Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Jun 2009
Case ReportsDirect percutaneous endoscopic duodenostomy: a case report.
A 78-year-old male, who had undergone left upper lobectomy because of traumatic pulmonary contusion at the age of 25 years, succumbed to left hemiplegia with impaired consciousness that was caused by right putaminal hemorrhage. Aspiration pneumonia was complicated and he was set on tracheostomy and tube feeding through a nasogastric tube. Although it was apparent that enteral nutrition through the percutaneous endoscopic gastrostomy was appropriate for him, performing a percutaneous endoscopic gastrostomy seemed impossible as the computed tomography revealed that the elevated stomach was located behind the heart. In this patient, we successfully performed a direct percutaneous endoscopic duodenostomy without any complication.
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Surg Laparosc Endosc Percutan Tech · Jun 2009
Randomized Controlled Trial Comparative StudyA prospective randomized, controlled study comparing low pressure versus high pressure pneumoperitoneum during laparoscopic cholecystectomy.
The increase in intra-abdominal pressure by insufflation of carbon dioxide during laparoscopy brings certain changes in function of organ systems and also leads to postoperative pain. Degree of intra-abdominal pressure is directly related with such change. Laparoscopic cholecystectomy can be performed at low pressure pneumoperitoneum. However, available space for dissection is less than the high pressure pneumoperitoneum. ⋯ An uncomplicated gall stone disease can be treated by low pressure laparoscopic cholecystectomy with reasonable safety by an experienced surgeon. Though surgeons experience more difficulty in dissection during low pressure pneumoperitoneum, it is significantly advantageous in terms of postoperative pain, use of analgesics, preservation of pulmonary function, and hospital stay.