Biomedical subjects

S B Gilroy

Publications and source records attributed to S B Gilroy.

3 recordsLinked to original sources

PubMed1995

Intraoperative trans-gallbladder cholangiography intended to delineate bile duct anatomy.

Intraoperative cholangiography has been recommended to lower the incidence and severity of biliary tract injury during laparoscopic cholecystectomy. However a literature review of common bile duct (CBD) injuries does not appear to support this concept. Most cystic duct cholangiographies disclose the injury after the fact. This study was designed to compare the technical difficulties and complications of laparoscopic cholecystectomy in three groups of patients: Group 1 underwent intraoperative cholangiography through the gallbladder (n = 288), group 2 underwent intraoperative cholangiography through the cystic duct (n = 162), and group 3 did not undergo cholangiography (n = 227). Cholecystectomies were defined as "difficult" if there was a need to convert to open procedure in the absence of an accidental complication, or if estimated blood loss was over 100 ml, and/or if operating time was over 2 h. Difficult cholecystectomies were encountered in 34% of patients in group 2 and 28.2% of patients in group 3, but in only 7.6% of patients in group 1. Technical complications (bleeding, bile leak, common bile duct injury, retained common bile duct stones, false positive choledocholithiasis, pancreatitis, and trocar injuries) occurred in 11.7% of cases in group 2, 4.4% in group 3, and in only 1.4% of group 1. Intraoperative cholangiography performed through the gallbladder before any dissection was initiated significantly facilitated the operation and helped decrease the incidence of technical complications.

Adolescent↗

PubMed1992

[Laparoscopy in acute appendicitis].

Our experience shows that laparoscopy is an excellent diagnostic method in cases where acute appendicitis is suspected, but when the clinical picture and tests are equivocal. Laparoscopy can help diagnose other abdominal conditions mimicking acute appendicitis and, in addition, may be used to remove the appendix in most cases, with advantages over open surgery.

Acute Disease↗

PubMed1992

The role of laparoscopy in the diagnosis of acute appendicitis.

Patients with acute appendicitis who present with an atypical clinical picture are frequently subjected to a series of laboratory and x ray tests and sometimes to prolonged observation before surgery. There is a significant number of normal appendixes found at laparotomy, particularly in some subgroups of patients such as the immunocompromised, the elderly, and the young woman. Laparoscopy was done in 38 patients with right lower quadrant pain of undetermined cause after extensive diagnostic efforts. This group of patients included men and women with an even distribution of ages between 20 and 78 years. Laparoscopy was done under local anesthesia to better establish the site of pain if no obvious pathology could be visualized. Acute appendicitis was confirmed in only 26.3 per cent of the cases, and a wide variety of nonappendiceal diseases were identified, the majority of them requiring no surgery. Diagnostic laparoscopy performed under local anesthesia should be considered in patients suspected to have acute appendicitis, regardless of age and sex, who present with an atypical picture and who still offer diagnostic doubts after other available conventional tests.

Acute Disease↗