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G Gecelter

Publications and source records attributed to G Gecelter.

5 recordsLinked to original sources
PubMed1990

Peritoneal lavage in abdominal sepsis. A controlled clinical study.

The value of intraoperative peritoneal lavage (IOPL) with saline solution, with or without antibiotics, in the treatment of peritoneal contamination, continues to be controversial. A prospective trial was carried out in 87 patients who underwent emergency laparotomies for peritonitis. They were randomized to be treated in one of three ways: group 1 (mean acute physiologic and chronic health evaluation [APACHE] II score, 8) received no IOPL; group 2 (mean APACHE II score, 10) received IOPL with saline solution; and group 3 (mean APACHE II score, 8) received IOPL with saline solution and 2 g of chloramphenicol succinate. In groups 1, 2, and 3, the mortality was 21%, 21%, and 10%, respectively (not significant), and correlated well with the preoperative APACHE II scores. In groups 1, 2, and 3, the mean hospital stay was 13, 13, and 10 days, respectively (not significant), and the incidence of wound infections was 20%, 17%, and 17%, respectively; the incidence of surgical complications was 10%, 24% and 7%, respectively (not significant), and of medical complications, 24%, 31%, and 17%, respectively. We concluded that IOPL with saline solution or antibiotics did not influence the outcome following laparotomies for peritonitis.

Adolescent↗
PubMed1990

APACHE II in emergency operations for perforated ulcers.

Most reports concerning the management of patients with perforated peptic ulcers suffer from inadequate documentation of the severity of illness and the operative risk of these patients. This study attempts to evaluate the prognostic value of the APACHE II scoring system in a homogeneous group of patients with perforated peptide ulcers, to assess it as a potential clinical and research tool for future studies, and to examine its usefulness in stratifying these patients according to their surgical risk. Our results confirm the prognostic value of the APACHE II scoring system, measured either retrospectively or prospectively, in patients who undergo emergency operations for perforated ulcers. When measured preoperatively, it accurately stratifies these patients to various risk groups and should therefore be used in future trials examining various treatment aspects of this condition. Our data, evaluating the results of various procedures in subgroups of patients stratified by the APACHE II, failed to support the superiority of one approach over another.

Duodenal Ulcer↗
PubMed1990

Thoracic empyema--a delayed complication of excluded benign thoracic oesophagus. Case report.

Delayed 'blow-out' of retained thoracic oesophagus, 2 years after its exclusion for iatrogenic oesophageal perforation, gave rise to thoracic empyema. Oesophageal exclusion performed for benign, non-caustic conditions tends particularly to cause complications. Excision of the oesophageal remnant should therefore be considered in restoration of alimentary-tract continuity.

Aged↗
PubMed1989

APACHE II score in massive upper gastrointestinal haemorrhage from peptic ulcer: prognostic value and potential clinical applications.

This study examined the prognostic value of the APACHE II scoring system in patients undergoing emergency operations for bleeding peptic ulcer. There were 96 operations for gastric ulcers and 58 for duodenal ulcers. The mean scores in survivors and in patients who died were 10.8 and 17.5 respectively. None of the 66 patients with an APACHE II score less than 11 died, while the mortality rate in those scored greater than 10 was 22 per cent. In patients scored greater than 10 non-resective procedures carried less risk of mortality than gastrectomy. The APACHE II score is useful when measuring the severity of the acute disease and predicting the outcome in these patients. If used in daily practice it may assist the surgeon in stratifying patients into a low-risk group (score less than 11) in which major operations are well tolerated and outcome is favourable and a high-risk group (score greater than 10) in which the risk of mortality is high and the performance of procedures of lesser magnitude is probably more likely to improve survival.

Duodenal Ulcer↗