Langenbeck's archives of surgery
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Langenbecks Arch Surg · Nov 2002
Clinical TrialThe use of polypropylene mesh in midline incision closure following gastric by-pass surgery reduces the risk of postoperative hernia.
Incisional hernia is a common problem following Roux-en-Y gastric bypass for morbid obesity. ⋯ In our opinion prophylactic use of polypropylene mesh in bariatric patients is highly effective in postoperative hernia prevention.
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Langenbecks Arch Surg · Nov 2002
Surgical management of bile duct injuries following laparoscopic cholecystectomy: analysis and follow-up of 28 cases.
Biliary tract lesions pose a dreaded complication of laparoscopic cholecystectomy. In a retrospective study we analyzed the clinical presentation, diagnostic and therapeutic management and outcome of 28 patients presenting with iatrogenic bile duct injuries. ⋯ Major iatrogenic bile duct injuries are associated with high morbidity and prolonged hospitalization. Interdisciplinary cooperation and early referral to an experienced center is crucial in the management of patients suffering from this affliction. Cholangitis is a marked problem in the follow-up.
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Langenbecks Arch Surg · Nov 2002
Morbidity and mortality of perforated peptic gastroduodenal ulcer following emergency surgery.
This study assessed the surgical concept and prognosis of perforated gastroduodenal ulcers. ⋯ Prognosis of perforated ulcer disease is highly correlated with age, comorbid conditions (ASA status), and time of surgery. The proposed classification system helps to determine patients at risk of mortality.
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Langenbecks Arch Surg · Nov 2002
Clinical Trial Controlled Clinical TrialPerioperative effects of hepatic resection surgery on hemodynamics, pulmonary fluid balance, and indocyanine green clearance.
Major liver resection is a routine surgical treatment, but hemodynamic and pulmonary complications are common. We investigated the effects of hepatic resection on hemodynamics and pulmonary and liver function. ⋯ After liver resection the physiological response resulted in elevated cardiac output and moderate pulmonary edema. Dynamic liver function was elevated within 24 h due to an increase in perfusion and regeneration activity of the remaining parenchyma.
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Langenbecks Arch Surg · Jul 2002
Treatment of complex proximal humeral fractures with minimally invasive fixation of the humeral head combined with flexible intramedullary wire fixation - introduction of a new treatment concept.
The treatment of three- or 4-part proximal humerus fractures is still a matter of scientific discussion. The following study presents the results of a combined procedure using limited invasive fixation techniques for reconstruction of the humerus head and retrograde intramedullary wiring with elastic nails for the treatment of displaced three- or 4-part fractures. A prospective study of 24 patients with 3-part and 4-part fractures was performed from September 1995 to December 1998. ⋯ Forty-five percent had satisfactory and 15% unsatisfactory results. The initial results of this study reveal that a combination of limited internal fixation of the humerus head and retrograde elastic intramedullary wiring provide stable fixation with limited soft-tissue destruction. This approach has been shown to be especially useful for the combined treatment of three- or four-part fractures of the humeral head.