereas the sōna Coccidioides Antibody LFA averaged a total TAT of <24 hours. Conclusion The sōna Coccidioides Antibody LFA offers a rapid, simple, and inexpensive method for accurately detecting antibodies against Coccidioides spp. in patient serum. Disclosures All authors: No reported disclosures.

Identification, Specification, and Development of Web-Oriented Architectures

2012 ◽  
Vol 4 (1) ◽  
pp. 1-21 ◽  
Author(s):  
Gunnar Thies ◽  
Gottfried Vossen
Keyword(s):  
Distributed Systems ◽  
Service Oriented Architectures ◽  
Web Architecture ◽  
Black Boxes ◽  
Core Elements ◽  
Service Oriented ◽  
The Cost ◽  
Specific Technology ◽  
The Web

Web-oriented Architectures (WOAs) provide a way of designing an IT system by using a variety of Web Procedures, i.e., procedures (or services) called over the Web. The idea of (typically atomic) components that are black boxes, have interfaces, and can be assembled into a larger process is fundamental and has existed since the early days of distributed systems. Two particular types of modern distributed systems are Service-oriented Architectures and Resource-oriented Architectures, which are built on specific technology stacks and define their own concepts. A WOA uses the best of both worlds plus specifics like Web APIs to build an interconnected IT system in the easiest way possible. In this article, the authors introduce the concept behind a WOA, the topology of a WOA, and possible integration scenarios within an enterprise. More importantly, the authors discuss what a methodology for building a WOA can look like and how control can be achieved, by using a logical software element called the Web Architecture Controller, which specifies the Web-centric core elements of a WOA. Lastly, the cost of implementing and running such a system is briefly addressed.

scholarly journals Importance of Pre-Operative COVID 19 Screening of Asymptomatic Patients Undergoing Maxillofacial Surgery

2020 ◽  
Vol 38 (4) ◽  
pp. 229-231
Author(s):  
SM Anwar Sadat ◽  
Muhammad Badruddoza
Keyword(s):  
Older People ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Rt Pcr ◽  
College Hospital ◽  
Cross Sectional ◽  
Asymptomatic Patients ◽  
Surgery Department ◽  
The Cost ◽  
Improve Patient

COVID-19 usually presents with fever, coughs dyspnea, myalgia, and fatigue and may infect people of any age though older people with co morbidities are more vulnerable. But many carriers do not present any symptoms. Operating on undiagnosed COVID-19 patients may cause exposure of medical staff in ward and theatre.A cross sectional was done on 100 consecutive cases suffering from oral and maxillofacial pathologies from 20th May 2020 to 28th August 2020, recruited from Oral and Maxillofacial Surgery department of Dhaka Dental College Hospital and Square Hospitals Ltd, Dhaka, Bangladesh. Out of 100 cases, 7 were affected (7%) by COVID 19 confirmed by RT-PCR in pre-operative screening.Preoperative COVID 19 screening of asymptomatic patients should be considered to improve patient and provider safety and reduce the cost of resource. J Bangladesh Coll Phys Surg 2020; 38(4): 229-231

scholarly journals Effectiveness of Home Visits to Pediatric Peritoneal Dialysis Patients

2012 ◽  
Vol 32 (4) ◽  
pp. 419-423 ◽  
Author(s):  
Eileen N. Ellis ◽  
Christine Blaszak ◽  
Sherida Wright ◽  
Andrea Van Lierop
Keyword(s):  
Peritoneal Dialysis ◽  
Home Visit ◽  
Pediatric Patients ◽  
Clinical Care ◽  
Home Visits ◽  
Home Dialysis ◽  
Number Of Patients ◽  
Continuous Cycling ◽  
Trained Personnel ◽  
The Cost

Home visits by trained personnel to patients undergoing home dialysis are required, but little is reported about the effectiveness of such home visits. We retrospectively reviewed home visits to 22 pediatric patients undergoing continuous cycling peritoneal dialysis (PD) at home. A trained dialysis nurse completed each home visit. An average of 1.5 pertinent dialysis findings and 1 pertinent medication finding was noted for each home visit to these patients. The interdisciplinary dialysis team reviewed the home visit findings and made specific recommendations after each home visit. In addition, the training process has been enhanced to incorporate visit findings for future home PD patients. Although not statistically significant in this small number of patients, peritonitis rates declined in the 6 months after initiation of the home visit program. The average cost for a dialysis nurse to complete a home visit is less than the cost of antibiotics for 1 episode of peritonitis. Home visits are valuable for improving clinical care in pediatric patients on home PD.

scholarly journals Ileo-Sigmoidian Node: About A Case in the Visceral Surgery Department of the Donka National Hospital

2021 ◽  
Vol 9 (1) ◽  
pp. 179-184
Author(s):  
Barry Alpha Madiou ◽  
Balde Abdoulaye Korse ◽  
Camara Soriba Naby ◽  
Camara Cheick Christian ◽  
Camara Fode Lansana ◽  
...  
Keyword(s):  
Small Intestine ◽  
Sigmoid Colon ◽  
Preoperative Diagnosis ◽  
Clinical Case ◽  
Visceral Surgery ◽  
Clinical Entity ◽  
National Hospital ◽  
Ileosigmoid Knot ◽  
Surgical Emergency ◽  
Surgery Department

The aim of this study was to report a clinical case of ileocaecal node in the visceral surgery department of Donka. The ileosigmoid node or the ileosigmoid knot (ISK), is an exceptional clinical entity, it is a surgical emergency characterized by strangulation of the small intestine forming a knot around the base of the sigmoid colon with risk of rapid necrosis of the small intestine. And the colon. The preoperative diagnosis of this condition is difficult because of its rarity and atypical radiographic results. We report a case of an ileosigmoid node discovered in a 62-year-old subject who consulted in our department for an occlusive syndrome.

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