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F Docobo Durántez

Publications and source records attributed to F Docobo Durántez.

16 recordsLinked to original sources
PubMed2005

Laparoscopic treatment of cholelithiasis in cirrhotic patients.

OBJECTIVE: To assess the safety and efficacy of laparoscopy in the treatment of symptomatic cholelithiasis in patients with Child's Class A and Class B cirrhosis. STUDY DESIGN: Descriptive and retrospective study. PATIENTS: We studied 14 patients (mean age 60 yrs) with Child's Class A and Class B hepatic cirrhosis who underwent laparoscopic cholecystectomy. We analyzed the occurrence of intraoperative and postoperative complications. RESULTS: Eight patients were women (57.14%) and 6 were men (42.85%). Eight of the 14 patients presented with Child's Class B cirrhosis and 6 patients with Class A. Cholecystectomy was programmed for all patients. The average duration of surgery was 77 min. Intraoperative complications occurred in 2 patients (14.28%) in the form of liver bed bleeding. Postoperative complications were observed in 3 patients (21.42%), 2 presented with ascites which led to a worsening of Child's Class in one of them, and the third patient presented with angina-like symptoms (acute, sharp pain in the chest irradiating to the back). Mean length of hospital stay was 3 days. No postoperative morbidity or mortality occurred, and there were no conversions. CONCLUSIONS: LC (laparoscopic cholecystectomy) is a safe and effective alternative for the treatment of symptomatic cholelithiasis in patients with well-compensated Child's Class A and Class B cirrhosis. Postoperative morbi-mortality is low, bleeding is unimportant, and both duration of surgical procedure and hospital stay are short.

Cholecystectomy, Laparoscopic↗
PubMed2004

Laparoscopic cholecystectomy in the treatment of biliary lithiasis: outpatient surgery or short stay unit?

OBJECTIVE: Analysis of clinical and surgical factors in a series of patients subjected to laparoscopic cholecystectomy in an outpatient unit and their relationship with time of discharge and patient acceptance. PATIENTS AND METHOD: Eighty one consecutive patients underwent to elective laparoscopic cholecystectomy during year 2002 within S.A.S. (Andalusian Health Service) from a surgical waiting list. Retrospective and comparative study between two groups: group A includes patients discharged between 24 and 48 hours after intervention; group B includes patients discharged in less than 24 hours. We analyse the clinical and surgical characteristics and post-operative outcome of both groups of patients. RESULTS: Group A was composed of 53 patients and group B of 28 patients. Factors of clinical significance which determined discharge after 24 hours included: early post-surgical incidences or complications (p = 0.017), inability to tolerate oral diet (p = 0.002), and doubts and feelings insecurity of patients regarding discharge by traditional means 62.3% (p = 0.0003). CONCLUSIONS: Outpatient laparoscopic cholecystectomy is a safe and reliable procedure with a high acceptance rate and few complications. Perhaps traditional culture has to be changed to obtain better results.

Ambulatory Surgical Procedures↗
PubMed2003

[Levels of satisfaction and perceived quality in a day surgery unit of a tertiary referral hospital].

INTRODUCTION: Surgical and anesthetic advances have allowed an adequate develop at the day surgery programs, with a rational application and cost-effectiveness of the hospital resorts. The aim of this study, is to know the level of quality perceived in surgical treatment in a program of day surgery. MATERIAL AND METHODS: A randomised selection of 204 patients from a series of 751 operated, between April-May 2001 in a day-surgery institution, was done. Phone questionnaire was done following protocol SERCAL (sociodemographic factors and general satisfaction, accessibility, personal assistance, guarantee and fidelity service) with validation for day surgery programs. Absolute and relatives frequencies were evaluated for dichotomous and categoric variables and medium and standard deviation for numeric variables. Possible differences were evaluated by chi2 test in qualitative variables and Student's t and ANOVA test for quantitative variables. RESULTS: Response index was 70.1%. Satisfaction general index was 9.1%, for 18 numeric items (range 0-10). Social and demographic items show that the best validity of treatment were by elderly, women, retired and low cultural patients. Data reduction by factorial analysis showed 4 factors with incidence (total variance 71.62%): Scientific-technical guarantee service and adequate personal treatment (Cronbach's alpha 0.9060), comfortable and security assistance (Cronbach's alpha 0.8708), accessibility to hospital and professionals (Cronbach's alpha 0.0652), accessibility to surgical service. CONCLUSIONS: General satisfaction of the patients treated in the day-surgery program was high, 9.1 (range 0-10). 88.8% patients would recommend this type of treatment to their parents or friends and in 84.3% would repeat the same experience in the surgery unit. The best appreciate items were the direct treatment and relation, respect, intimacy and information along the assistential circuit by implicated professionals. The worst identified item was the time past in waiting surgical list.

Adult↗
PubMed1992

[The treatment of upper digestive hemorrhages due to duodenal ulcer by direct hemostasis and vagotomy of the oxyntic cells].

Management of upper gastrointestinal haemorrhage continues to present a challenge in surgical judgment. To evaluate the incidence of rebleeding, ulcer recurrence, mortality and morbidity derived from the surgical technique, we made a prospective study in patients with active bleeding duodenal ulcer (endoscopy diagnosis in all cases), excluding patients with serious intercurrent diseases NSAIDS intake drugs and over seventy years of age. In 49 patients, oxyntic cell vagotomy with undersewing bleeding ulcer were performed in the period 1972-1984. Periodic controls were established, included clinical, radiographic and gastroduodenoscopic evaluation. Five years after operation 35 patients could be evaluated. In these cases, mortality was nil. No early rebleeding was observed. Long term endoscopic results showed only 2.85% of relapses. The results obtained in this study show that oxyntic cell vagotomy with undersewing bleeding ulcer may be a technique of choice in the treatment of bleeding duodenal ulcers and it should be more extensively used in emergency services.

Adult↗
PubMed1991

[Surgery in the treatment of nonvaricose upper digestive hemorrhages].

The surgical treatment in 154 patients with upper gastrointestinal hemorrhage, was analyzed retrospectively. One hundred and twenty-two were males (79.2%) and 20.7% were females. Mean age was 58.3 years. Surgery was performed immediately or on a wait and see fashion, according to the evolution of the bleeding, during 1985-1989. Survivals were analyzed with the chi-square test with 95% confidence limits. Overall mortality was 11.68% (18 patients), 12.69% after immediate surgery and 9.1% after deferred surgery. Resections had a higher mortality than simple suture in patients with associated severe risk and urgent surgical indication. In patients with less risk, a vagotomy procedure is added if no intercurrent diseases are present. Gastrectomy should be performed only out of necessity.

Age Factors↗
PubMed1990

[Therapy of ulcer recurrence after vagotomy of oxyntic cells with sucralfate].

Several methods of treatment have been proposed for the recurrences of peptic ulcers after surgery; they consist of different forms of re-operation, medical treatment (H2 receptors antagonists, cytoprotectors, etc...). First, it is convenient to establish the cause of the recurrence and to rule out the presence of hypersecretory conditions, as inadequate previous surgery or a non identified gastrinoma. Because of the enhancing effect of the cytoprotective drugs on the defense mechanisms of the mucosal barrier, the group of patients with limited acid secretion and recurrent ulcer may obtain benefit from these drugs. To demonstrate this hypothesis we realized a prospective study on 30 patients with recurrent gastro-duodenal peptic ulcer after parietal cell vagotomy without drainage; all the patients were treated with sucralfate during two months. The results can be considered favourable, with endoscopic healing of the ulcer in more than 50% of the cases at the end of the treatment.

Adult↗
PubMed1990

[Risk of carcinoma of the stomach after vagotomy].

To evaluate the influence of vagotomy in the development of gastric carcinoma, we conducted a prospective, controlled study of 183 patients diagnosed of gastric or duodenal peptic ulcer resistant to medical treatment; all cases had been treated by oxyntic cell vagotomy, without drainage, in the Departamento de Cirugía del Hospital Universitario Virgen del Rocío, Sevilla. Once a year all patients were clinically, radiologically and endoscopically evaluated. In 149 patients followed during 14 years, we did not find any case of carcinoma or premalignant lesions. Therefore, our experience does not suggest that, in the absence of drainage, vagotomy constitutes a contributory factor in the development of gastric carcinoma.

Adult↗
PubMed1989

[Treatment of congenital aganglionic megacolon in adults].

The authors present 5 cases of congenital aganglionar megacolon in patients over 12 years of age. They were diagnosed and treated in the Digestive System Service and Surgery Department of the "Virgen del Rocío" University Hospital of Seville (Spain). After describing the infrequent incidence of this pathology outside early childhood, the different procedures proposed for its diagnosis are described. Once clinical suspicion of megacolon was established, a careful clinical history with special reference to bowel habit from birth was made, as well as a barium enema, anorectal manometry and rectal endoscopy and biopsy for histological and histochemical studies. Once diagnosed, all patients underwent surgery consisting in excision of the aganglionar colorectal segment, retrorectal lowering of the healthy colon and exteriorization through the fibers of the internal anal sphincter. A side-to-side transanal anastomosis between the healthy colon and diseased rectum (Duhamel II) was fashioned. All the patients had a satisfactory evolution with little immediate morbidity. Five to ten years after performing the operations, the patients remained asymptomatic, without bowel habit disturbances and showed an adequate development.

Adolescent↗
PubMed1989

[Vagotomy of the oxyntic cells associated with simple closing as surgical treatment of perforated duodenal ulcer. A comparative study with simple closing alone].

To evaluate the incidence of ulcer recurrence, mortality and morbidity derived from the surgical technique, we made a prospective and randomized study in patients with perforated duodenal peptic ulcer, within 10 hours after the acute episode and without intercurrent serious diseases. In a total of 180 patients, oxyntic cell vagotomy (VCO) with simple closure or simple closure alone were performed alternatively in the period from 1971 to 1977. Periodic controls were established that included clinical, radiographic and gastroduodenoscopic evaluation. Twelve years after operation, 115 of the patients could be evaluated. Recurrence was defined as endoscopic or surgical evidence of the ulcerous lesion. The endoscopic results after 12 years showed 1.56% of relapses in the group that underwent oxyntic cell vagotomy with simple closure, and 54.9% in the group that only had simple closure (p less than 0.0005). There were also significant differences in the clinical and radiographic controls, and in the degree of comfort achieved with the technique. Mortality was null in both groups and there were no differences between the two techniques as regards morbidity. The results obtained in this study show that oxyntic cell vagotomy with simple closure of the perforation may be the technique of choice in the treatment of perforated duodenal peptic ulcer, which is why we think is should be more extensively used in emergency services.

Adult↗
PubMed1989

[Carcinoma of the gastric stump after surgery of gastroduodenal ulcer].

Thirty-two cases are presented of carcinoma of the gastric stump after surgery for gastroduodenal ulcer disease, duodenal in 19 patients (59.38%) and gastric in 13 (40.65%). All underwent gastric resection, with Billroth I type reconstruction in 5 cases (15.62%) and Billroth II in 27 (84.36%). The patients generally had very advanced carcinoma at the time of diagnosis and the studies made, barium contrast and endoscopy, were always positive. The operability rate was 84.26% and the rate of curative resectability was 28.12%, this group of patients attaining the longest survival. An evaluation was made of the possible mechanisms implicated in the pathogenesis of this type of carcinoma, type of operation performed, location of the peptic lesion, type of reconstruction, etc. A follow-up protocol was established for the patients who underwent resection, the degree of risk being evaluated in relation to the postoperative period. Finally, to prevent the potentially neoplastic stage of the gastric stump, we present surgical procedures for the treatment of the ulcerative disease which have not been demonstrated to increase the long-term risk of gastric carcinoma.

Aged↗