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  • 1
    Electronic Resource
    Electronic Resource
    Diagnostic laparoscopy: Reducing the number of normal appendectomies (1993)
    Springer
    Diseases of the colon & rectum 36 (1993), S. 763-766 
    Details
    ISSN: 1530-0358
    Keywords: Appendicitis ; Diagnostic laparoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A prospective, controlled study was conducted to determine whether a selective policy of diagnostic laparoscopy could reduce the number of unnecessary normal appendectomies in patients with acute right iliac fossa pain. The cohort consisted of patients admitted with acute right iliac fossa pain by the emergency department. Of 102 patients in the study group, 28 subsequently required a diagnostic laparoscopy when a definite diagnosis could not be reached after 8 to 12 hours of observation. Of these, only 18 had inflamed appendices, which were removed. In the rest of the patients (10), the appendices were normal and unnecessary laparotomies were avoided. In the control group, wherein equivocal cases were laparotomized after a similar period of observation, there was a normal appendectomy rate of 15.7 percent (P〈0.05). There was no significant difference in the incidence of perforation between the control and study groups. Diagnostic laparoscopy in equivocal cases could thus significantly reduce the number of unnecessary appendectomies without compromising on the rate of perforation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02048368
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  • 2
    Electronic Resource
    Electronic Resource
    Comparison between laparoscopic and conventional omental patch repair for perforated duodenal ulcer (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 1060-1063 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopic omental patch repair — Perforated duodenal ulcer — Conventional omental patch repair
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The aim of the study is to evaluate the safety and efficacy of laparoscopic omental patch repair. Method: This is a retrospective review of 53 consecutive patients with omental patch repair for perforated duodenal ulcer; 38 underwent conventional open approach and 15 underwent laparoscopic patch repair. The only selection criterion was availability of expertise for laparoscopic repair on the day of admission. By chance, the open group had poorer ASA scores. There were four deaths and five postoperative complications in the open group. Results: Laparoscopic repair was successful in 14 cases with one postoperative complication. Operative time was longer in the laparoscopic group (80 vs 65 min in open group, p= 0.02). Patients required less postoperative analgesics in the laparoscopic group (median amount of pethidine was 75 mg vs 175 mg in the open group, p= 0.03). There was no statistically significant difference in terms of hospital stay and return to normal activities between the two procedures. Follow-up Visick scores were comparable in both groups. Conclusions: Laparoscopic omental patch repair offers a safe alternative to the conventional method and causes less postoperative pain.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900240
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  • 3
    Electronic Resource
    Electronic Resource
    The E.A.E.S. Consensus development conferences on laparoscopic cholecystectomy, appendectomy, and hernia repair (1995)
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 550-563 
    Details
    ISSN: 1432-2218
    Keywords: Consensus development conferences ; Laparoscopic cholecystectomy ; Laparoscopic appendectomy ; Laparoscopic inguinal hernia repair
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Under the mandate of the Educational Committee of the European Association of Endoscopic Surgery (E.A.E.S.), three consensus development conferences (CDCs) were performed in order to assess the current status of the endoscopic surgical approaches for the treatment of cholelithiasis, appendicitis, and inguinal hernia. Consensus panels for the different disease states (10–13 members each) selected by the education committee on the basis of members' clinical expertise, academic activity, community influence, and geographical location weighed the evidence on the basis of published results according to the criteria for technology assessment: feasibility, efficacy, effectiveness, economy. Draft statements were prepared, discussed by the panels, and presented at plenary sessions of the 2nd European Congress of the E.A.E.S. in Madrid September 15–17, 1994. Following discussions final consensus statements were formulated to provide specific answers for each topic to a minimum of the following questions: 1. What stage of technological development is the endoscopic surgical procedure at (in September 1994)? 2. Is endoscopic surgery safe and feasible? 3. Is it beneficial to the patients? 4. Who should undergo endoscopic surgery? 5. What are the training recommendations? Laparoscopic cholecystectomy is the procedure of choice for symptomatic cholelithiasis. Laparoscopic appendectomy is presently at the efficacy stage of development, because most of the data on feasibility and safety originate from centers with special interest in endoscopic surgery: it is not yet the gold standard for acute appendicitis. Endoscopic hernia repair is presently a feasible alternative for conventional hernia repair if performed by experienced endoscopic surgeons. It appears to be efficacious in the short-term. The full text of the consensus panel's statements is given in this publication.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00206852
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  • 4
    Electronic Resource
    Electronic Resource
    Early international results of laparoscopic gastrectomies (1997)
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 650 -652 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopic gastrectomy — International results — Questionnaire survey
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The first totally laparoscopic Billroth II gastrectomy was performed in 1992. To date, laparoscopic gastrectomy has been performed by a small number of surgeons around the world and the laparoscopic approach has been extended to Billroth I and total gastrectomy. The aim of this study is to review the state of laparoscopically performed gastrectomies in the international scene. Methods: Questionnaires were prepared and sent to every surgeon in the world known by the authors or their contacts to have performed a laparoscopic gastrectomy. A questionnaire survey was started in July 1994 and completed by November 1994. Data collected included age, sex, type of gastric resection, technique of reconstruction after resection, average duration of surgery, time to liquid and solid intake, postoperative hospital stay, complications, and opinions of the surgeons. Results: Sixteen surgeons contributed to this study. A total number of 118 cases of laparoscopic gastrectomies, comprising Billroth I (11), Billroth II (87), vagotomy and antrectomy (10), and total gastrectomy (10) had been performed. The indications were gastric and/or duodenal ulcers and benign and malignant gastric tumors. Conclusions: Laparoscopic gastrectomy was found to be superior to the open technique by 10 of 16 surgeons because of faster recovery, less pain, and better cosmesis. The procedure was an expensive and long operation according to four. Two surgeons were uncertain of any benefit because of limited experience.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900413
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  • 5
    Electronic Resource
    Electronic Resource
    Laparoscopic antireflux surgery for gastroesophageal reflux disease (GERD) (1997)
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 413 -426 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Consensus development conferences — Laparoscopic antireflux operations — Outcome assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Laparoscopic antireflux surgery is currently a growing field in endoscopic surgery. The purpose of the Consensus Development Conference was to summarize the state of the art of laparoscopic antireflux operations in June 1996. Methods: Thirteen internationally known experts in gastroesophageal reflux disease were contacted by the conference organization team and asked to participate in a Consensus Development Conference. Selection of the experts was based on clinical expertise, academic activity, community influence, and geographical location. According to the criteria for technology assessment, the experts had to weigh the current evidence on the basis of published results in the literature. A preconsensus document was prepared and distributed by the conference organization team. During the E.A.E.S. conference, a consensus document was prepared in three phases: closed discussion in the expert group, public discussion during the conference, and final closed discussion by the experts. Results: Consensus statements were achieved on various aspects of gastroesophageal reflux disease and current laparoscopic treatment with respect to indication for operation, technical details of laparoscopic procedures, failure of operative treatment, and complete postoperative follow-up evaluation. The strength of evidence in favor of laparoscopic antireflux procedures was based mainly on type II studies. A majority of the experts (6/10) concluded in an overall assessment that laparoscopic antireflux procedures were better than open procedures. Conclusions: Further detailed studies in the future with careful outcome assessment are necessary to underline the consensus that laparoscopic antireflux operations can be recommended.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900382
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  • 6
    Electronic Resource
    Electronic Resource
    Predictive factors for synchronous common bile duct stones in patients with cholelithiasis (1997)
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 928 -932 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Predictive factors — Synchronous common bile duct stones — Cholelithiasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: To determine the predictive factors of synchronous common bile duct (CBD) stones, data from 878 consecutive patients who underwent cholecystectomy in a university clinic from June 1991 to June 1996 were retrospectively analyzed. Methods: Based on clinical, biochemical, and ultrasonographic criteria, 194 patients were selected for ERCP, 180 preoperative and 14 postoperative. Results: Cannulation of CBD was successful in 192 (99%) patients. Stones were identified in 62 (32%) patients and sphincterotomy was performed in 56 (90%). Duct clearance was achieved in 43 (77%) cases. There was a high predictive value for the presence of CBD stones in patients with cholangitis, present jaundice, and dilated CBD with evidence of stones on ultrasound (75%, 72%, and 67% respectively). A dilated CBD without stone on ultrasound and elevated liver enzymes had less than 40% positive predictive value. History of previous jaundice, pancreatitis, previously raised liver enzymes, and present pancreatitis was predictive in less than 20% of the cases. Univariate analyses revealed that clinical findings of cholangitis and obstructive jaundice, elevated liver enzymes (previous and present), and ultrasonographic findings of stones in a dilated CBD were significant positive predictors. Subanalysis of each elevated liver enzyme revealed that alanine transaminase, aspartate transaminase, alkaline phosphatase, and gamma glutamyl transpeptidase were significant predictors. Both elevated conjugated and total bilirubins were also significant predictors for CBD stones. Conclusion: Multivariate logistic regression analysis on these significant predictors showed that cholangitis (odds ratio [OR]: 10.5), dilated CBD with evidence of stones on ultrasound (OR: 7.4), elevated aspartate transaminase (OR: 2.9), and conjugated bilirubin (OR: 5.3) were jointly significant. The likelihood of having stones in the duct without any of these predictors was 7%, but 99% when all the predictors were positive.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900489
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  • 7
    Electronic Resource
    Electronic Resource
    Endoscopic patch closure of malignant esophagotracheal fistula using Histoacryl glue (1994)
    Springer
    Surgical endoscopy and other interventional techniques 8 (1994), S. 1434-1435 
    Details
    ISSN: 1432-2218
    Keywords: Esophagotracheal fistula ; Endoscopy ; Patch closure ; Histoacryl glue
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Esophagotracheal fistula is one sequel of advanced carcinoma of the esophagus. Although the pneumatic cuffed tracheoesophageal fistula stent provides satisfactory palliation for fistulas, high fistulas remain a major problem. We report a case of a 64-year-old gentleman with a high fistula that was treated successfully with endoscopic patch closure using Histoacryl glue.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00187353
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  • 8
    Electronic Resource
    Electronic Resource
    Needlescopic or minisite cholecystectomy (1999)
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 303-305 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Minisite cholecystectomy — Needlescopic cholecystectomy — Gallstone disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Needlescopic or minisite cholecystectomy is laparoscopic cholecystectomy done through tiny ports from 1.4 mm to 3 mm in size. This refinement of conventional laparoscopic cholecystectomy reduces further the invasiveness of the operation and gives an improved cosmetic effect. This series describes the result of 36 needlescopic cholecystectomies done between February 1996 and April 1997. Patients with acute cholecystitis were excluded. There were two conversions to conventional laparoscopic surgery and no conversions to open surgery. Thirty-four patients were successfully treated by this technique. Analgesic consumption and cosmetic result was superior compared to a previous published series of conventionally done cases in the same department.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900971
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    Paper (German National Licenses)
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