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External Drainage (external + drainage)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Reconstruction of the pancreatic duct after pancreaticoduodenectomy: A modification of the Whipple procedure

JOURNAL OF SURGICAL ONCOLOGY, Issue 1 2001
Stylianos Katsaragakis MD
Abstract Background and Objectives: Pancreaticoduodenectomy is still associated with high morbidity and mortality even though there has been significant progress in the field of pancreatic surgery and postoperative follow-up. The pancreatoenteric anastomosis, regardless of the technique used, is a major cause for both morbidity and mortality after Whipple procedure. To overcome all problems resulting from anastomotic leakage, we used external drainage of the pancreatic duct. Methods: In 24 patients who underwent pancreaticoduodenectomy in our Department from 1986 to 1995, a modification to the standard Whipple procedure was performed. Instead of pancreaticoenteric anastomosis, external drainage of the pancreatic duct remnant was performed. The pancreatic duct was intubated with a silastic tube, the external end of which was sutured to the skin. All patients received substitution therapy with pancreatic enzymes. Results: Mortality in our group of patients was 4%. No complications due to the external drainage of the pancreatic duct were reported, while no patient developed diabetes mellitus after surgery. Conclusions: External drainage of the pancreatic duct remnant can be used alternatively to pancreatoenteric anastomosis after pancreatoduodenectomy. The technique is safe and simple to perform and appears to reduce overall operative time. It may be an option for patients with significant comorbidity and/or intraoperative hemodynamic instability which mandates expeditious completion of the operation. J. Surg. Oncol. 2001; 77:26,29. © 2001 Wiley-Liss, Inc. [source]

Efficiency of obliteration procedures in the surgical treatment of hydatid cyst of the liver

ANZ JOURNAL OF SURGERY, Issue 11 2004
Yilmaz Akgun
Background: Hydatid cyst of the liver (HCL) is a parasitic infestation caused by several species of Echinococcus and is endemic in many sheep-raising areas. The aim of the present study is to evaluate the value of clinical, physical and laboratory findings and to discuss the diagnostic and therapeutic options in 250 patients with HCL. Methods: Between January 1980 and December 1989, 148 patients with HCL were treated surgically, and surgical procedures performed were evaluated retrospectively. On the basis of these findings, a prospective study of 102 patients was initiated between January 1990 and December 1999. Results: External drainage was performed in retrospective and prospective groups, respectively, in 110 and five patients, obliteration procedures in 31 and 82 and resectional procedures in seven and 15. While mean hospitalization time morbidity, mortality and recurrence rates were 16.2 ± 6.9 days, 37.8%, 2.0% and 6.7% in the retrospective group, these rates were decreased to 7.8 ± 3.5 days, 10.7%, 0.9% and 1.9%, respectively, in the prospective group. Overall morbidity, mortality and recurrence rates and median hospitalization time were 49.5%, 2.6%, 9.5% and 18.0 ± 7.4 days in external drainage group, 7.0%, 0% 0.8% and 8.5 ± 4.5 in obliteration procedures and 9.0%, 4.5%, 0% and 7.3 ± 1.9 resectional procedures, respectively. Conclusions: External drainage should be performed only in infected HCL. Resection procedures are too radical and extensive for benign lesions. Obliteration procedures are simple and safe methods for the treatment of HCL, and they have low morbidity, mortality and recurrence rates. [source]

Reconstruction of the pancreatic duct after pancreaticoduodenectomy: A modification of the Whipple procedure

JOURNAL OF SURGICAL ONCOLOGY, Issue 1 2001
Stylianos Katsaragakis MD
Abstract Background and Objectives: Pancreaticoduodenectomy is still associated with high morbidity and mortality even though there has been significant progress in the field of pancreatic surgery and postoperative follow-up. The pancreatoenteric anastomosis, regardless of the technique used, is a major cause for both morbidity and mortality after Whipple procedure. To overcome all problems resulting from anastomotic leakage, we used external drainage of the pancreatic duct. Methods: In 24 patients who underwent pancreaticoduodenectomy in our Department from 1986 to 1995, a modification to the standard Whipple procedure was performed. Instead of pancreaticoenteric anastomosis, external drainage of the pancreatic duct remnant was performed. The pancreatic duct was intubated with a silastic tube, the external end of which was sutured to the skin. All patients received substitution therapy with pancreatic enzymes. Results: Mortality in our group of patients was 4%. No complications due to the external drainage of the pancreatic duct were reported, while no patient developed diabetes mellitus after surgery. Conclusions: External drainage of the pancreatic duct remnant can be used alternatively to pancreatoenteric anastomosis after pancreatoduodenectomy. The technique is safe and simple to perform and appears to reduce overall operative time. It may be an option for patients with significant comorbidity and/or intraoperative hemodynamic instability which mandates expeditious completion of the operation. J. Surg. Oncol. 2001; 77:26,29. © 2001 Wiley-Liss, Inc. [source]

Submacular fluid after encircling buckle surgery for inferior macula-off retinal detachment in young patients

ACTA OPHTHALMOLOGICA, Issue 1 2009
Hana Abouzeid
Abstract. Purpose:, Characterization of persistent diffuse subretinal fluid using optical coherence tomography (OCT) after successful encircling buckle surgery for inferior macula-off retinal detachment in young patients. Methods:, Institutional retrospective review of six young patients (mean age 31 ± 6 years; five female, one male) with spontaneous inferior rhegmatogenous macula-off retinal detachment. All patients were treated with encircling buckle surgery and five out of six underwent additional external drainage of subretinal fluid. Mean follow-up was 37 ± 25 months (range 17,75 months) and included complete ophthalmic and OCT examination. Results:, At 6 months, 100% of patients showed persistence of subretinal fluid on OCT. Four patients had diffuse fluid accumulation, whereas two patients showed a ,bleb-like' accumulation of fluid. This fluid was present independent of whether or not patients had been treated with external fluid drainage. Subretinal fluid only started to disappear on OCT between 6 and more than 12 months after surgery. Conclusion:, Young patients with inferior macula-off retinal detachments and a marginally liquefied vitreous may show persisting postoperative subclinical fluid under the macula for longer periods of time than described previously. [source]