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Biomedical subjects

N G Richardson

Publications and source records attributed to N G Richardson.

13 recordsLinked to original sources
PubMed1999

Percutaneous transcholecystic cholangiography during laparoscopic cholecystectomy.

BACKGROUND: Controversy still exists regarding the role of routine cholangiography in laparoscopic cholecystectomy. Although the need to identify common bile duct stones is perhaps less critical than it was in the past, confirmation of anatomy by peroperative cholangiography is important for both clinical and medico-legal purposes. Conventionally, contrast has been introduced into the biliary tree via the cystic duct after dissection of Calot's triangle. METHODS: A simple technique of cholangiography by direct gall-bladder puncture is described, which can be done quickly and easily at the beginning of the operation. RESULTS: The retrospective analysis of 250 consecutive cases shows the technique to be safe, accurate and to provide useful cholangiograms in 85% of cases. CONCLUSIONS: Percutaneous transcholecystic cholangiography can be performed readily without special equipment. It provides valuable anatomical information in 85% of cases before commencing dissection of the cystic duct.

Adolescent↗
PubMed1998

Abdominal ultrasonography in the diagnosis of colonic cancer.

BACKGROUND: Colonic cancer is normally diagnosed by barium enema or colonoscopy. Neither investigation is ideal, especially in the elderly patient. This study investigates the potential role of abdominal ultrasonography in the diagnosis of colorectal carcinoma. METHODS: Fifty-four patients with known or suspected colonic carcinoma were referred for abdominal ultrasonography. A single radiologist performed scans on these patients and the site of any colonic mass or wall thickening considered to be consistent with a colonic carcinoma was reported. All carcinomas were confirmed by histology on tissue obtained at colonoscopy or surgery against which the ultrasonographic diagnosis was compared. Colonic masses detected in patients undergoing routine abdominal ultrasonography for abdominal symptoms were also reported. RESULTS: Forty-five of the 54 patients referred had colonic carcinoma and abdominal ultrasonography detected 43 of the tumours and correctly identified the site of 41. The sensitivity, specificity and accuracy of abdominal ultrasonography in the detection of colonic tumours considered to be consistent with a colonic carcinoma was 96, 67 and 91 per cent respectively. Seven tumours were identified in patients referred before any other investigation had been carried out. CONCLUSION: Abdominal ultrasonography may detect a colonic mass or wall thickening consistent with a colonic carcinoma with a high degree of accuracy and may be useful when barium enema or colonoscopy is not possible.

Colonic Neoplasms↗
PubMed1998

Maximum surgical blood ordering schedule in a district general hospital saves money and resources.

A 6-month prospective audit was carried out in three surgical departments of a district general hospital. Over that period, 2720 units of red cells were electively cross-matched, 957 being transfused. The overall cross-match-to-transfusion ratio (CTR) was 2.8, but this varied from over 40 for some gynaecological procedures to 1.5 for major surgical procedures. The average CTR for general surgery was 2.2, orthopaedics 2.3, and obstetrics and gynaecology 5.7. A maximum surgical blood ordering system (MSBOS) was introduced and a second 6-month audit carried out. The number of units cross-matched had fallen by 36% to 1746, with a CTR of 1.8. The change in activity had led to a saving conservatively estimated at 11,616.00 Pounds per annum. Local audit and the introduction of a MSBOS in a district general hospital is an exercise which can demonstrate inefficiencies in blood ordering practices and can lead to large financial savings without detracting from standards of patient care.

Blood Grouping and Crossmatching↗
PubMed1995

Use of albumin.

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Albumins↗