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Kwok Kay Yau

Publications and source records attributed to Kwok Kay Yau.

15 recordsLinked to original sources
PubMed2006

Laparoscopic cholecystectomy for acute cholecystitis: the evolving trend in an institution.

BACKGROUND: Laparoscopic cholecystectomy (LC) is the gold standard for symptomatic cholecystolithiasis. Technical maturation and advances in instrumentation have enabled the application of this procedure for acute cholecystitis (AC). We review the evolving role of LC for AC in our institution. METHODS: A retrospective study was conducted of patients who received LC for AC between January 1994 and June 2001. Patients' demographics, clinical findings and perioperative outcomes were evaluated. RESULTS: There were 140 men and 141 women with a mean age of 56.9 years (range, 23-89 years). Two hundred and eighteen of these patients underwent successful LC. There were 63 conversions (22.4%) for uncertain anatomy and difficult dissection (41), gangrenous or perforated gallbladder (16) and bleeding (6). The conversion rates as stratified to surgeon's seniority were 25.1%, 22.8% and 9.7% for registrar, senior registrar and consultant, respectively. The mean operative time was 84.3 minutes (range, 30-255 minutes) and the mean postoperative stay was 5.8 days (range, 1-35 days). The overall complication rate was 11.6%, including two bile duct injuries and two perioperative deaths. CONCLUSION: LC for AC is safe and effective and associated with a low incidence of complications when routinely applied by surgical residents. The conversion rate is related to operators' surgical experience.

Adult↗
PubMed2006

Acute symptomatic abdominal aortic aneurysm secondary to endovascular stent graft associated type II endoleak.

Endovascular abdominal aneurysm repair (EVAR) is popular because of its low invasiveness and feasibility for high-risk patients. Endoleak is common after EVAR and is characterized by blood flow within the aneurysm sac but outside the stent graft. Type II or collateral endoleak commonly results from retrograde filling of the aneurysm from collateral visceral vessels, lumbar, inferior mesenteric, accessory renal or sacral arteries. Collateral leaks are generally thought to be benign and over half of the early leaks will seal spontaneously. Sporadically, collateral endoleak could lead to aneurysm sac pressurization and place the patient at ongoing risk of rupture. Herein, we report an uncommon case of early post-stent graft placement symptomatic abdominal aortic aneurysm associated with type II endoleak.

Aged↗
PubMed2006

Abdominal tuberculosis mimicking metastasis in a patient with carcinoma of the oesophagus.

Oesophageal carcinoma typically manifests as ulcerative growth. Cases of oesophageal tuberculosis mimicking carcinoma of the oesophagus have been reported and create considerable diagnostic difficulty. Abdominal tuberculosis, however, is an uncommon extrapulmonary manifestation of tuberculosis. Here, we report a case of abdominal tuberculosis in a patient with squamous carcinoma of the oesophagus.

Abdominal Neoplasms↗
PubMed2005

Laparoscopic approach compared with conventional open approach for bezoar-induced small-bowel obstruction.

BACKGROUND: Bezoar-induced small-bowel obstruction (SBO) is an uncommon surgical emergency. Accurate preoperative diagnosis is notoriously difficult, and conventional management often necessitates laparotomy. Recent articles demonstrate the feasibility of laparoscopy in the management of SBO. This study compares the outcomes of a series of cases managed laparoscopically with the outcomes of matched open cases. HYPOTHESIS: Laparoscopic management of bezoar-induced SBO is safe and effective when compared with traditional laparotomy treatment. PATIENTS AND METHODS: A retrospective study was conducted from November 1, 1998, to November 30, 2003, to compare laparoscopic vs open treatment for bezoar-induced SBO. Patients' demographics, operative details, and surgical outcomes were evaluated. RESULTS: During the study period, 24 patients (16 men and 8 women) with a mean age of 68.2 years underwent operative treatments for bezoar-induced SBO. Ten patients received laparoscopic treatments and the other 14 received laparotomy treatments. The patients were comparable in age, sex, and physiological status. There were 3 conversions in the laparoscopy group owing to technical difficulties. The laparoscopic approach was associated with statistically significant shorter operative time (P = .048), fewer postoperative complications (P = .04), and reduced hospital stay (P = .009). CONCLUSIONS: When expertise is available, laparoscopy is safe and effective in the management of bezoar-induced SBO and is associated with superior postoperative outcomes when compared with the conventional open approach.

Aged↗
PubMed2005

Management of brachial artery pseudoaneurysms secondary to drug abuse.

Arterial pseudoaneurysm secondary to parenteral drug abuse poses a difficult problem to vascular surgeons. This study prospectively evaluates the outcome of surgical treatment for brachial artery pseudoaneurysms secondary to drug abuse. From February 1996 to July 2003, all brachial artery pseudoaneurysms secondary to drug abuse as diagnosed by duplex imaging were recruited for the study. Aneurysm excision, ligation, and radical debridement along with revascularization by axial reanastomosis were performed for all patients except one with chronic degenerative fusiform aneurysm, who received aneurysm resection and interposition reverse saphenous vein graft. Upper limb arterial flow was evaluated clinically and with hand-held Doppler in the perioperative period and during subsequent follow-up. During the study period, nine consecutive patients presented with cubital fossa swelling following deliberate drug arterial injections. Two of them suffered from thromboembolic complications and were managed conservatively by heparinization. Seven patients (six male, one female), aged 32-53, were confirmed to have brachial artery pseudoaneurysms by duplex scan and recruited for data analysis. Pseudoaneurysms ranged 10-40 mm in size. One ex-heroin abuser, who presented with median nerve palsy, underwent aneurysm resection and reversed saphenous vein interposition. The other six patients presented with painful pulsatile cubital fossa swellings. They underwent aneurysm resection, extensive debridement, and primary axial reanastomosis. There were no perioperative procedure-related complications. With an average follow-up of 38.7 months, no recurrences or neurovascular complications were detected. Routine revascularization by aneurysm resection and axial anastomosis for brachial artery pseudoaneurysm secondary to drug abuse is a safe, effective approach with low associated morbidity.

Adult↗
PubMed2005

Acute abdomen: an unusual case of ruptured tuberculous mesenteric abscess.

BACKGROUND: Abdominal tuberculosis is an uncommon extra-pulmonary manifestation of tuberculosis. METHODS: Case report and literature review. RESULTS: Herein, we report an unusual case of ruptured tuberculous mesenteric cold abscess, which was managed by laparotomy for diagnosis and drainage, and post-operative chemotherapy. CONCLUSIONS: Peritoneal tuberculosis may present to surgeons as ascites, an abdominal mass, or peritonitis. Preoperative diagnosis of abdominal tuberculosis is notoriously difficult. Acute peritonitis provoked by rupture of tuberculosis mesenteric cold abscess is exceedingly rare. Surgical intervention is warranted for diagnosis and drainage.

Abdomen, Acute↗
PubMed2005

Laparoscopy-assisted surgical management of obscure gastrointestinal bleeding secondary to Meckel's diverticulum in a pediatric patient: case report and review of literature.

Despite advances in endoscopy and imaging, acute gastrointestinal (GI) bleeding of obscure origin in children presents a challenge to pediatric gastroenterologist. Bleeding Meckel's diverticulum (MD) commonly presents with acute episode of lower GI bleeding. A conventional diagnostic algorithm includes endoscopy, technetium 99m pertechnetate scintigraphy, angiography, and exploratory laparotomy. The advent of minimal access surgery prompts the use of laparoscopy for children with obscure GI bleeding. Laparoscopy assists in the diagnosis and can offer definitive treatment of patients with MD. Herein, we report a case of pediatric GI bleeding of obscure origin associated with MD that was successfully diagnosed and managed via laparoscopy. This article updates the current management for pediatric patients with obscure GI bleeding and the role of laparoscopy in the management of MD.

Child↗
PubMed2004

Therapeutic minilaparoscopy for perforated peptic ulcer.

Laparoscopic repair for perforated peptic ulcer has been demonstrated to be safe and effective. We report our initial experience of applying therapeutic minilaparoscopy for peptic ulcer perforation. Five patients with perforated peptic ulcers managed by a team of surgeons using minilaparoscopy are reported. There were no conversions, perioperative morbidity, or mortality. Patients experienced minimal wound pain and required minimal parental analgesia. The access wound scars were hardly discernable at 3-month followup. Therapeutic minilaparoscopy is technically feasible for patients with perforated peptic ulcer and is associated with satisfactory clinical and cosmetic outcome.

Adult↗
PubMed2004

Vagotomy and gastrojejunostomy for benign gastric outlet obstruction.

OBJECTIVE: Peptic-ulcer-induced gastric outlet obstruction is an indication for operative intervention. The advent of minimal access surgery allows the conventional open procedure to be performed via laparoscopy. PATIENTS AND METHODS: From 1996 to 2000, 15 consecutive patients, aged 29 to 75 years, underwent laparoscopic truncal vagotomy and gastrojejunostomy for gastric outlet obstruction. Perioperative data and longterm followup results were analyzed. RESULTS: There were no conversions or perioperative mortality. The mean operative time was 114 minutes. Patients required on average 1 dose of intramuscular pethidine for analgesia. Eleven patients were discharge by postoperative day 10; the remaining 4 patients had delayed gastric emptying which settled with conservative treatment. With an average followup period of 80 months, patients were classified as Visick I (n = 7), II (n = 5), III (n = 1), and IV (n = 2). CONCLUSION: Laparoscopic truncal vagotomy and gastrojejunostomy is technically feasible for patients with benign gastric outlet obstruction and is associated with satisfactory perioperative and longterm outcome.

Adult↗