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P J Imperato

Publications and source records attributed to P J Imperato.

At least 19 recordsLinked to original sources
PubMed1992

Complications of laparoscopic cholecystectomy in a geriatric population group.

The purpose of this study was to assess the complications of laparoscopic cholecystectomy among geriatric patients in New York State who receive their medical care under the Federal Medicare Program. A 20% random sample survey (304 patients) of the 1,520 patients who underwent laparoscopic cholecystectomy between January 1, 1990, and June 30, 1991, was selected. Coded ICD-9 diagnoses and procedures were carefully reviewed for these patients. In some patients with complications, the medical charts were reviewed by a medical epidemiologist and a surgeon to more fully elucidate the reported complications. The patients in this study were randomly selected from public, proprietary, voluntary, and teaching hospitals. Seventy-two complications (23.68% of the 304 patients) were identified in 48 patients (15.78% of the 304 patients). Of these complications, 27 (8.88%) were surgical, and 43 (14.14%) were medical in character. There were two deaths (0.66% of the 304 patients). Individual chart review of 32 of the 48 cases with complications revealed physician-related surgical quality-of-care problems which directly contributed to complications in 10 patients (31.25%). The overall complication rate of 23.68% found in this study represents one of the highest so far reported among published studies of laparoscopic cholecystectomy. The results of this study indicate a significant level of morbidity when laparoscopic cholecystectomy is performed on a geriatric population group. Although age-associated risk factors contributed to this high complication rate, so too did errors of surgical judgment and technique.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Serious complications of laparoscopic cholecystectomy in New York State.

Serious surgical complications following laparoscopic cholecystectomy are described in a series of 17 patients who underwent the procedure in New York State in 1990 and 1991. Among the 17 cases, the most frequent complication (41.1%) was laceration of the common bile duct and/or right hepatic duct. Other serious surgical complications included perforation or laceration of the small bowel, laceration or injury of an intrahepatic bile duct, and post-operative bleeding. Some of the serious complications described here, such as laceration of the aorta and iatrogenic resection of portions of the extrahepatic biliary tree, have not been previously described. The results of this study point out the need for carefully designed retrospective and prospective studies to assess the prevalence of complications from this procedure.

Adult↗
PubMed1991

First year medical student experiences with being discouraged from entering medical school.

Three hundred and fourteen first year medical students from two consecutive classes were surveyed for their experiences with being discouraged from entering medical school. Sixty-eight percent (215) had been discouraged from becoming physicians. The sources of discouragement were varied, with 43% citing physician acquaintances and 40% friends and neighbors. Parents were the principal source of encouragement (58%) followed by friends and neighbors (47%). More students (34%) were encouraged by undergraduate professors and advisors than by their family doctor (23%), a physician relative (18%), or a physician acquaintance (31%). Discouragement centered on three broad areas: diminished financial rewards, increased financial costs, and quality of life.

Attitude↗