Biomedical subjects

Luis Ibáñez

Publications and source records attributed to Luis Ibáñez.

8 recordsLinked to original sources

PubMed2006

[Gallbladder polyps: correlation between ultrasonographic and histopathological findings].

BACKGROUND: Gallbladder polyps are becoming a common finding. The management of these polyps is complicated considering that they can bear malignant lesions. AIM: To analyze the ultrasonographic and histopathologic findings of patients operated due to gallbladder polyps. PATIENTS AND METHODS: The records of patients with ultrasonographic diagnosis of gallbladder polyp and that underwent cholecystectomy in a thirteen years period were reviewed, collecting their demographic, ultrasonographic and histopathological data. RESULTS: One hundred and twenty three patients were operated. The mean age was 44+/-13 years, and 69% were women. The mean size of polyps in ultrasonography was 7.3+/-5 mm. Histopathology confirmed the presence of polyps in 79% of patients, with a mean size and number of lesions of 5.1+/-3.8 mm and 2.1+/-2, respectively. Nine percent of polyps were greater than 10 mm, and single polyps were significantly larger than the multiple ones (p =0.003). Four cases of adenoma (3.2%) were diagnosed; one of them had in situ carcinoma. All were single and larger than 10 mm. We found a significant correlation between ultrasonographic and histopathological polyp size determination (r =0.47; p =0.002). Polyp size was also a predictor of the presence of adenoma (p =0.043; confidence intervals: 1.006-1.424). CONCLUSIONS: There is a good correlation between the size of the gallbladder polyp in ultrasonography and the size in the histopathology report. Gallbladder adenoma is uncommon and it correlates with the size of the polyp. In this series, size was the only predictor of the presence of adenoma.

Abdomen↗

PubMed2005

Integrating segmentation methods from the Insight Toolkit into a visualization application.

The Insight Toolkit (ITK) initiative from the National Library of Medicine has provided a suite of state-of-the-art segmentation and registration algorithms ideally suited to volume visualization and analysis. A volume visualization application that effectively utilizes these algorithms provides many benefits: it allows access to ITK functionality for non-programmers, it creates a vehicle for sharing and comparing segmentation techniques, and it serves as a visual debugger for algorithm developers. This paper describes the integration of image processing functionalities provided by the ITK into VolView, a visualization application for high performance volume rendering. A free version of this visualization application is publicly available and is available in the online version of this paper. The process for developing ITK plugins for VolView according to the publicly available API is described in detail, and an application of ITK VolView plugins to the segmentation of Abdominal Aortic Aneurysms (AAAs) is presented. The source code of the ITK plugins is also publicly available and it is included in the online version.

Algorithms↗

PubMed2005

Teaching medical image analysis with the Insight Toolkit.

We present several case studies which examine the role that the Insight Toolkit (ITK) played in three medical image analysis courses and several conference tutorials. These courses represent the first use of ITK in a teaching environment, and we believe that a discussion of the teaching approach in each case and the benefits and challenges of ITK will be useful to future medical image analysis course development. ITK was found to provide significant value in a classroom setting since it provides both working "canned" algorithms, including some recently developed methods that are unavailable elsewhere, as well as a framework for developing new techniques and applications. Several areas of difficulty, particularly in regards to code complexity and advanced object-oriented design techniques, have been identified which may make the learning curve of ITK somewhat more complex than a language such as Matlab.

Algorithms↗

PubMed2005

Prospective randomized study of T-tube versus biliary stent for common bile duct decompression after open choledocotomy.

The T-tube has been the alternative of choice for decompression following common bile duct (CBD) exploration. The development of laparoscopic surgery has suggested using a biliary stent as an alternative to the T-tube following choledochotomy. The purpose of this prospective randomized study was to compare clinical results obtained from patients who underwent open CBD exploration using a biliary stent versus those from patients with a T-tube for decompression. Between September 2000 and June 2002 a total of 81 patients were randomly assigned to a biliary stent or a T-tube as the decompression method following choledochotomy. An open CBD exploration was performed when CBD stones were suspected, in both elective and emergency settings. The length of the postoperative hospital stay was 6.8 +/- 4.7 days for patients with the T-tube and of 5.2 +/- 3.3 days for, patients with the biliary stent (p = 0.19). Postoperative complications were observed in 13 patients (30%) with the T-tube and in 4 patients (11%) with the biliary stent (p = 0.03). One patient with a biliary stent was reoperated because of an intraabdominal abscess, and another patient was reoperated because of biliary peritonitis following T-tube removal. Three patients (7%) with a biliary stent and one patient (3%) with a T-tube were rehospitalized. There were no deaths. The T-tube and biliary stent were removed 27.1 +/- 10.8 days and 34.9 +/- 12.9 days after surgery, respectively (p = 0.24). The biliary stent is a safe alternative to the T-tube as a biliary decompression method following an open CBD exploration.

Adult↗

PubMed2005

Gastric cancer after Roux-en-Y gastric bypass.

Roux-en-Y gastric bypass (RYGBP) is one of the most commonly performed surgical procedures for morbid obesity. Several complications that may develop in the short- and long-term have been reported. We present a patient who presented with cancer in the bypassed stomach 8 years after RYGBP. Although the development of this lesion is rare and only a few cases have been reported, there are aspects worthy of discussion. Several monitoring, diagnostic and therapeutic alternatives are analyzed.

Adenocarcinoma↗

PubMed2004

Wernicke's encephalopathy after Roux-en-Y gastric bypass.

Complications of bariatric operations include the development of nutritional deficiencies. If protracted vomiting is added, severe vitamin depletion could arise such as thiamine deficiency, resulting in the development of Wernicke's encephalopathy (WE). This article describes the rapid onset of WE in a 6-week postoperative morbidly obese woman. Because the occurrence of micronutrient deficiencies is infrequent, although reports are increasing, symptoms may be misdiagnosed leading to possible irreversible effects on the central nervous system. The importance of a prompt diagnosis of this serious complication and of adequate therapy is emphasized.

Adult↗

PubMed2003

[Elective laparoscopic surgery in diverticular disease. A comparative study with conventional operative surgery ].

BACKGROUND: Elective surgery in diverticular disease (DD) consists classically in performing an open sigmoidectomy. Laparoscopic surgery of the colon can have results that are comparable to those of open surgery. AIM: To compare the results of laparoscopic and conventional surgery for DD. MATERIALS AND METHODS: Retrospective review of preoperative, operative and postoperative variables of patients operated by laparoscopic surgery between the years 2000 and 20002. These results were compared with those of patients treated with conventional surgery in the same period. RESULTS: Thirty nine patients, mean age 59 years old, were operated via laparotomy and 18 patients, mean age 47 years old, were treated with laparoscopic surgery. Both groups were comparable in gender, amount of previous laparotomies, type of surgery performed and American Society of Anestesiologists classification. The operative time was significantly higher in the laparoscopic surgery group (230 v/s 130 min), but the opioid requirements, stay in an intensive surgical care ward, postoperative ileus and hospital stay were significantly shorter in the laparoscopic group. Eleven percent of the patients included in the laparoscopic group and 31% of the patients treated with operative surgery had complications (p = 0.07). The length of the excised colon, the degree of inflammation and treatment costs were comparable. CONCLUSIONS: Laparoscopic surgery in DD is feasible, safe, requires less analgesia and allows a faster recovery of post-operative ileus and a lower hospital stay.

Adult↗

PubMed2002

[Surgical treatment of hepatocellular carcinoma. Long term results].

BACKGROUND: Surgical treatment for hepatocellular carcinoma remains controversial due to a lack of prospective randomized studies. MATERIAL AND METHOD: Between January 1990 and December 2000, 121 liver transplantations (group 1) and 52 hepatectomies (group 2) were performed for hepatocellular carcinoma. Each surgical treatment was carried out depending on patients' and tumor's characteristics. RESULTS: Patients from group 1 had a more advanced tumoral grade, with higher involvement of two lobes (19 vs 4%; p = 0.015) and higher number of nodules (1.9 DE [2] vs 1.2 [0.6]; p = 0.001); yet the mean tumor size was lower (3 cm [1.5] vs 4.2 [3.2]; p = 0.006). Operative mortality (4% vs 2%; p = 0.66) and 5- and 10-years survival (68% and 42% vs 63% and 45%; p = 0.23) were similar between both groups. Nevertheless, 5- and 10-years recurrence rates (10.6% and 10.6% vs 50% and 65.5%; p < 0.0001) were more favourable in group 1. Prognostic factors of recurrence included microscopic vascular invasion (RR = 12.12; CI, 2.02-75.52) and alpha-fetoprotein levels higher than 300 ng/mL (RR = 7.12; 95% CI, 1.08-47.02) in group 1, and the pT3-4 stage (RR = 3.86; 95% CI, 1.06-14.03) in group 2. Mean time on waiting lists for liver transplantation was 3.06 (2.66) months and it has increased significantly in last years, especially among blood group 0 patients. However, this fact has not been associated with a worsening of survival rates (p = 0.98). CONCLUSIONS: After a good patient selection, either liver transplantation or hepatectomy achieve excellent long term survival rates in patients with hepatocellular carcinoma, though the former allows a better control of the tumoral disease. The increase of mean time on waiting lists for liver transplantation during the last years has not led to a worsening of survival results.

Carcinoma, Hepatocellular↗