Hepato Gastroenterol
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Hepato Gastroenterol · Jan 2009
Comparative StudyEvaluation of early versus delayed laparoscopic cholecystectomy in the treatment of acute cholecystitis.
The optimal timing of laparoscopic cholecystectomy (LC) in the treatment of acute cholecystitis remains controversial. This retrospective study was undertaken to assess the clinical outcomes, possible advantages and disadvantages of early versus delayed LC for acute cholecystitis. ⋯ Both early and delayed LC appears to be effective and safe in the treatment of acute cholecystitis. Early LC may be more technically demanding and time-consuming, and may be associated with a higher rate of wound infections; however, it also tends to shorten the total length of hospital stay and reduce the risk of repeat cholecystitis. We recommend early LC for acute cholecystitis comparison with delayed LC.
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Hepato Gastroenterol · Jan 2009
Prognostic re-evaluation of peritoneal lavage cytology in Japanese patients with gastric carcinoma.
The aim of the present study was to re-evaluate CY(+) with gastric carcinoma in Japanese patients to identify the characteristics that might distinguish patients with a poor prognosis from those with an intermediate prognosis among CY(+) patients. ⋯ Gastric carcinoma with CY(+) has a poor prognosis because it is associated with non-curative factors, peritoneal dissemination, and liver or lymph nodes metastases. However, a small subpopulation of patients with P(-)CY(+) showed an intermediate prognosis.
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Hepato Gastroenterol · Jan 2009
Management and mid- to long-term results of early referred bile duct injuries during laparoscopic cholecystectomy.
Bile duct injuries (BDI) usually need operative repair and remain as a challenge even for surgeons who specialize in hepatobiliary surgery. The objective of this study was to define the presentation, in-hospital management, and mid- to long-term outcome of BDIs during laparoscopic cholecystectomy (LC) referred to a tertiary center in their early period. ⋯ Minor BDIs can be satisfactorily treated with endoscopic interventions. Extended lateral injuries, complete CBD transsections, and long segment stenosis usually require surgical therapy. Duct-to-duct anastomosis may be an option as the first-line therapy in selected patients after early referral, though many patients eventually require a Roux-en-Y hepaticojejunostomy.