Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
-
J. Gastrointest. Surg. · Feb 2013
Randomized Controlled TrialLength and pressure of the reconstructed lower esophageal sphincter is determined by both crural closure and Nissen fundoplication.
Laparoscopic Nissen fundoplication is comprised of: a wrap thought responsible for the lower esophageal sphincter function and crural closure performed to prevent herniation. We hypothesized gastroesophageal junction competence effected by Nissen fundoplication results from closure of the crural diaphragm and creation of the fundoplication. ⋯ The Nissen fundoplication restores the function of the gastroesophageal junction and thus the reflux barrier by means of two main components: the crural closure and the construction of a 360° fundal wrap. Each of these components is equally important in establishing both increased sphincter length and pressure.
-
J. Gastrointest. Surg. · Feb 2013
Comparative StudyThe management of acute cholecystitis in chronic hemodialysis patients: percutaneous cholecystostomy versus cholecystectomy.
Treatment of acute cholecystitis in chronic hemodialysis (HD) patients still remains controversial. Because of underlying disease that can influence surgical results, less invasive alternative managements have been tried over the last decades. The goal of this study was to analyze the results of cholecystectomy versus percutaneous cholecystostomy for acute cholecystitis (AC) in chronic HD patients. ⋯ This study confirms that the safety and effectiveness of CC has a higher success rate and lower morbidity and mortality rate compared with percutaneous cholecystostomy for acute cholecystitis in chronic HD patients.