RESUMEN
The one-staged subtotal/total colectomy with formation of primary ileo-sigmoanastomosis or ileo-rectal anastomosis is applied in tumoral left colonic ileus. There were estimated immediate results and the role of the method in the treatment of 46 patients with left colonic obstructive tumor. Postoperative complications had occurred in 52% of the patients, postoperative mortality had constituted 10.9%. Performance of subtotal/total colectomy with formation of primary anastomosis constitutes the alternative and preferable method of treatment of patients with left colonic obstructive tumor.
Asunto(s)
Carcinoma/cirugía , Colectomía , Neoplasias del Colon/cirugía , Ileus/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Anastomosis Quirúrgica , Carcinoma/complicaciones , Neoplasias del Colon/complicaciones , Femenino , Humanos , Ileus/etiología , Masculino , Persona de Mediana EdadRESUMEN
In 241 patient choledocholithiasis the transduodenal sphincteroplasty (TDSP) and in 118--choledochoduodenostomy (CDS) was conducted. The incidence of specific postoperative complications after TDSP was 10.3%, after CDS--10.2%, postoperative mortality accordingly was 6.2% and 6.8%, the hospital stay duration from the time of operation performance till the discharge of patient from hospital--16.8 and 21 day on the average. Authors speculate the TDSP as a method of choice of operative choledocholithiasis treatment.
Asunto(s)
Cálculos Biliares/cirugía , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Colecistitis/cirugía , Coledocostomía/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Síndrome Poscolecistectomía/cirugía , Reoperación , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
In acute cholecystitis of the 460 patients, in 126, besides the cholecystectomy, the transduodenal sphincteroplasty (79) and supraduodenal choledochoduodenostomy (47) were performed. The postoperative lethality was 6.3 and 4.2%, respectively, mean duration of treatment of the patients at the hospital after the operation - 18.5 and 23.5 days. The excellent and good long-term results were noted in 78 and 73% of the patients examined. A conclusion is drawn, that sphincteroplasty and choledochoduodenostomy in complicated acute cholecystitis is more preferable, than choledochotomy and external drainage of the common bile duct.
Asunto(s)
Colecistitis/cirugía , Coledocostomía , Esfinterotomía Transduodenal , Enfermedad Aguda , Anciano , Colecistectomía , Colecistitis/mortalidad , Colelitiasis/mortalidad , Colelitiasis/cirugía , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Inducción de RemisiónRESUMEN
Transduodenal sphincteroplasty was carried out in 237 (24%) of 1002 patients subjected to planned and emergency primary operations for benign lesions of the bile tracts and in 50 (58%) of 86 patients who were operated on for a second time. On the whole, 287 operations for sphincteroplasty accounted for 63% of operations on the hepaticocholedochus. The indications for transduodenal sphincteroplasty (TDSP), its techniques, specific complications, and mortality are discussed on the basis of retrospective analysis of the clinical material. Nineteen patients (6.6%) died after the operation, 11 of them due to a severe initial condition and unspecific postoperative complications. Specific complications were registered in 22 patients and were the cause of death in 8 of them. The author suggests an improved TDSP method which reduces the risk of the occurrence of technical errors and postoperative complications. It is concluded that TDSP is expedient and necessary in choledocholithiasis and stenosis of Oddi's sphincter.
Asunto(s)
Esfinterotomía Transduodenal , Adulto , Anciano , Enfermedades del Conducto Colédoco/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Esfinterotomía Transduodenal/mortalidadRESUMEN
The results of clinical use of periarterial neurectomy of the superior mesenteric artery, the Bauhin's valve plasty according to Vitebsky, and their combination with different variants of colonic resection, subtotal and total colectomy with creation of ileosigmoid and ileorectal anastomosis in 64 patients are presented. The best functional results were noted after subtotal colectomy with the ileosigmoid anastomosis formation.