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Patpong Navicharern

Publications and source records attributed to Patpong Navicharern.

3 recordsLinked to original sources

Can a single dose corticosteroid reduce the incidence of post-ERCP pancreatitis? A randomized, prospective control study.

BACKGROUND: Acute pancreatitis is one of the complications after Endoscopic retrograde cholangio pancreatography (ERCP) and it could be fatal. Several drugs were used to prevent or decrease this complication. Corticosteroid is one of the medications which may have such potential. It is affordable and available everywhere. OBJECTIVES: To compare the incidence of post-ERCP pancreatitis in patients receiving single dose corticosteroid prior to the procedure with that of the control group . RESEARCH DESIGN: A prospective randomized controlled double-blinded study. MATERIAL AND METHOD: A total of 120 patients were randomized to receive either intravenous hydrocortisone 100 mg. or normal saline 1 hour prior to the procedure. The serum amylase levels were recorded 4 and 24 hours after the procedure. Abdominal pain and back pain were also recorded. Patients were diagnosed as having post-ERCP pancreatitis if ones had new or worsened epigastric pain with or without radiation to the back combined with elevation of serum amylase more than 2.5 times the upper limit. RESULTS: The overall incidence of pancreatitis was 6.67% with 1.64% in the study group compared with 11.86% in the control group (p = 0.031). The groups were similar with regard to age, gender, type of procedure performed (diagnostic or therapeutic), difficulty of cannulation, concentration of contrast media and pre operative amylase level. CONCLUSION: The results of the present trial indicate that hydrocortisone could reduce the risk of post-ERCP pancreatitis.

Acute Disease↗

Minimally invasive surgery training in soft cadaver (MIST-SC).

OBJECTIVES: The purpose of this study was to evaluate the surgical anatomy, tissue plane, organ consistency of soft cadaver and the possibility of minimally invasive surgery training in soft cadaver. SETTING: Surgical Training Center. Department of Anatomy and Department of Surgery Faculty of Medicine, Chulalongkorn University. DESIGN: Prospective descriptive study. MATERIAL AND METHOD: 2 soft cadavers were scheduled for fully laparoscopic surgery in upper gastrointestinal, colorectal, hepatopancreatobiliary and solid organs surgery. All the procedures were performed by the experienced surgical staffs and assisted by surgical staffs and/or surgical residents. The surgical anatomy, tissue plane, organ consistency and the satisfactory in performing the procedures were recorded for evaluation. RESULTS: The surgical anatomy, the tissue consistency the anatomical plane were very well preserved with mean score of 4.72 +/- 0.45. All the surgeons were satisfied with the findings, the mean score was 4.97 +/- 0.18. All the plan procedures were completely performed with great satisfactory results. CONCLUSION: The Minimally Invasive Surgery Training in Soft Cadaver (MIST-SC) was feasible with great satisfactory. This successful integration of basic and advanced laparoscopic procedures into the soft cadaver setting would be the next step in evolution of MIS training.

Cadaver↗

Endoscopic transaxillary thyroid lobectomy: flexible vs rigid laparoscope.

BACKGROUND: The use of the endoscopic procedure for thyroid lobectomy in benign solitary thyroid nodule has been developed rapidly and increasingly refined in recent years. The early results are technically feasible, safe and mainly provide promising cosmetic results, some show a quicker recovery. The authors wanted to know if this procedure can be performed via rigid laparoscope which is simple, less expensive and widely available in many surgical centers. OBJECTIVES: The aims of this study were to evaluate operative time, blood loss, complication of flexible compared to 30 degrees rigid laparoscope in endoscopic transaxillary thyroid lobectomy for solitary thyroid nodule. METHOD: From February 2004 to June 2004, 13 cases of benign solitary thyroid nodule underwent the endoscopic transaxillary thyroid lobectomy. Flexible laparoscope techniques were performed in 9 cases and 30 degrees rigid laparoscope in the other 4 cases. Port site, number of ports and dissected method were the same in both procedures by the same surgeon. Operative time, blood loss, post-operative results were measured for evaluation. RESULTS: From 13 cases, 9 in the flexible laparoscope group and 4 in the rigid laparoscope group. All but one in the flexible group with torn internal jugular vein were successful. The mean operation time was 165.42 +/- 35.06 minutes, which was 175.63 +/- 35.70 minutes for flexible laparoscope group and 145 +/- 26.45 minutes for rigid laparoscope group. There was no recurrent laryngeal nerve injury and no subcutaneous emphysema. The patients were satisfied with the cosmetic results. CONCLUSION: On the basis of early experience with these 13 patients, the authors believe that endoscopic thyroidectomy using the rigid laparoscope has proved to be no different in the intra-operative results, so the authors do aimed to show that with the rigid laparoscope which is available in many surgical centers, less expensive and easy in maintenance will provide another surgical option for treatment of thyroid nodule, with maximized cosmetic effect.

Adult↗