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Duodenal perforation in course of endoscopic retrograde cholangiopancreatography-endoscopic sphincterotomy. Therapeutic considerations
No full textLaparoscopic adrenalectomy: transperitoneal lateral approach. Cases study.
No full textAIM OF THE STUDY:
To compare the results of the laparoscopic adrenalectomy achieved with the traditional laparotomic one.
MATERIAL AND METHOD:
In the period 1997-September 2004 we treated 17 patients with adrenal pathology: eight patients underwent to an open anterior transperitoneal adrenalectomy and nine patients underwent a laparoscopic adrenalectomy with lateral transperitoneal approach.
RESULTS:
Among the immediate results a longer operative time was evident in the laparoscopic approach and a greater blood loss in the open approach; there were no conversions to a laparotomic procedure. In the postoperative period there were some bronchopneumonic infiltrates and some infections of the laparotomy in the open group; in the laparoscopic group there was a parietal haematomas that cleared up spontaneously, in correspondence of a trocar access.
DISCUSSION:
Both procedures allow to achieve the complete resolution of the adrenal pathology if it is confined within the gland and no more than 8 cm. in size. The morbidity in the mininvasive approach is surely much lower than the open technique. The advantages of a laparoscopic approach can be found in a minor surgical stress. The evident datum that results from the literature analysis of the results of the the laparoscopic adrenalectomies, is the very rapid resumption of the normal activities in the postoperative course.
CONCLUSIONS:
The laparoscopic adrenalectomy with lateral transperitoneal approach is a safe and efficacious procedure. Therefore, the AA can believe that the laparoscopic approach is at present the gold standard in the treatment of all benign adrenal pathologies with a no more than 8 cm. size
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Antegrade dissection in laparoscopic cholecystectomy
No full textBACKGROUND AND OBJECTIVES:
The aim of this study was to evaluate the usefulness of gallbladder antegrade dissection (GAD) cholecystectomy to reduce the risk of common biliary duct injuries and to demonstrate that it is an easier and more time-sparing technique than the traditional one.
METHODS:
The operative procedure performed since 2002 consists of the incision of the visceral peritoneum from the infundibulum away from Calot's triangle along the gallbladder bed up to the fundus. Then it continues from the fundus up to the infundibulum. This method was used to perform 127 laparoscopic cholecystectomies (LC) (first group). We compared the results of 119 LC (second group) performed from 1998 to 2001 by means of a completely retrograde method.
RESULTS:
In both groups, there were no major complications; 1 vs 4 conversions (0.8% vs 3.4%), mean operative time 70 minutes vs 90 minutes, residual choledocholithiasis in 2 patients in both groups (1.6% for the first group vs 1.7% for the second group).
CONCLUSIONS:
GAD for laparoscopic cholecystectomy can reduce the time of surgery and is an easier technique to perform. Therefore, it can be proposed as the standard procedure and not only be used for difficult cholecystectomies
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