AIM: To present our clinical experience with gallbladder perforation cases. METHODS: Records of 332 patients who received medical and/or surgical treatment with the diagnosis of acute cholecystitis in our clinic betwe...AIM: To present our clinical experience with gallbladder perforation cases. METHODS: Records of 332 patients who received medical and/or surgical treatment with the diagnosis of acute cholecystitis in our clinic between 1997 and 2006 were reviewed retrospectively. Sixteen (4.8%) of those patients had gallbladder perforation. The parameters including age, gender, time from the onset of symptoms to the time of surgery, diagnostic procedures, surgical treatment, morbidity, and mortality were evaluated. RESULTS: Seven patients had typeⅠgallbladder perforation, 7 type Ⅱ gallbladder perforation, and 2 type Ⅲ gallbladder perforation according to Niemeier’ s classification. The patients underwent surgery after administration of intravenous electrolyte solutions, and were treated with analgesics and antibiotics within the first 36 h (mean 9 h) after admission. Two patients died of sepsis and multiple organ failure in the early postoperative period. Subhepatic abscess, pelvic abscess, pneumonia, pancreatitis, and acute renal failure were found in 6 patients. CONCLUSION: Early diagnosis and emergency surgical treatment of gallbladder perforation are of crucial importance. Upper abdominal computerized tomography for acute cholecystitis patients may contribute to the preoperative diagnosis of gallbladder perforation.展开更多
AIM:To compare the results of the anoscope of the PPH kit and a modified anoscope during stapled haemorrhoidopexy. METHODS:The hospital records of 37 patients who underwent stapled haemorrhoidopexy between 2001 and 20...AIM:To compare the results of the anoscope of the PPH kit and a modified anoscope during stapled haemorrhoidopexy. METHODS:The hospital records of 37 patients who underwent stapled haemorrhoidopexy between 2001 and 2006 were reviewed.The purse-string suture anoscope in the PPH kit was used on 15 patients(Group 1), and the modified anoscope was used on 22 patients (Group 2).Demographic characteristics of the patients, operation time,surgeon's performance,analgesic requirement,and complications were compared. RESULTS:Operation time was significantly longer in Group 1(42.0±8.4 min vs 27.7±8.0 min,P=0.039). The surgeons reported their operative performance as significantly better in Group 2(the results of the assessments were poor in ten,medium in four and good in one in Group 1,while good in all patients in Group 2,P<0.001).The need for haemostatic sutures was significantly higher in Group 1(six cases)and was needed in two cases in Group 2(P=0.034). CONCLUSION:Operation time decreased and thesurgeon's satisfaction increased with use of the modified anoscope,and fewer haemostatic sutures were required if the surgeon waited longer before and after firing the stapler.展开更多
文摘AIM: To present our clinical experience with gallbladder perforation cases. METHODS: Records of 332 patients who received medical and/or surgical treatment with the diagnosis of acute cholecystitis in our clinic between 1997 and 2006 were reviewed retrospectively. Sixteen (4.8%) of those patients had gallbladder perforation. The parameters including age, gender, time from the onset of symptoms to the time of surgery, diagnostic procedures, surgical treatment, morbidity, and mortality were evaluated. RESULTS: Seven patients had typeⅠgallbladder perforation, 7 type Ⅱ gallbladder perforation, and 2 type Ⅲ gallbladder perforation according to Niemeier’ s classification. The patients underwent surgery after administration of intravenous electrolyte solutions, and were treated with analgesics and antibiotics within the first 36 h (mean 9 h) after admission. Two patients died of sepsis and multiple organ failure in the early postoperative period. Subhepatic abscess, pelvic abscess, pneumonia, pancreatitis, and acute renal failure were found in 6 patients. CONCLUSION: Early diagnosis and emergency surgical treatment of gallbladder perforation are of crucial importance. Upper abdominal computerized tomography for acute cholecystitis patients may contribute to the preoperative diagnosis of gallbladder perforation.
文摘AIM:To compare the results of the anoscope of the PPH kit and a modified anoscope during stapled haemorrhoidopexy. METHODS:The hospital records of 37 patients who underwent stapled haemorrhoidopexy between 2001 and 2006 were reviewed.The purse-string suture anoscope in the PPH kit was used on 15 patients(Group 1), and the modified anoscope was used on 22 patients (Group 2).Demographic characteristics of the patients, operation time,surgeon's performance,analgesic requirement,and complications were compared. RESULTS:Operation time was significantly longer in Group 1(42.0±8.4 min vs 27.7±8.0 min,P=0.039). The surgeons reported their operative performance as significantly better in Group 2(the results of the assessments were poor in ten,medium in four and good in one in Group 1,while good in all patients in Group 2,P<0.001).The need for haemostatic sutures was significantly higher in Group 1(six cases)and was needed in two cases in Group 2(P=0.034). CONCLUSION:Operation time decreased and thesurgeon's satisfaction increased with use of the modified anoscope,and fewer haemostatic sutures were required if the surgeon waited longer before and after firing the stapler.
