Endoscopy
-
Randomized Controlled Trial Clinical Trial
A randomised controlled trial to evaluate the effects of flumazenil after midazolam premedication in outpatients undergoing colonoscopy.
The degree of sedation and amnesia, subjective assessment of awakening and side effects after intravenous injection of 3-4 mg midazolam and 1 mg flumazenil or placebo were studied directly after colonoscopy, and on the first and the eight day. A total of 91 patients were studied; 45 patients were given flumazenil and 46 patients a placebo. Five minutes after injection of the test drugs all 45 patients given flumazenil but only 38 patients given the placebo were alert (p = 0.006). ⋯ However, resedation due to the effects of midazolam may occur. Flumazenil thus permits administration of a higher dose of midazolam without prolongation of the surveillance time. Improved exploitation of time, space and nursing resources is thus possible without jeopardizing patient safety, although caution is necessary since patients may not be fit to resume all normal activities.
-
Case Reports
Septic shock and bacteremia associated with laparoscopic guided liver biopsy, report on two cases.
Two cases of infectious complications after liver biopsy are reported. Klebsiella pneumoniae and beta-hemolytic Streptococcus were cultured. ⋯ A 67-year-old man with hepatic fibrosis suffered from transient bacteremia and recovered uneventfully after antibiotic therapy. In these patients, there was evidence to implicate pre-existing cholangitis as factor predisposing to postbiopsy bacteremia.
-
In a total of 8,400 laparoscopies performed over a period of 16 years, 42 cases of tuberculous peritonitis (0.5%) were diagnosed. Free ascites with multiple yellowish-white nodules in the peritoneum, thickening and hyperemia and retraction of the greater omentum were found in 35 cases. ⋯ Tuberculous peritonitis was found to be associated with genital tuberculosis in 3 women, with hepatic tuberculosis in 2 cases, and with renal and hepatic tuberculosis in 1 case. Laparoscopic diagnosis was confirmed by intralaparoscopic biopsy in all cases.
-
The selective cannulation of the intrahepatic branches of the biliary system is made possible by the use of torsion-stabilized angiographic catheters passed via short-channel duodenoscopes. Other feasible applications are the endoscopic selective positioning of biliary endoprosthesis, and the cannulation of the gall bladder using a cysto-nasal catheter through which a litholytic fluid can be installed directly into the gall bladder.