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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seventy-eight cardiac transplantations were performed between July 1982 and March 1989. The perioperative death rate was 10%. Overall survival was 86%. Among the long-term survivors, 14 patients underwent 16 noncardiac surgical procedures. Seven of them required emergency laparotomy, four for biliary tract disease, one for ruptured abdominal aortic aneurysm, one for suspected abdominal sepsis and one for enterocolitis. Elective surgical interventions included repair of symptomatic abdominal wall hernia, treatment of hemorrhoids or perianal condylomas, total hip arthroplasty, maxillary sinus drainage and resection of a duodenal villous adenoma. Preoperatively, all patients received cyclosporine orally. Ten of the 14 patients were on triple-drug immunosuppression (cyclosporine, azathioprine and low-dose prednisone [less than 0.20 mg/kg daily]). The remaining four patients took cyclosporine with either azathioprine or prednisone. There were no deaths. Complications were limited to residual choledocholithiasis treated by percutaneous removal, two cases of wound infection and an incisional hernia. The authors' experience indicates that noncardiac surgical procedures may be safely performed in patients who have received a heart transplant.
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PMID:General surgical procedures after heart transplantation. 235 Jul 41

The role of intraoperative cholangiography during laparoscopic cholecystectomy is controversial. Between July 1990 and June 1991, 82 of 84 consecutive patients (mean age, 46 +/- 14 years) with symptomatic cholelithiasis successfully underwent laparoscopic cholecystectomy with only one intraoperative cholangiogram. Fourteen patients underwent preoperative endoscopic retrograde cholangiopancreatography (ERCP) for suspected choledocholithiasis of which two demonstrated common duct stones and underwent sphincterotomy. Complications of laparoscopic cholecystectomy included one each of bilioma, umbilical wound infection, epigastric trocar site hernia, and flank seroma. No major bile duct or vascular injury occurred. Follow-up data was available on all patients for a mean of 7.4 months (range, 3-13 months). Three patients developed symptoms suggestive of biliary tract disease at 0.25, 4, and 8 months postoperatively. Symptoms spontaneously resolved in all three; all underwent ERCP, of which two were normal and one unsuccessful. We have concluded that (a) a meticulous operative dissection resulted in no major bile duct or vascular injury; (b) patients with unsuspected choledocholithiasis preoperatively rarely developed postoperative symptoms; and (c) the practice of laparoscopic cholecystectomy can be conducted safely without intraoperative cholangiography.
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PMID:Safe laparoscopic cholecystectomy without intraoperative cholangiography. 826 73

The experience of effective work of endoscopic service in district hospital, including surgeon and gynecologist in laparoscopic team is presented. The results of 1000 laparoscopic cholecystectomies were analyzed. In 868 cases the operation was performed for chronic and in 132 cases--for acute calculous cholecystitis. The additional endoscopic retrograde pancreatocholangiography and papillosphincterotomy (if it was necessary) was performed in patients with cholangitis and obstructive jaundice and also with choledocholithiasis, revealed during elective examination. In 33 cases in thick infiltrate of gall bladder neck or neck congenital anomalies, laparotomy was performed, 30 patients underwent minilaparotomy. Simultaneous operations were performed in 116 (11.6%) patients. In early postoperative period, the complications were seen in 8 patients. In 2 cases the injury of common hepatic duct was observed. Suppuration of paraumbilical wound was seen in 13 patients, postoperative paraumbilical hernia (4-6 months after operation)--in 18 patients. There were no cases of lethal outcomes.
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PMID:[Experience of 1000 laparoscopic cholecystectomies in district hospital]. 1107 Jun 68

A 45-year-old man was suffering from abdominal pain and vomiting. He was admitted to our hospital with a diagnosis of ileus and obstructive jaundice. He had undergone Roux-en-Y anastomosis for choledocholithiasis 14 years earlier. A computed tomography scan revealed a dilated afferent loop and dilated intrahepatic bile duct. Upper gastrointestinal examination with contrast medium and percutaneous transhepatic cholangiography showed a high intestinal obstruction around the jejunojejunal anastomosis. The patient underwent laparotomy based on a diagnosis of obstructive jaundice due to ileus. During the operation, he was found to have internal herniation of the small bowel through a rent in the mesentery around the Roux-en-Y anastomosis for choledochojejunostomy. The hernia was reduced, and bowel resection was performed due to stenosis of the afferent loop. Jejunojejunal anastomosis was re-performed and the defect in the mesocolon was closed. Internal herniation after Roux-en-Y anastomosis is a rare sequela, but it should be recognized that this complication can occur after Roux-en-Y anastomosis. For prevention of internal herniation around the Roux-en-Y limb, secure closing of the mesenteric defects is important.
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PMID:Obstructive jaundice due to internal herniation: a case report and review of the literature. 1214 94