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Biomedical subjects

P Holéczy

Publications and source records attributed to P Holéczy.

10 recordsLinked to original sources
PubMed2001

30% complications with adjustable gastric banding: what did we do wrong?

BACKGROUND: The authors analyzed the complications in patients following laparoscopic adjustable gastric banding (LAGB) for morbid obesity. METHODS: Retrospective analysis of the 36 LAGB patients was done. The operations were performed from December 1997 to the December 1999 using the Lap-Band. RESULTS: 11 complications occurred. Most common was port-site infection or port migration (5 patients). These complications were termed minor. In 3 patients, slippage of the gastric wall was observed, all corrected laparoscopically. In another 3 patients, removal of the band was necessary for poor patient compliance (1), for intussusception of the gastric wall through the band with occlusion of the stoma (1), and for infection of the band (1). These complications were termed major. The overall complication rate was 30.5%. CONCLUSION: Compared to the literature, our complication rate was rather high. Based on our analysis, the following measures are recommended: 1) antibiotic prophylaxis; 2) drainage of the port-site; 3) proper band and port placement and fixation; 4) closer psychological evaluation and follow-up. By these measures, hopefully we can obtain better results in the future.

Adult↗
PubMed2001

[Angio-organic ischemic syndromes--etiopathogenesis and differential diagnosis].

The authors analyze in the submitted review the classification, etiopathogenesis and in particular the differential diagnostic principles of the main obliterating arterial diseases which condition angio-organ syndromes. The most frequent disease which causes angio-organ ischaemic syndromes worldwide is at present atherosclerosis which however is not the only nosological unit, and in clinical practice it is important to consider also other organically conditioned diseases of the vascular system. In addition to ischaemic hypoxia it is important to consider also all types and varieties non-angiogenic (non-vascular) hypoxia. In the management of angio-organ ischaemic syndromes the surgeon (angiosurgeon) must collaborate in particular with the angiologist because vascular diseases are conditioned by many risk factors of a medical character and their elimination and treatment are within the competence of internal medicine and its specialized branch--angiology.

Arterial Occlusive Diseases↗
PubMed2001

[Unusual treatment of late complications of acute pancreatitis].

AIM OF THE STUDY: To present the case of 28 years old man operated on acutely for gastric bleeding. Pancreatic pseudocyst and portal hypertension was diagnosed intraoperatively. METHODS: For this reason the Jurasz procedure (pseudocystogastrostomy) was performed. In emergency reoperation for recurrent bleeding total gastrectomy had to be performed. The situation was solved by creating the oesophago-jejunostomy and pseudocystojejunostomy on the Roux-Y limb as a single anastomosis. RESULTS: Postoperative course was uneventful. After 5 years time the patient was readmitted for secondary malabsorbtive syndrome. The conservative treatment was used successfully. CONCLUSION: Unusual solving of above mentioned complication was successful in this case. The follow up and substitutive treatment is necessary following the total gastrectomy.

Acute Disease↗
PubMed1999

Laparoscopic adjustable gastric band: first experience in Slovakia.

BACKGROUND: Until recently, surgery for obesity was not done in Slovakia. After preparation in workshops, the authors began to perform laparoscopic adjustable gastric banding. Their laparoscopic work is based on a 7-year experience in laparoscopy. METHODS: From December 1997 to May 1998, 14 procedures were done. The laparoscopic adjustable gastric band was used in all procedures. The group consisted of 8 women and 6 men. Their ages ranged from 30 to 53 years (mean 43), the body mass index was 37-56 (average 46.2), the hospital stay was 3-7 days (4.8), and the operating time was 75-285 minutes (145.3). A five-trocar technique was used. RESULTS: Weight loss in the first month ranged from 9 to 15 kg. In follow-up, the weight loss averaged 3-4 kg monthly. Up to the time of writing, no band had been adjusted. Intraoperative hemorrhage occurred in two patients. No conversion was done. One patient underwent reoperation and removal of the band because of obstruction of the stoma caused by profuse vomiting after enormous intake of food. CONCLUSIONS: Despite a small early series, the procedure seems to be safe and well tolerated by patients, with sufficient early weight loss.

Adult↗
PubMed1997

[Laparoscopic cholecystectomy and its safety--observations after 2000 procedures].

The authors experience with laparoscopic cholecystectomy in the group of 2200 patients operated on from March 1992 to September 1996 is discussed. The complications rate at the beginning and at the end of the study is expressed. In the last 100 cases there was conversion rate of 1%, no biliary injury was observed and the average postoperative hospital stay was 2.26 days. In the whole group of patients biliary injuries were observed in 0.18%. Lethality was 0.13%. The authors conclude, that laparoscopic cholecystectomy is a save method in the treatment of the gallstone disease, when certain rules are respected.

Cholecystectomy, Laparoscopic↗
PubMed1996

[Reoperation in laparoscopic procedures].

Besides of really positives bring laparoscopic procedures also complications, which sometimes demand reoperation. When in our literature nobody mentioned this topics the authors bring their own experiences with reoperations after laparoscopic procedures. The authors in time from March 1992 to November 1995 performed together 1836 laparoscopic operations. 19 times, it means in 1.03%, the reoperations was needed. In the paper the authors discuss the causes of the reoperations, possibilities and methods of complications solution. They also discuss possibilities of complications prevention. The open surgery was performed in lesions of biliary tree, in pancreatitis, peritonitis and duodenal lesion. This type of surgery was performed also in hernia repair after technical error. Laparoscopic reoperations were performed in haemorrhage from the gallbladder bed, in pritonitis and in recurrent inquinal hernia. There is to be said, that laparoscopic reoperations need experience in this technique. In euphory from the growing laparoscopic surgery there is the need to remark also complications and unsuccesses. With gaining experiences it is possible to perform also reoperations laparoscopically. It is important to be sufficiently aggressive in diagnostic procedures and also in therapy of complications. It is advisable to use diagnostic laparoscopy with adequate solution of situations. Keeping this all in mind, there is possible to minimise the sequelae of complications and reoperations. There is also the possibility to prevent the reoperations.

Humans↗
PubMed1994

[The importance and role of laparoscopic appendectomy].

Inspite of earlier beginning the laparoscopic appendectomy is in the shadow of laparoscopic cholecystectomy. In connection with laparoscopic appendectomy some problems are discussed--his significance or substantiality, techniques, advantages or disadvantages in contrast to classical appendectomy. The authors discussed these questions on the base of their own experiences with 56 laparoscopic appendectomies. These were done from 21. October 1992 to 7. February 1994. Known advantages of laparoscopic procedures are expressed--shorter hospital stay after the operation (in average 2.3 days), better view in the operating field with possibility of the treatment of gynecological pathology. Technical aspects are also discussed. The equipment with staplers according their opinion is needed. The time of the operations--average 44 minutes--is acceptable. The complication and conversion rate, which were noted in 3.6% resp. 5.3%, is quite good. There is a possibility to lower these numbers with increasing experience. The possibility for training in the laparoscopic field is great opportunity especially for young surgeons. In the end there is stated, that the authors consider laparoscopic appendectomy as an important step to the advanced procedures. The broad acceptance is recommended.

Adolescent↗
PubMedDate not supplied

Circadian rhythmicity of plasma somatostatin, gastrin and cortisol in colon cancer patients.

BACKGROUND/AIMS: The aim of the study was to compare somatostatin, gastrin and cortisol levels over a 24 hour period in patients suffering from large bowel cancer and to compare this group with healthy subjects and patients suffering from other large bowel diseases (ulcerative colitis, large bowel polyps). MATERIALS AND METHODS: There were 11 cancer patients (8 men and 3 women). The plasma levels of somatostatin, gastrin and cortisol were determined by radioimmunoassay. Fisher's periodogram and Halberg's cosinor analysis were used for statistical evaluation. RESULTS: We confirmed 24-hour rhythm of somatostatin, gastrin and cortisol secretion in patients with colon cancer. The most important findings were a higher mesor (p < 0.01) of gastrin compared to all other groups and a lower 24-hour amplitude (p < 0.05) and a shorter 12-hour acrophase (p < 0.05) of cortisol compared to all other groups were found. CONCLUSION: Chrono-abnormalities in gastrin and cortisol secretion may reflect the role of gastrin in the etiopathogenesis of colon cancer and a reduced responsiveness to stimulus in patients with malignant diseases. Somatostatin blood levels probably do not reflect its antitrophic effect at cellular and subcellular level.

Adult↗