Laparoscopic technique was used to place peritonesl terminal tube incerebrospinal fluid shunt in six patients with hydrocephalus in our series.Three kinds ofmethods were introduced.The results showed that the laparosc...Laparoscopic technique was used to place peritonesl terminal tube incerebrospinal fluid shunt in six patients with hydrocephalus in our series.Three kinds ofmethods were introduced.The results showed that the laparoscopic fine trocar puncture andsubcutaneous fixation method was the most efficient one.This approach was simple,reliableand less time-consuming.No complications associated with the technique were encountered.展开更多
Objective To investigate the dynamic changes of peritoneal catheter of ventriculoperitoneal shunt (V-P shunt) prospectively,and to determine simple,effective disposal method of peritoneal catheter. Methods From Jan 20...Objective To investigate the dynamic changes of peritoneal catheter of ventriculoperitoneal shunt (V-P shunt) prospectively,and to determine simple,effective disposal method of peritoneal catheter. Methods From Jan 2007 to Oct 2010,consecutive 40 patients with hydrocephalus were treated by V-P shunt. All展开更多
More than five decades after it was originally conceptualized as rescue therapy for patients with intractable variceal bleeding,the transjugular intrahepatic portosystemic shunt(TIPS)procedure continues to remain a fo...More than five decades after it was originally conceptualized as rescue therapy for patients with intractable variceal bleeding,the transjugular intrahepatic portosystemic shunt(TIPS)procedure continues to remain a focus of intense clinical and biomedical research.By the impressive reduction in portal pressure achieved by this intervention,coupled with its minimally invasive nature,TIPS has gained increasing acceptance in the treatment of complications of portal hypertension.The early years of TIPS were plagued by poor long-term patency of the stents and increased incidence of hepatic encephalopathy.Moreover,the diversion of portal flow after placement of TIPS often resulted in derangement of hepatic functions,which was occasionally severe.While the incidence of shunt dysfunction has markedly reduced with the advent of covered stents,hepatic encephalopathy and instances of early liver failure continue to remain a significant issue after TIPS.It has emerged over the years that careful selection of patients and diligent post-procedural care is of paramount importance to optimize the outcome after TIPS.The past twenty years have seen multiple studies redefining the role of TIPS in the management of variceal bleeding and refractory ascites while exploring its application in other complications of cirrhosis like hepatic hydrothorax,portal hypertensive gastropathy,ectopic varices,hepatorenal and hepatopulmonary syndromes,non-tumoral portal vein thrombosis and chylous ascites.It has also been utilized to good effect before extrahepatic abdominal surgery to reduce perioperative morbidity and mortality.The current article aims to review the updated literature on the status of TIPS in the management of patients with liver cirrhosis.展开更多
BACKGROUND Portal vein arterialization(PVA)has been used in liver transplantation(LT)to maximize oxygen delivery when arterial circulation is compromised or has been used as an alternative reperfusion technique for co...BACKGROUND Portal vein arterialization(PVA)has been used in liver transplantation(LT)to maximize oxygen delivery when arterial circulation is compromised or has been used as an alternative reperfusion technique for complex portal vein thrombosis(PVT).The effect of PVA on portal perfusion and primary graft dysfunction(PGD)has not been assessed.All patients receiving PVA and LT at the Fundacion Santa Fe de Bogota between 2011 and 2022 were analyzed.To account for the time-sensitive effects of graft perfusion,patients were classified into two groups:prereperfusion(pre-PVA),if the arterioportal anastomosis was performed before graft revascularization,and postreperfusion(post-PVA),if PVA was performed afterward.The pre-PVA rationale contemplated poor portal hemodynamics,severe vascular steal,or PVT.Post-PVA was considered if graft hypoperfusion became evident.Conservative interventions were attempted before PVA.展开更多
研究先天性脑积水早期分流手术对学习能力的影响。采用分流术组及不实施手术治疗组,用morris水迷宫和旷场观察21 d时各组大鼠的空间学习能力,资料用one and two way AVONA和t-检验分析。在两组实施分流术的脑积水大鼠中,表现未见显著的...研究先天性脑积水早期分流手术对学习能力的影响。采用分流术组及不实施手术治疗组,用morris水迷宫和旷场观察21 d时各组大鼠的空间学习能力,资料用one and two way AVONA和t-检验分析。在两组实施分流术的脑积水大鼠中,表现未见显著的不同,但与脑积水大鼠比较有显著意义。脑积水大鼠早期分流手术能显著提高学习能力,但是早期发生脑积水的一些症状不能逆转。展开更多
文摘Laparoscopic technique was used to place peritonesl terminal tube incerebrospinal fluid shunt in six patients with hydrocephalus in our series.Three kinds ofmethods were introduced.The results showed that the laparoscopic fine trocar puncture andsubcutaneous fixation method was the most efficient one.This approach was simple,reliableand less time-consuming.No complications associated with the technique were encountered.
文摘Objective To investigate the dynamic changes of peritoneal catheter of ventriculoperitoneal shunt (V-P shunt) prospectively,and to determine simple,effective disposal method of peritoneal catheter. Methods From Jan 2007 to Oct 2010,consecutive 40 patients with hydrocephalus were treated by V-P shunt. All
文摘More than five decades after it was originally conceptualized as rescue therapy for patients with intractable variceal bleeding,the transjugular intrahepatic portosystemic shunt(TIPS)procedure continues to remain a focus of intense clinical and biomedical research.By the impressive reduction in portal pressure achieved by this intervention,coupled with its minimally invasive nature,TIPS has gained increasing acceptance in the treatment of complications of portal hypertension.The early years of TIPS were plagued by poor long-term patency of the stents and increased incidence of hepatic encephalopathy.Moreover,the diversion of portal flow after placement of TIPS often resulted in derangement of hepatic functions,which was occasionally severe.While the incidence of shunt dysfunction has markedly reduced with the advent of covered stents,hepatic encephalopathy and instances of early liver failure continue to remain a significant issue after TIPS.It has emerged over the years that careful selection of patients and diligent post-procedural care is of paramount importance to optimize the outcome after TIPS.The past twenty years have seen multiple studies redefining the role of TIPS in the management of variceal bleeding and refractory ascites while exploring its application in other complications of cirrhosis like hepatic hydrothorax,portal hypertensive gastropathy,ectopic varices,hepatorenal and hepatopulmonary syndromes,non-tumoral portal vein thrombosis and chylous ascites.It has also been utilized to good effect before extrahepatic abdominal surgery to reduce perioperative morbidity and mortality.The current article aims to review the updated literature on the status of TIPS in the management of patients with liver cirrhosis.
文摘BACKGROUND Portal vein arterialization(PVA)has been used in liver transplantation(LT)to maximize oxygen delivery when arterial circulation is compromised or has been used as an alternative reperfusion technique for complex portal vein thrombosis(PVT).The effect of PVA on portal perfusion and primary graft dysfunction(PGD)has not been assessed.All patients receiving PVA and LT at the Fundacion Santa Fe de Bogota between 2011 and 2022 were analyzed.To account for the time-sensitive effects of graft perfusion,patients were classified into two groups:prereperfusion(pre-PVA),if the arterioportal anastomosis was performed before graft revascularization,and postreperfusion(post-PVA),if PVA was performed afterward.The pre-PVA rationale contemplated poor portal hemodynamics,severe vascular steal,or PVT.Post-PVA was considered if graft hypoperfusion became evident.Conservative interventions were attempted before PVA.
文摘研究先天性脑积水早期分流手术对学习能力的影响。采用分流术组及不实施手术治疗组,用morris水迷宫和旷场观察21 d时各组大鼠的空间学习能力,资料用one and two way AVONA和t-检验分析。在两组实施分流术的脑积水大鼠中,表现未见显著的不同,但与脑积水大鼠比较有显著意义。脑积水大鼠早期分流手术能显著提高学习能力,但是早期发生脑积水的一些症状不能逆转。
