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C Linderman

Publications and source records attributed to C Linderman.

3 recordsLinked to original sources
PubMed1997

Laparoscopic cholecystojejunostomy: a technical application in unresectable biliary obstruction.

Laparoscopic cholecystojejunostomy was accomplished utilizing an endoscopic gastrointestinal stapler in 2 patients with biliary obstruction and jaundice secondary to inoperable pancreatic carcinoma. This technique was performed on patients judged to be poor candidates for an open resection, due to medical conditions and associated comorbidities. The actual operating time, taking into account delays not related to the operation or technique, was 45-60 min. Both patients experienced immediate significant overall clinical improvement with minimal operative sequelae. The first patient was eating and ready for discharge in 4 days, and the second was prepared for discharge in less than 24 h. This operative procedure offers the patient excellent palliation with many advantages over traditional open surgery.

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PubMedDate not supplied

Inferolateral retraction reduces the risk of thermal injury to biliary structures.

OBJECTIVES: Do various traction techniques significantly change the anatomic position during laparoscopic cholecystectomy? METHODS: 16 cadaveric liver specimens were dissected and measurements were taken between structures in the triangle of Calot. Measurements were taken while traction was placed on the infidubilum in the inferolateral, cephalad and anatomic positions. Thermal necrosis data was measured one week post-injury in a rat model for Non-contact Yag laser, Quartz, Sapphire tip, and electrocautery. RESULTS: Inferolateral traction provided statistically significant increases in distance (P < 0.01) between the critical biliary structures. The increase in length by cephalad traction on the gallbladder was not statistically significant. Depth of necrosis for the devices were: cautery 1.03 mm, sapphire tip 0.63 mm, non-contact Yag laser 2.13 mm, and bare quartz tip laser 1.05 mm. CONCLUSION: Inferolateral traction produced a statistically significant increase in distance between the critical biliary structures. This was not demonstrated with cephalad traction. We recommend avoiding thermal dissection in the Triangle of Calot due to the thermal devices necrosis depth in relation to the proximity of the biliary structures.

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