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  • Intrathoracic stomach  (1)
  • Key words: Laparoscopic ultrasound—Intraoperative cholangiogram—Digital fluorocholangiogram—Laparoscopic cholecystectomy—Choledocholithiasis  (1)
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  • 1
    Electronic Resource
    Electronic Resource
    A comparison of laparoscopic ultrasound with digital fluorocholangiography for detecting choledocholithiasis during laparoscopic cholecystectomy (1998)
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 929-932 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopic ultrasound—Intraoperative cholangiogram—Digital fluorocholangiogram—Laparoscopic cholecystectomy—Choledocholithiasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Laparoscopic ultrasound is an alternative to operative cholangiogram for evaluation of the common bile duct (CBD) during laparoscopic cholecystectomy. It is a safe, fast, and reliable method for detecting choledocholithiasis. Methods: We prospectively evaluated the sensitivity and specificity of laparoscopic ultrasound (LUS) and digital fluorocholangiogram (DFCG) in a three-phase study of 360 consecutive patients. Results: In phase I, 140 patients undergoing laparoscopic cholecystectomy had LUS performed first, followed by DFCG. Thirteen patients had CBD calculi identified on LUS. Four patients with confirmed (two cases) or presumed (two cases) CBD calculi on DFCG were not identified on LUS. Thus, the specificity of LUS was 100%, whereas the sensitivity was 76.5%. DFCG had four false positives, for a sensitivity of 100% with a specificity of 96.7%. LUS was performed, on average, in 6.6 min, whereas DFCG required 10.9 min to perform. In phase II, the infusion of saline through a cystic duct catheter was performed in instances where the distal CBD could not be well seen. This maneuver distended the intrapancreatic portion of the CBD, allowing better visualization. Nine stones were identified on LUS in 78 patients, increasing the sensitivity to 100%. One false positive DCFG was encountered, resulting in a sensitivity of 100% and a specificity of 98.6%. In phase III, we performed routine LUS and used DFCG only in select cases. The sensitivity and specificity for LUS were 95.7% and 100%, respectively, whereas DFCG had a sensitivity of 95.2% and a specificity of 100%. One patient in phase III has returned 11 months post-op with a CBD stone. This was initially missed on LUS, DFCG, and postoperative ERCP. The sensitivity and specificity in all 360 patients were 90% and 100% for LUS and 98.1% and 98.1% for DFCG, respectively. A total of five CBD stones were missed by LUS, four early in the study (phase I). One missed on LUS in phase III was also missed by DFCG and ERCP. Conclusions: LUS is a reliable alternative to DFCG during laparoscopic cholecystectomy (LC). With experience, it is as sensitive as DFCG and more specific. It is more rapidly performed than cholangiography.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900749
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    194. Zur Funktion des thorakalen Magens: Pyloroplastik oder nicht? (1987)
    Springer
    Langenbeck's archives of surgery 372 (1987), S. 845-846 
    Details
    ISSN: 1435-2451
    Keywords: Intrathoracic stomach ; 24 h pH measurement ; Gastric drainage ; Intrathorakaler Magen ; 24 h pH-Metrie ; Drainageoperation des Magens
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 11 Patienten mit einer distalen Resektion des Oesophagus und einer Oesophagogastrostomie in Höhe der Trachealbifurkation (n = 5) und einer transabdominalen subtotalen Oesophagektomie ohne Thoracotomie (n = 6) wurden untersucht. Es wurden keine Drainageoperationen ausgeführt. 6 Patienten hatten ein Plattenepithel-, 3 ein Adenocarcinom des Oesophagus, 2 ein Kardiacarcinom. Die Patienten wurden endoskopisch bis zu 8mal untersucht, jeder Patient hatte mindestens ein postop. CT, 4 Patienten wurden 24 h pH-metriert. 7 Patienten hatten eine Oesophagitis, 5 eine Gastritis. Obwohl die Mehrzahl der Patienten Speisereste im Magen zeigte, wurde bei keinem tumorfreien Patienten eine Magenausgangsstenose beobachtet. Eine primäre Drainageoperation des Magens halten wir daher für nicht indiziert.
    Notes: Summary Eleven patients with distal resection of the esophagus and esophagogastrostomy at the level of the tracheal bifurcation (n = 5), as well as transhiatal esophagectomy without thoracotomy (n = 6), were studied. No drainage procedures were carried out. Three patients had an adenocarcinoma and 6 squamous cell carcinoma of the esophagus. Two patients presented with carcinoma of the cardia. The patients were examined endoscopically up to 8 times. In each patient at least one postoperative CAT scan was carried out; pH was measured for 24 h in 4 patients. Seven had esophagitis and 5 had gastritis of various degrees. Although the majority of the patients had food remains in the stomach, no gastric outlet stenosis was observed. Thus a primary gastric drainage operation is not necessary.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01297978
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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