Identification of bile duct stones in patients undergoing laparoscopic cholecystectomy.
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Bile Duct Diseases↗
Biomedical subjects
A D Scott
Publications and source records attributed to A D Scott.
Preoperative laser therapy in a patient with resectable bronchogenic carcinoma and severe coronary artery disease.
A 67 year old man with severe coronary artery disease was found to have a resectable bronchogenic carcinoma. Myocardial revascularisation and lung resection were considered to be unduly hazardous as either separate or combined operations. Preoperative laser therapy, however, enabled the two procedures to be performed in greater safety in the most appropriate sequence.
Aged↗
Laparoscopic laser cholecystectomy: results of the technique in 210 patients.
The results of laparoscopic laser cholecystectomy (LLC) in a consecutive series of 210 patients, operated on between May 1990 and August 1991, were assessed to analyse the advantages of the technique and to detail the causes of any technical problems, failures, or complications. The operations were performed by JMcKW and ADNS. A success rate of 98% (206/210) was achieved with a minor complication rate of 13% (26/210) and major complication rate of 3% (7/206), including three patients (3/206; 1.5%) who had a reactionary haemorrhage postoperatively, two requiring laparotomy. The length of hospital stay was 48 h or less in over 80% (148/184) of the patients. The period of absence from work was 2 weeks or less in over 90% (118/130) of the patients. Cholecystectomy can safely be performed laparoscopically and this procedure has significant advantages over open cholecystectomy.
Adolescent↗
Blood transfusion and recurrent Crohn's disease.
The effect of blood transfusion on the postoperative recurrence of Crohn's disease has been investigated. Clinical and pathological data from 197 patients treated by right hemicolectomy between 1947 and 1988 have been analysed. Symptomatic recurrences confirmed radiologically or histologically have been recorded and cumulative recurrence rates calculated for transfused and non-transfused patients. Perioperative blood transfusion does not influence the development of recurrent disease (log rank test, chi 2 = 0.112).
Adolescent↗
Traumatic cardiac tamponade: a heartbreaking tale.
Penetrating cardiac injuries following civil violence are less common in Britain than in other parts of the world, but, in the light of recent evidence, the incidence of the problem is likely to increase. The patient described in this report demonstrates the pitfalls in the management of traumatic cardiac tamponade and highlights the need for a change in the management of the seriously injured patient.
Adult↗
Clinical assessment and anorectal manometry before postanal repair: failure to predict outcome.
It has been suggested that preoperative measurement of resting anal canal pressure and internal sphincter function can be used to identify those patients with neurogenic faecal incontinence who are unlikely to benefit from the operation of postanal repair. We have therefore analysed the results of the operation in 62 patients (six men and 56 women, mean age 59 years, range 30-83 years) and related clinical outcome to preoperative assessment of: resting anal canal pressure, the presence of gape and a combination of gape and low resting pressure. None of these factors was found to predict a poor result after postanal repair.
Adult↗
Chondrosarcoma--local recurrence and systemic embolization.
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Chondrosarcoma↗
Ileitis and pouchitis after colectomy for ulcerative colitis.
Ileitis can occur after surgical treatment of ulcerative colitis. Following continent ileostomy or restorative proctocolectomy ileitis can become a serious clinical problem and is then known as pouchitis although this condition is yet to be clearly defined. It is likely that pouchitis is the result of an abnormal host response to a change in bacterial flora and that the nature of this host response is related to the underlying pathogenesis of ulcerative colitis. Continued study of the immunological basis of ulcerative colitis is therefore required to solve the problem of pouchitis.
Colectomy↗
Analgesia following inguinal herniotomy or orchidopexy in children: a comparison of caudal and regional blockade.
The effectiveness of postoperative analgesia was compared in 44 children undergoing inguinal surgery, 19 of whom received caudal analgesia (1 ml 0.2% bupivacaine/kg) and 25 ilioinguinal block (0.25 ml 0.5% bupivacaine/kg). The requirement for supplementary analgesia (intramuscular morphine) was less in the caudal group, although this did not reach statistical significance in the number studied. Ilioinguinal and caudal blockade both provide useful postoperative analgesia for children following ilioinguinal surgery.
Analgesia↗
Diaphragm pacing in the treatment of ventilatory failure.
Thirty years of clinical and technical research have produced a reliable apparatus for diaphragm pacing. This entails electrical stimulation to the phrenic nerve by a remote radio-frequency transmitter. Prerequisites for diaphragm pacing are adequate alveolar gas exchange, an intact phrenic nerve and diaphragm muscle, and a co-operative patient for the prolonged period of rehabilitation. Diaphragm pacing has been used in cases of central alveolar hypoventilation and chronic obstructive airway disease, as well as for lesions of the cervical cord. To avoid fatigue and possible irreversible injury to the muscle, the right and left hemidiaphragms are paced alternately. We demonstrate the effectiveness of diaphragm pacing for long-term artificial respiration in a patient with transection of the cord at C3/4. The decisive benefit of diaphragm pacing for the quadriplegic patient is that it renders him free of dependence on a mechanical ventilator with its associated social and psychological impediments.
Adult↗