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G Giustozzi

Publications and source records attributed to G Giustozzi.

20 records · Page 2Linked to original sources

[The surgeon's role in the treatment of cholelithiasis].

From a surgeon's point of view, the management of biliary tract calculi can be simplified as follows: 1) In the asymptomatic patients a prophylactic surgery is not justified. 2) In the symptomatic patients the cholecystectomy is by far the best procedure as it eliminates the symptoms and it prevents the complications. 3) If performed in elective and good-risk patients, this surgical technique is without morbidity and mortality. 4) Such a statement which absolutely fits in case of laparotomic cholecystectomy, is not true in case of laparoscopic cholecystectomy which, on the contrary, presents with an higher mortality. 5) Laparoscopic cholecystectomy must be performed by surgeons with biliary tract management wide experience. 6) The management of complications is still almost surgical. 7) Common duct calculi are often treated by endoscopic techniques in association with surgery. 8) The surgeon must always be able to evaluate his patient and to suggest the best management with particular regard to the alternative not surgical procedures which sometimes are more favourable to the patient. 9) Actually, to left behind the statement "a chance to cut is a chance to cure" could sometimes involve much credit to the surgeon and more profit to the patient.

Cholecystectomy↗

Postoperative intraabdominal abscesses: percutaneous versus surgical treatment.

The optimal treatment of postoperative intraabdominal abscesses has not yet been defined and mortality and morbidity remain high. In this retrospective study 2.310 laparotomies were reviewed. The records of 39 patients with postoperative intraabdominal abscesses (1.6%) are reported and the results obtained in percutaneous drainage (PD, n = 27) versus surgical drainage (SD, n = 10) are compared. The choice of drainage was made after consultation with the interventional radiologist, and PD was preferred in single, well-defined abscesses. Two patients had prompt spontaneous resolution of the abscess. The two groups were homogeneous for age, sex and postoperative day of abscess diagnosis. There was no difference in severity of illness assessed by Acute Physiologic Score (APS) between PD and SD groups (7.9 vs 9.3). No significant difference was found in mortality (11% vs 20%), morbidity (11% vs 40%) and duration of drain tube (14 vs 15 days) between PD group and SD group. This study confirms the data of recent retrospective stratified series: PD and SD are equally efficacious to cure postoperative intraabdominal abscesses. However, PD should be the treatment of choice because of its lower invasiveness and cost.

Abdominal Abscess↗