The European journal of surgery = Acta chirurgica
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To report our experience in the management of accidental injuries to the structures of the hepatoduodenal ligament. ⋯ Blunt injuries to the hepatoduodenal ligament are easily overlooked, leading to delayed morbidity. Complete transsections of the bile duct are best managed by choledochojejunostomy with a Roux-en-Y loop; T tube choledochostomy is usually sufficient when treating small partial lesions of lobar bile ducts; and most non-circumferential vascular lesions are best treated by suture.
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To describe our experience in the diagnosis and treatment of haematoma of the rectus abdominis. ⋯ The single most important factor in the diagnosis of haematoma of the rectus abdominis is awareness of its existence; it should be included as a differential in all patients who present with an acute abdomen. Once the diagnosis has been confirmed (by ultrasonography or computed tomography) patients should be treated conservatively as those that are operated on are at risk of developing complications.
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To assess the feasibility and morbidity of laparoscopic appendicectomy. ⋯ Laparoscopic appendicectomy is safe, the stay in hospital is short, patients recover quickly, with little pain and the cosmetic result is good.
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To identify the contribution of necropsy results to the audit care of severely injured patients. ⋯ Necropsies in patients who die after severe injuries make a useful contribution to the audit of the care of patients admitted with such injuries.
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Randomized Controlled Trial Clinical Trial
Effect of tissue perfusion and oxygenation on accumulation of collagen in healing wounds. Randomized study in patients after major abdominal operations.
To compare the accumulation of collagen in standardised wounds in patients who had abdominal operations and whose postoperative fluid replacement was decided either clinically or by measurements of subcutaneous oxygen tension (PscO2). ⋯ Replacement of fluid according to measurements of PscO2 rather than by clinical criteria results in improved accumulation of collagen in healing wounds.