Medicine
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One of the most important reasons for avoiding percutaneous transhepatic gall bladder drainage (PTGBD) is the deterioration of quality of life (QOL). However, there is no study comparing the QOL between primary laparoscopic cholecystectomy (LC) and LC following PTGBD. Among the LC patients, 69 non-PTGBD patients and 21 PTGBD patients were included after excluding the patients with malignant disease or who needed additional common bile duct procedures. ⋯ Comparative analysis of the 2 groups showed no significant difference in global heath scale either preoperative or postoperatively, while the functional scale and emotional scale were better in the PTGBD group compared to the non-PTGBD group. Regarding the symptom scale, postoperative dyspnea and perioperative diarrhea were better in the PTGBD group. LC following an interval from earlier PTGBD that targets acute cholecystitis or complicated GB had little to no impact on QOL when compared to standard LC.
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Postoperative thoracogastric necrosis (TGN) associated with thoracogastric-tracheal fistula (TGTF) of an endoscopic McKeown-type resection of esophageal carcinoma is rare and has a poor prognosis and high mortality. Few cases have been reported and successful treatment is rare. Surgery is the major treatment option. ⋯ Staging surgery can be an alternative treatment for TGN associated with TGTF of an endoscopic McKeown-type resection of esophageal carcinoma.
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Here, we describe a series of 7 patients who presented with acute paraparesis due to anterior communicating artery aneurysm rupture. This study aimed to assess the clinical and radiological factors associated with acute paraparesis syndrome caused by subarachnoid hemorrhage (SAH). Between June 2005 and December 2012, our institution consecutively treated 210 patients with anterior communicating aneurysm rupture within 24 hours after ictus. ⋯ The presence of acute hydrocephalus (P = .001) and GCE (P = .003) were significantly different between the groups. Acute paraparesis syndrome after SAH is transient and gradually improves if the patient does not develop severe vasospasm. The present study demonstrates that acute paraparesis after SAH is associated with acute hydrocephalus and GCE.