Laparoscopic cholecystectomy using intracorporeal lithotripsy

Article Abstract:

Cholecystectomy (removal of the gallbladder) is the most efficient treatment for gallstones. Traditionally, gallbladder removal is performed through an upper abdominal incision. But a new technique, laparoscopic cholecystectomy, is a minimally invasive procedure which avoids the discomfort of major abdominal surgery and permits a shorter and less painful recovery. Several small incisions are made, through which a laparoscope (instrument used to visualize internal organs) and trocars (sharply pointed tubes) fitted with forceps or other surgical instruments are inserted. Under laparoscopic visualization, the gallbladder is removed. A report is presented of laparoscopic cholecystectomies performed over a 13-month period on 104 patients. The average patient age was 37. Three procedures were begun as laparoscopic procedures but required open operation due to hemorrhage with unanticipated findings of liver cirrhosis (two patients) and dense liver adhesions (one patient). Three other patients were found to have common bile duct stones; these were successfully treated with ERCP or endoscopic retrograde cholangiopancreatography (imaging of the bile ducts and pancreas). There were only three complications encountered in the 104 procedures performed: one biliary fistula, and two abscesses. No patients died. Ultrasonic lithotripsy (crushing of gallstones using ultrasonic waves) was carried out on 61 patients; their postoperative course did not differ from that of patients who underwent simple gallbladder removal. Laparoscopic cholecystectomy is less aggressive than the traditional procedure, and avoids the morbidity that results from laparotomy, or opening the abdominal wall. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Methods, Surgery, Gallstones, Abdomen, Laparotomy, Laparoscopy, Lithotripsy, Biliary tract Radionuclide imaging

---

Stunned myocardium during extracorporeal membrane oxygenation

Article Abstract:

Stunned myocardium is a reversible syndrome involving the abnormal function of the heart muscle (myocardium). The syndrome may occur as a result of severe coronary insufficiency followed by reperfusion of the heart. Stunned myocardium has also been seen following cardiopulmonary bypass. Cardiopulmonary bypass, or extracorporeal membrane oxygenation (ECMO) is a procedure used to oxygenate the blood; the venous blood is diverted outside the body to a heart-lung machine. Stunned myocardium may be caused by oxygen-derived free radicals that act as mediators of the reperfusion injury. Oxygen-derived free radicals are very reactive and directly attack cell membranes; therefore, an early rise in lipid peroxide would be expected if this were the primary cause of the heart dysfunction. A study of 16 newborns undergoing ECMO was undertaken. These infants were evaluated by echocardiogram, and levels of serum creatinine phosphokinase (CPK-mb) isoenzymes and lipid peroxide were measured. Six infants showed echocardiographic evidence of stunned myocardium during the cardiopulmonary bypass. This occurred shortly after the bypass was commenced, and there were concurrent elevations of CPK-mb fraction, but lipid peroxide levels did not rise. It is concluded that oxygen-derived free radicals may not be the cause of stunned myocardium. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Physiological aspects, Blood oxygenation, Extracorporeal, Extracorporeal membrane oxygenation, Free radicals (Chemistry), Free radicals, Heart muscle, Myocardium, Cardiopulmonary bypass

---

Extracorporeal shock-wave lithotripsy of renal calculi

Article Abstract:

Extracorporeal shock-wave lithotripsy (ESWL) is a noninvasive technique that utilizes focused shock waves to reduce kidney stones into sand-sized particles, which then are spontaneously passed from the body through urination. Chaussy and associates introduced the clinical use of this technique in 1980 in Germany and it has since replaced most open surgery for stone removal. A discussion of physics of shock waves, equipment, techniques, and patient selection in ESWL is presented. A review and comparison of the results of treatment of small calculi, or concentrations of mineral salts in the kidney, upper urethra, and lower urethra is also presented.

Evaluation, Kidney stones, Ultrasonic lithotripsy

Similar abstracts:

• Abstracts: Cataracts and inhaled corticosteroids. Bone loss accompanying medical therapies. Effects of inhaled glucocorticoids on bone density in premenopausal women
• Abstracts: Impaired action of thyroid hormone associated with smoking in women with hypothyroidism. Maternal-fetal transfer of thyroxine in congenital hypothyroidism due to a total organification defect or thyroid agenesis
• Abstracts: Carotid endarterectomy in a community hospital: a change in physicians' practice patterns. Comparison of regional and general anesthesia for carotid endarterectomy
• Abstracts: Influence of clerkship structure and timing on individual student performance. Reliability of different grading systems used in evaluating surgical students

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.