390 research outputs found
Palliative laparoscopic hepatico- and gastrojejunostomy for advanced pancreatic cancer
No full textOnly 10% to 20% of pancreatic tumors are resectable at the time of diagnosis. Patients with advanced disease have a median survival of 4.9 months. Palliation is often required for biliary or duodenal obstruction, or both, and for pain. Optimal palliation should guarantee the shortest possible hospital stay and as long a survival as possible with a good quality of life. In recent years, treatment options for palliation of biliary and duodenal obstruction due to pancreatic cancer have broadened. Endoscopic and percutaneous biliary stenting have been shown to be successful tools for safe palliation of high-risk patients. Nevertheless, fit patients with unresectable pancreatic cancer benefit from surgery, which allows long-lasting biliary and gastric drainage. While laparoscopic cholecystojejunostomy and gastroenterostomy in patients with advanced pancreatic cancer have been widely reported, laparoscopic hepatico-jejunostomy has been rarely described. In this article, we describe our technique of laparoscopic hepatico-jejunostomy and gastrojejunostomy. We also discuss current evidence on the indications for these procedures in patients with unresectable pancreatic cancer
Effect of bariatric surgery on future general surgical procedures
No full textBariatric surgery is now accepted as a safe and effective procedure for morbid obesity. The frequency of bariatric procedures is increasing with the adoption of the laparoscopic approach. The general surgeons will be facing many more of such patients presenting with common general surgical problems. Many of the general surgeons, faced with such situations, may not be aware of the changes in the gastrointestinal anatomy following bariatric procedures and management of these clinical situations will therefore present diagnostic and therapeutic challenges. We hereby present a review of management of few common general surgical problems in patients with a history of bariatric surgery
Subcutaneous endoscopic fasciotomy in a porcine model of abdominal compartment syndrome: A feasibility study
No full textPurpose: Treatment of abdominal compartment syndrome (ACS) involves abdominal decompression via a laparotomy, which can result in significant wound-related morbidity. Our aim was to determine if subcutaneous endoscopic abdominal fasciotomy in a porcine model of ACS is feasible and what effect it may have on intra-abdominal pressure (IAP) and superior mesenteric artery (SMA) blood flow.Materials and Methods: A total of 6 female pigs weighing 50 kg each were used for the study. Each animal underwent placement of an arterial line, pulmonary artery catheter, SMA blood flow probe, IAP catheter, and intra-abdominal saline infusion line. After endoscopic dissection of a subcutaneous pocket overlying the rectus muscles, saline was infused into the abdomen to a pressure of 40 mm Hg. Physiologic parameters were measured before and after bilateral endoscopic anterior rectus fasciotomies were performed, and analyzed with a paired t-test.Results: Mean subcutaneous dissection time was 42.5 +/- 11.3 minutes, and mean fasciotomy time was 5.5 +/- 2.3 minutes. There were no significant changes in heart rate, cardiac output, pO(2), or pH during the experiment. IAP increased exponentially as fluid was instilled into the abdomen. SMA blood flow decreased reliably and linearly with increasing IAP. Mean baseline IAP was 4.0 +/- 1.7 mm Hg. IAP decreased from 37 nun Hg to 25 mm Hg after fasciotomy (P < 0.001). Mean baseline SMA blood flow was 629 +/- 164 mL/min. SMA blood flow improved from 265 mL/min to 389 mL/min after fasciotomy (P < 0.01).Conclusion: Subcutaneous endoscopic abdominal fasciotomy is feasible and appears to lower IAP and raise SMA blood flow in a porcine model of ACS
Effect of bariatric surgery on future general surgical procedures
No full textBariatric surgery is now accepted as a safe and effective procedure for
morbid obesity. The frequency of bariatric procedures is increasing
with the adoption of the laparoscopic approach. The general surgeons
will be facing many more of such patients presenting with common
general surgical problems. Many of the general surgeons, faced with
such situations, may not be aware of the changes in the
gastrointestinal anatomy following bariatric procedures and management
of these clinical situations will therefore present diagnostic and
therapeutic challenges. We hereby present a review of management of few
common general surgical problems in patients with a history of
bariatric surgery
Bakassi: Or the Politics of Exclusion and Occupation?
No full textThis is a complex volume that combines a good deal of survey data on Bakassi and its populations with more ethnographically based insights into the conditions of the Bakassi communities. The book is the outcome of research carried out by Fongot Kini between 2004 and 2009. The work is intended to serve as first hand exhaustive information on the live situation in the contested Bakassi Cameroon-Nigeria border region. The term Bakassi engenders multiple meanings loaded with many conflicting emotional, spiritual and material interests. Native inhabitants are systematically disinherited of their ancestral cultural heritage and socio-economic resources. They are bastardised, humiliated and scammed by unscrupulous opportunists who deliberately misidentify them with intentions of dispossessing them of their ancestral lands and natural resources. Overall the author is in sympathy with the Bakassi who he argues have been marginalised and neglected by the Cameroon state. In particular, the value of the indigenous communities in terms of local economies as well as securing this vital border area has not been recognised and various external groups have been either allowed or encouraged to settle there to both the detriment of local populations and to the security of the region
Rokok Elektrik (Vape) sebagai Gaya Hidup Perokok Masa Kini di Kota Lhokseumawe
No full textIn all parts of the world, every human being has various kinds of habits. One of the human habits is smoking. Today, smoking itself is not something that is considered taboo by society. Cigarettes have become objects that are familiar to humans in general. This smoking habit is difficult to break. On this occasion, researchers will try to raise a theme of smoking habits that have become more modern among teenagers, namely vape as a lifestyle for today\u27s smokers. The background of this research is the author\u27s curiosity about why active smokers, especially teenagers, consume vapes as a substitute for tobacco cigarettes. As for the problem formulation in this study, namely why has vape become a trend in Lhokseumawe City? What effect does vape have on the lifestyle of today\u27s smokers? This research took place in Lhokseumawe City. The method used in this research is qualitative research with data collection techniques, namely observation, interviews, documentation, and literature studies using the perspective of consumerism culture and lifestyle studies. AbstrakSetiap manusia di seluruh belahan dunia memiliki berbagai macam kebiasaan. Salah satu kebiasaan itu adalah merokok. Dewasa ini, merokok bukanlah hal yang dianggap tabu oleh masyarakat. Rokok sudah menjadi benda yang sudah tidak asing lagi bagi manusia pada umumnya. Pada kenyataannya kebiasaan merokok ini sulit dihilangkan. Pada kesempatan ini, peneliti akan coba mengangkat sebuah tema kebiasaan merokok yang kini telah menjadi lebih modern di kalangan remaja, yaitu rokok elektrik (vape) sebagai gaya hidup perokok masa kini. Yang melatarbelakangi penelitian ini adalah keingintahuan penulis mengapa kini perokok aktif khususnya para remaja mengonsumsi vape sebagai pengganti rokok tembakau. Adapun yang menjadi rumusan masalah dalam penelitian ini yaitu mengapa rokok elektrik menjadi tren di Kota Lhokseumawe? Apa pengaruh rokok elektrik bagi gaya hidup perokok masa kini? Penelitian ini bertempat di Kota Lhokseumawe. Metode yang digunakan dalam penelitian ini adalah penelitian kualitatif dengan teknik pengambilan data yaitu observasi, wawancara, dokumentasi, dan studi literatur dengan menggunakan perspektif kajian budaya konsumerisme dan gaya hidup
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