Biomedical subjects

J Prousalidis

Publications and source records attributed to J Prousalidis.

6 recordsLinked to original sources

PubMed1999

Surgical management of calcified hydatid cysts of the liver.

Hydatid disease of the liver is still a major cause of morbidity in Greece. Beside the common complications of rupture and suppuration, calcification of the hepatic cysts represent a not well studied, less frequent and sometimes difficult surgical problem. In the present study 75 cases with calcified symptomatic liver echinococcosis were operated on in the 1st Propedeutic Surgical Clinic between 1964 to 1996. Twenty-eight patients were male and 47 female with ages from 23 to 78 years. The diagnosis was based mainly on the clinical picture and radiological studies. In 5 cases the operative method was cystopericystectomy. We performed evacuation of the cystic cavity and partial pericystectomy and primary closure of the residual cavity in 6 cases, omentoplasty or filling of the residual cavity with a piece of muscle of the diaphragm in 4 cases and external drainage by closed tube, in 60 cases. In 12 of those with drainage, after a period of time, a second operation with easy, removal of most of the calcareous wall plaques was performed. The mortality rate was 2%. Our results could be considered satisfactory. In the calcified parasitic cysts of the liver the proposed technique is cystopericystectomy. An alternative procedure is pericystectomy and drainage with a "planned" reoperation with a bloodless, due to intervening inflammation, chiseling of the calcification.

Adult↗

PubMed1998

Uncommon sites of hydatid disease.

Echinococcosis remains an endemic surgical problem in many Mediterranean countries. We report our experience with such cases when the disease is located in uncommon sites, outside the liver and lungs. This study was an effort similar to a previous one but with more cases and additional information. Between 1967 and 1994 a total of 49 patients suffering from hydatid cysts located in various organs other than the liver and lungs presented to our clinic. There were 28 men and 21 women, with their ages ranging from 10 to 66 years and 22 to 80 years, respectively. Among these patients, 25 had the parasitic cyst in the peritoneal cavity, 10 in the spleen, 5 in the kidney, 3 in the spinal column, 2 in the retroperitoneal space, 1 in the abdominal wall, 1 in the myocardium, 1 in the thoracic wall, and 1 in the thigh. Their hospital stay was 9 to 88 days (average 27 days). Only two patients--one with cardiac hydatidosis and one with spinal hydatidosis--died postoperatively. Three patients with multiple cysts in the peritoneum and one with cysts in the thigh had recurrences of the disease and were reoperated successfully.

Adult↗

PubMed1998

External biliary fistula.

We report 210 cases of external biliary fistula treated in our clinics between 1970-1992. In 7 cases, fistulas were formed after iatrogenic bile duct injury, in 4 cases after exploration of common bile duct, in 4 cases due to disruption of biliary-intestinal anastomosis, and in 2 cases due to liver trauma. In 85 cases bile leak was observed after cholecystomy, in 103 cases after hydatid disease surgery, and in 4 cases after the passage of P.T.C. catheter. In one patient the appearance of the fistula was due to spontaneous discharge of a gallbladder empyema. 173 cases were managed conservatively, and 37 cases surgically.

Biliary Fistula↗

PubMed1996

Subtotal cholecystectomy.

Subtotal cholecystectomy has been carried out in 34 patients from 1972 to 1992. In the same period 1620 total cholecystectomies were performed. The indications were severe inflammation and/or severe fibrosis in 31 patients, and Mirizzi syndrome type 1 in 3 patients. The morbidity was insignificant, but one patient died, due to severe sepsis. In follow up studies ranging from 6 months to 9 years, there was one patient with retained stones in the common bile duct. No other post cholecystectomy sequelae were noticed in the remaining 32 patients. Subtotal cholecystectomy is a safe, feasible and definitive operation in patients for whom the standard operation could be dangerous. This operation is less burdensome to the patient, and is accompanied by fewer complications than ordinary cholecystostomy.

Adult↗

PubMed1996

Acute cholecystitis in aged patients.

The aim of this study is the analysis of the results in 62 patients over 70 years of age with acute cholecystitis treated in our Department from 1970 to 1990. The clinical picture in 47 patients was mild and in 15 severe. In 14 cases (10 calculous, 4 acalculous) the acute cholecystitis subsided with antibiotics (Group A). In 48 more cases (45 calculous, 3 acalculous) following 1-3 days conservative treatment, operation was undertaken. Besides acute cholystitis there was gangrene of gallbladder in 10, choledocholithiasis in 7 and choloperitoneum without perforation in 7 cases. Cholecystostomy in 25, cholecystectomy in 15 and cholecystectomy with exploration of the bill duct in 8 cases was performed (Group B). There was one death in group A and 3 deaths in group B. The hospital stay was 20 days. In conclusion the clinical findings in acute cholecystitis in the aged are usually mild. In the case of failure of medical treatment, after 2-3 days emergency surgery should be performed.

Acute Disease↗

PubMed1996

Hanging noncalculous gallbladder.

The removal of acalculous and not acutely inflamed gall-bladder in patients with typical biliary pain remains a questionable procedure. This study was conducted to present our experience. In the period 1982-90, 1089 cases of calculous and acalculous gallbladder disease were treated in our clinic. In this period, 27 patients were subjected to cholecystectomy because of an acalculous, non inflamed gallbladder which was elongated lying in an abnormal position with a long cystic duct. The mean duration of symptoms supportive of cholelithiasis, was 5 years. Oral cholecystogram and ultrasonography led to the diagnosis and other causes of chronic abdominal pain were excluded. There were 13 lumbar, 9 pelvic and 5 iliac gallbladders, with poor function in 20 of them. During cholecystectomy, the organ was invested by peritoneum and suspended in 7 cases from a mesentery. On pathological examination mild chronic inflammation was reported in 19 cases and minimal changes in 8. The minimum follow up was one year and the maximum 9 years. Complete relief of symptoms was achieved in all the cases. In conclusion, cholecystectomy should be offered in these symptomatic "hanging" gallbladders.

Adult↗