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BACKGROUND AND OBJECTIVE: To evaluate the clinical role of the routine use of a drain in an elective laparoscopic cholecystectomy operation applied to patients with symptomatic cholelithiasis not showing acute inflammation. METHOD: Following laparoscopic removal of the gallbladder, patients were separated into two groups of 30 each, either with subhepatic drain placement or without. The presence of subhepatic fluid collection was evaluated with transabdominal ultrasonography (USG) at 24 hours postoperatively and on the 7th day. The other parameters evaluated were postoperative morbidity, shoulder and abdominal pain. RESULTS: No statistically significant difference was found between the two groups in respect of demographic characteristics and operative details. The median pain score was determined to be statistically significantly higher in the group with a drain applied compared to the group without a drain (p=0.007). In the comparison between the groups of fluid collection on USG at 24 hours and shoulder pain persisting until the 7th day, although seen less in the group with no drain applied, no statistically significant difference was determined (p=0.065, p=0.159). In the examinations made on the 7th day, no hematoma or significant fluid collection was determined on USG and no wound infection was observed in any patient of either group. CONCLUSION: The routine application of prophylactic subhepatic drain in laparoscopic cholecystectomy procedure did not show any benefit to the patient.
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INTRODUCTION: The study aimed to identify the presence of peritoneal penetration in management of anterior abdominal stab wound by using computed tomography (CT) tractography. MATERIAL AND METHODS: Hemodynamically stabile, CT tractography-performed patients who were admitted to our emergency clinic with anterior abdominal stab wounds between the years 2012 and 2014 were included in this study, and all images were evaluated in terms of peritoneal penetration and possible intra-abdominal injury. RESULTS: In the study CT tractography identified necessity of laparotomy accurately in 90% of the patients, and none of the patients without peritoneal penetration needed surgical treatment in their follow-up. CONCLUSION: The procedure may be used for some selected cases of hemodynamically stable patient with anterior abdominal stab wounds to abstain from local wound exploration.
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Traumatismos Abdominales/diagnóstico por imagen , Peritoneo/diagnóstico por imagen , Peritoneo/lesiones , Tomografía Computarizada por Rayos X/métodos , Heridas Punzantes/diagnóstico por imagen , Adulto , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Mesenterio/diagnóstico por imagen , Mesenterio/lesiones , Recto del Abdomen/diagnóstico por imagen , Recto del Abdomen/lesionesRESUMEN
OBJECTIVE: Postoperative iPTH assay may predict significant hypocalcemia after thyroid surgery. The present study aimed to evaluate the ability of iPTH assay to monitor parathyroid function and to identify the risk of postoperative hypocalcemia in patients underwent thyroid surgery. MATERIALS AND METHODS: One hundred patients participated in the study (7 male and 93 female). Hypocalcemia was defined as a serum calcium concentration less than 8.0 mg/dL and symptoms of hypocalcemia. Concomitant serum calcium and iPTH levels were measured before operation and at 1(st) h for iPTH, 24(th) h for calcium after thyroidectomy. RESULTS: Postoperative hypocalcemia was observed in 31 patients. The mean postoperative serum calcium concentration in normocalcemic patients was 8.8 ± 0.5 mg/dL, whereas it was 7.6 ± 0.3 mg/dL in hypocalcemic patients. The mean postoperative 1(st) hour iPTH of patients in the hypocalcemia group was 9.1 ± 4.9 pg/mL, whereas patients of the normocalcemia group had a mean postoperative iPTH of 35.8 ± 20.2 pg/mL. CONCLUSION: Postoperative 1(st) hour iPTH < 8 pg/mL with drop in iPTH level ≥ 81.5% together showed the highest diagnostic accuracy in predicting postoperative hypocalcemia.