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L Vereecken

Publications and source records attributed to L Vereecken.

At least 19 recordsLinked to original sources

Theoretical and experimental study of the product branching in the reaction of acetic acid with OH radicals.

The product distribution of the reaction of acetic acid, CH(3)COOH, with hydroxyl radicals, OH, was studied experimentally and theoretically. Mass-spectrometric measurements at 290 K and 2 Torr of He of the CO(2) yield versus the loss of acetic acid yielded a branching fraction of 64 +/- 14% for the abstraction of the acidic hydrogen as follows: CH(3)COOH + OH --> CH(3)COO + H(2)O --> CH(3) + CO(2) + H(2)O. A quantum chemical and theoretical kinetic analysis showed that the abstraction of the acidic hydrogen is enhanced relative to the abstraction of -CH(3) hydrogens because of the formation of a strong pre-reactive H-bonded complex, where the H-bonds are retained in the H-abstraction transition state. The potential energy surface of the reaction is explored in detail, and the reaction products of the individual channels are identified. The theoretical product branching is found to be critically dependent on the energetic and rovibrational differences between the H-abstraction transition states.

Journal Article↗

Residual appendicitis following incomplete laparoscopic appendectomy.

Growing popularity of laparoscopic interventions must bring along a thorough knowledge of possible complications inherent to the laparoscopic technique. With these two cases of residual appendicitis following incomplete appendectomy, the authors want to warn for this complication. Surgeons should be aware of residual appendicitis as a possible cause of acute abdomen at any time following a laparoscopic appendectomy.

Adolescent↗

Residual appendicitis following incomplete laparoscopic appendectomy.

Growing popularity of laparoscopic interventions must bring along a thorough knowledge of possible complications inherent to the laparoscopic technique. With these two cases of residual appendicitis following incomplete appendectomy, the authors want to warn for this complication. Surgeons should be aware of residual appendicitis as a possible cause of acute abdomen at any time following a laparoscopic appendectomy.

Abdomen, Acute↗

Laparoscopic repair of perforated duodenal ulcer. A prospective multicenter clinical trial.

BACKGROUND: A series of 100 consecutive patients with perforated peptic ulcer were prospectively evaluated in a multicenter study. The feasibility of the laparoscopic repair was evaluated. METHODS: All patients had peritonitis, 20% were in septic shock, and 57% had delayed perforation. Conversion to laparotomy was necessary in eight patients. The morbidity rate was 9% and mortality rate 5%. RESULTS: The mean delay of postoperative gastric aspiration (mean 3.4 days) and resumed food intake (mean 4.4 days) as well as the mean postoperative hospital stay (mean 9.3 days) were comparable to conventional surgery, but postoperative comfort was subjectively increased by laparoscopy and noticed by all laparoscopic surgeons participating in this study. CONCLUSIONS: Laparoscopic repair of perforated peptic ulcer proves to be technically feasable and carries an acceptable morbidity and mortality rate, compared with conventional surgery.

Adolescent↗

Multicentric experience of the Belgian Group for Endoscopic Surgery (BGES) with endoscopic adrenalectomy.

BACKGROUND: Adrenalectomy is not a frequent operation. Therefore the newly developed laparoscopic approach is sporadically performed by surgeons dealing with endocrine disorders. METHODS: Some 54 videoendoscopic adrenalectomies performed on 52 patients by five surgical teams between October 1993 and December 1996 were prospectively evaluated. RESULTS: Indications for endoscopic adrenalectomy were pheochromocytoma (n = 17), primary hyperaldosteronism (n = 15), Cushing's adenoma or disease (n = 7), nonsecreting adenoma (n = 7), single metastasis from adenocarcinoma (n = 2), adenoma with dehydroepiandrostenedione (DHEAS) hypersecretion (n = 3), and ACTH-secreting metastases from a thymoma (n = 1). Of the 54 adrenalectomies performed, 31 were of the left gland, 19 of the right and two bilateral. Laparoscopic adrenalectomy was successful in 50 patients (96%). Median tumor size was 4 cm (range 1.5-12), median operation duration was 80 min (range 59-360), and median postoperative stay was 4 days (range 2-13). One patient required blood transfusion. CONCLUSIONS: Endoscopic adrenalectomy can safely be performed-even sporadically-by surgeons well versed in adrenalectomy techniques for endocrine disorders and trained in endoscopic surgery.

Adenoma↗

The dramatic reality of biliary tract injury during laparoscopic cholecystectomy. An anonymous multicenter Belgian survey of 65 patients.

BACKGROUND: Most reports concerning the outcome of patients with biliary tract injury during laparoscopic cholecystectomy come from tertiary referral centers, and results could be very different in the everyday practice of community surgeons. OBJECTIVE: The objective is to define the presentation, mechanisms, results of treatment, and long-term outcome of biliary tract injuries during laparoscopic cholecystectomy in the setting of a community surgeon's practice. METHODS: An anonymous retrospective multicenter survey of 9,959 patients who underwent laparoscopic cholecystectomy was conducted by the Belgian Group for Endoscopic Surgery, composed mainly of community general surgeons. RESULTS: Sixty-five patients with bile duct injury were reported on; the incidence was 0.5%, varying from 0. 35 to 1.3% according to the experience of the surgeon. Thirty-four percent of ductal injuries occurred with experienced surgeons, often in association with local predisposing risk factors. Injury occurred in 87% of cases during dissection of the Calot triangle, with severe injury occurring in 46% of patients. Intraoperative cholangiography was performed in 34% of patients and was associated with a significantly improved operative detection rate of injury (68% vs 32%, p = 0.007). Operative detection of injury occurred in 45% of patients; diffuse bile ascitis was encountered postoperatively in 29%. The overall mortality was 9%, the postoperative biliary complication rate 31%, and the reintervention rate 14%. During a median follow-up of 49 months (range, 3-78 months), 20 of the 61 surviving patients (33%) had recurrent biliary strictures. Multivariate analysis demonstrated that the age of the patient (odds ratio: 0.893) and the presence of biliary peritonitis (odds ratio: 0.061) were independent predictive factors for mortality and that the age of the patient (odds ratio: 1.049) and the occurrence of postoperative biliary complications (odds ratio: 0.161) after the initial biliary repair were independent predictive factors for late biliary stricture. CONCLUSIONS: Biliary tract injury is associated with significant mortality and complications in the practice of Belgian community surgeons. Intraoperative detection of ductal injury by the routine use and a correct interpretation of intraoperative cholangiography improved outcome. The impact of the primary biliary repair on long-term outcome is an argument to refer these patients to specialized multidisciplinary experts. The results highlight the importance of surgical experience, proper selection of patients for laparoscopic cholecystectomy, and conversion to laparotomy in difficult cases.

Adult↗

Laparoscopic treatment of nonparasitic liver cysts: adequate selection of patients and surgical technique.

Results of laparoscopic fenestration in patients with a highly symptomatic solitary liver cyst (17 patients) or polycystic liver disease (PLD) (9 patients) were prospectively evaluated in a multicenter practice of general surgeons. Conversion to laparotomy was required in two patients because of inaccessible deep liver cyst in one and a diffuse form of PLD in the other. There was no mortality or major morbidity. Mean postoperative hospital stay was 4.6 days after successful laparoscopic procedures. During a mean follow-up of 9 months, 23% of the patients had recurrence of symptoms and 38% had radiographic reappearance of cysts. Factors predicting failure included previous surgical treatment, deepsited cysts, incomplete deroofing technique, location in the right posterior segments of the liver, and a diffuse form of PLD with small cysts. Adequate selection of patients and type of cystic liver disease and meticulous and aggressive surgical technique are recommended.

Adult↗

Common bile duct foreign body: an unusual case.

A 59-year-old woman had symptomatic gallbladder stones. A laparoscopic cholecystectomy was performed using absorbable clips. Eleven weeks later, recent pain in the right upper quadrant and interscapular resulted in an ERCP. This examination demonstrated two Absolok Plus clips migrated in the biliary tract. We question the use of those clips and discuss the migration mechanism.

Absorption↗

[Arterial thrombosis of the lower limb in patients over 80 years of age. Belgian multicentric experience concerning 802 patients].

This report concerns a joint study of fourteen centres about the treatment of arterial occlusion of the low extremity. Eight hundred and two patients older than 80 years have been studied during a period from 1 to 27 years. The operative mortality was 25.2%. There was no significant difference in mortality between emergency cases and those patients who were operated under elective conditions. Leg amputations are followed by a significant higher mortality than more conservative surgery such as arterial by-pass, sympathectomy or embolectomy. The most frequent cause of death was from cardiopulmonar origin (57%). The postoperative morbidity of cardiac, pulmonary, urinary or infectious origin was frequent (50%). Surgical complications in the true sence of the word are quite rare and their frequency is limited to 7%. The conclusion of this study is that conservative surgery such as reascularisation or sympathectomy is, whenever possible, to be preferred over amputation not only because of their lower mortality (13 to 19%) but also since they permit better revalidation of these elderly patients.

Aged↗

Urological complications following aortofemoral bypass graft.

3 cases of ureteric obstruction secondary to aortic femoral bypass grafting are presented. This complication has been infrequently reported and we feel that it may be more common than is recognised. In all other published cases the ureter lay behind the prosthesis but the authors present a surgically proved case where the ureter lay in its normal position. The aseptic vascular reconstructive surgical procedures are to be preferred to ureteric reconstruction.

Aorta↗

[Ureteral obstruction secondary to aortic femoral by-pass (author's transl)].

We have presented 3 cases of ureteral obstruction secondary to aortic femoral by-pass grafting. This complication has not been frequently reported and we feel that it may be more common than recognised. In all the other published cases the ureter was passing behind the prosthesis but the authors present a surgically proved case where the ureter lies in its normal position. They also prefer the aseptic vascular procedures for reconstruction.

Aorta, Abdominal↗

[Indications, method and results of autotransfusion in trauma and vascular surgery (author's transl)].

The authors have used the Bentley Ats 100 system, a disposable autotransfusion unit, in 31 cases of trauma and major vascular surgery. An original method of anticoagulation consisting in heparine (1 mg/kg bodyweight) and priming and flushing of the succion unit with ACD is described. The effect of the autotransfusion on the coagulation and the recent problems and advances are discussed.

Abdominal Injuries↗

An unusual case of blunt abdominal trauma: A bleeding and ruptured gall-bladder managed by laparoscopy.

An isolated gall-bladder injury after blunt abdominal trauma is rare. Intraluminal bleeding with a perforation and an intra-abdominal haemorrhage is even rarer. Early diagnosis is difficult, even with a CT-scan or an US-scan available. Clinical suspicion, serial clinical examination and repeated imaging, can prevent mortality and morbidity. We present a case where laparoscopy was used to diagnose and treat an isolated gall-bladder lesion after blunt abdominal trauma.

Abdominal Injuries↗