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  • 1
    Digitale Medien
    Digitale Medien
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 331-334 
    ISSN: 1432-2218
    Schlagwort(e): Key words: Laparoscopic surgery — Hepatic surgery — Liver — Four-hands technique
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: An effort was made to evaluate the indications, safety, and therapeutic efficacy of laparoscopic liver surgery. Methods: Between 1989 and 1996, 28 patients, 23 to 88 years old were operated upon laparoscopically. Pathology consisted of simple cyst (ten), polycystic liver disease (seven), hydatid cyst (three, two of them calcified), abscess (one), focal nodular hyperplasia (six), and metastatic breast cancer (one). Results: Operations included 17 fenestrations, three pericystectomies, and eight resections (two lateral lobes). Operative time was 45 to 525 min with only four cases longer than 4 h. There was a 21% morbidity rate. There were no mortalities. Follow-up was 1–67 months with one asymptomatic recurrence. Conclusions: Laparoscopic hepatic surgery can be performed safely with good results by surgeons with hepatic and laparoscopic experience when careful selection criteria are followed. We advocate the ``four-hands technique'' for simultaneous dissection and control of bleeding and bile ducts during resections.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 1051-1054 
    ISSN: 1432-2218
    Schlagwort(e): Key words: Surgery-laparoscopic — Vagotomy — Duodenal ulcer — Harmonic shears
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: Results from classic highly selective vagotomy (HSV) are technique dependent because an incomplete operation will result in early recurrence of duodenal ulcer. Few reports describe laparoscopic completion of the procedure. All techniques use clips for division of neurovascular branches, making the laparoscopic approach tedious and thus the results, uncertain. Methods: Ten patients with intractable duodenal ulcer and negative Helicobacter pylori status underwent an extended HSV. All procedures were performed laparoscopically using a new surgical tool, the harmonic shears. Results: All procedures were completed laparoscopically and took approximately 1 h. There were no deaths and no postoperative complications. Patients were discharged the next day. Follow-up endoscopy at 2 months showed healing of duodenal ulcer in all cases, and postoperative acid secretion studies demonstrated a decrease in basal acid output (BAO) by 74% (8.2 meq/h to 2.16 meq/h) and maximal acid output (MAO) by pentagastrin stimulation by 79.2% (40 to 8.32). Conclusions: Harmonic shears expedite laparoscopic HSV. The operation can be taught safely, yields good results in early follow-up, and represents an acceptable option in patients with intractable duodenal ulcers who are H. pylori negative.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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