General Surgery
نویسنده
چکیده
116 SAJS VOL. 51 NO. 4 NOVEMBER 2013 Laparoscopic cholecystectomy is the preferred and most widely used method of removal of the gallbladder in patients with symptomatic cholelithiasis. Although the technique was introduced more than 20 years ago, bile duct injuries occurring as a consequence of the procedure remain a major problem in surgical practice. Bile leaks after laparoscopic cholecystectomy represent a spectrum of extrahepatic biliary duct injuries, and range in severity from minor cystic duct (CD) leaks to complete transection of the common bile duct (CBD). Once a bile duct leak or injury is identified, the principles of management are well defined and include effective drainage of intra-abdominal collections and detailed cholangiographic evaluation of the biliary system.[1,2] In patients who have a CD leak or a side-hole in the bile duct, an operation may be avoided by either endoscopic or radiological biliary stenting if biliary continuity is present.[3-6] If a major duct injury has occurred and operative treatment is necessary, repair by a surgeon with expertise in biliary reconstructive surgery will be necessary. An important factor limiting morbidity is early recognition of the injury and appropriate intervention to prevent the potentially life-threatening complications of bile peritonitis, sub-hepatic abscesses, interloop and intra-abdominal sepsis and cholangitis, or the later secondary sequelae of biliary cirrhosis, portal hypertension and end-stage liver disease. There is consensus that optimal management of a bile duct injury requires multidisciplinary Endoscopic management of bile leaks after laparoscopic cholecystectomy
منابع مشابه
Adhesive small bowel obstruction: where do we stand now?
Adhesive small bowel obstruction (ASBO) is one of the most frequently encountered disorders in Emergency Surgery Departments worldwide without negligible hospital admission rates and social costs (1,2). Notwithstanding significant improvements in techniques and materials, intra-abdominal adhesions following abdominal surgery still represent a major unsolved and debated issue harbouring challeng...
متن کاملNicolau Syndrome after Intramuscular Benzathine Penicillin Injection
A 3-year-old boy was admitted to the emergency department with right lower limb pain, edema, and livedoid discoloration that occurred immediately after intramuscular injection of benzathine penicillin. The patient was diagnosed with Nicolau syndrome, a rare complication of intramuscular injection presumed to be related to the inadvertent intravascular injection. It was first reported following ...
متن کاملEvaluation of knowledge toward oral and maxillofacial surgery in general physicians of Yazd Province in 2017
IIntroduction: The scope of oral and maxillofacial surgery (OMFS) is extensive and good knowledge about OMFS among different healthcare providers will be essential for referral of the patient. Therefore, this study aimed to evaluate the knowledge of general physicians of Yazd Province about the field of oral and maxillofacial surgery. Methods: In this cross-sectional study, 112 general physici...
متن کاملTapia's Syndrome after Corrective Jaw Surgery under General Anesthesia: A Case Report
Introduction:Tapia’s syndrome is a rare complication of recurrent laryngeal and hypoglossal nerve paralysis due to anesthetic airway mismanagement or malpositioning of the patient’s head during surgery. Case Report:Here we present a case of Tapia's syndrome in a 22-year-old male after corrective jaw surgery under general anesthesia, with a long period of recovery, related to airway management p...
متن کاملThe effect of peritoneal repair or non-repair on complications after open appendectomy
Abstract Introduction: Appendicitis is the most common condition of emergency surgery. Complications after appendectomy include skin complications, infection, postoperative pain, hernia and obstruction. There is a difference of opinion among surgeons on peritoneal repair after abdominal surgery. Therefore, we aimed here to evaluate the effect of peritoneal repair versus non-repair in appendec...
متن کامل