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Biomedical subjects

A Chousleb

Publications and source records attributed to A Chousleb.

6 recordsLinked to original sources
PubMed1999

Laparoscopic common bile duct exploration.

Since the introduction of laparoscopic cholecystectomy, the management of common bile duct (CBD) stones has undergone significant change. Preoperative endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy is now routinely done in cases where the diagnosis of choledocholithiasis is suspected preoperatively, with clearance of the bile ducts before laparoscopic cholecystectomy. Intraoperative discovery of CBD stones by cholangiography represents a challenge to the surgeon, who must make a decision about when to perform laparoscopic CBD exploration, convert to open surgery, or send the patient for ERCP during the postoperative period. Because ERCP has a definite failure rate, laparoscopic CBD exploration can be a treatment option. Among 2500 laparoscopic cholecystectomies done by our group from January 1991 to June 1997, 50 patients (2%) underwent laparoscopic CBD exploration, 13 by the transcystic technique and 37 by choledocotomy, with a conversion rate of 8% and a hospital stay of 4.3 days. One patient died from complicated pancreatitis following ERCP and unsuccessful extraction of a CBD stone. We obtained our goal of a CBD free of stones in 92% of the cases. We conclude that laparoscopic CBD exploration is an effective method for treating choledocolithiasis that allows management of this pathology in one stage, although it requires advanced laparoscopic skills and adequate equipment.

Adult↗
PubMed1996

Topographic anatomy of the recurrent laryngeal nerve.

Anatomic and topographic studies were carried out in 30 recurrent laryngeal nerves (RLN), dissecting the vagus nerve retrogradely to identify corresponding fascicles to the RLN. By obtaining measurements of diameter and length, surgically practical data were obtained, allowing for a possible revision of reconstructive possibilities for nerve injuries to the RLN through dissection and nerve graft.

Female↗
PubMed1994

Thoracoscopic clipping and ligation of a patent ductus arteriosus.

Several techniques of patent ductus arteriosus occlusion primarily by thoracotomy have been practiced. They have shown to be more reliable than nonsurgical procedures. Videothoracoscopy has been useful in several intrathoracic surgical procedures with faster recovery and minimal mortality and morbidity. We report 2 patients with clipping and ligation of a patent ductus arteriosus by a thoracoscopic approach. This technique may be useful in children with a noncomplicated patent ductus arteriosus. It allows an easier recovery and causes less pain.

Child↗
PubMed1987

Polytetrafluoroethylene microprosthesis in the venous system of the rat.

In this study, a 2 mm internal diameter (i.d.) polytetrafluoroethylene (PTFE) microprosthesis was used in the venous system of the rat, to determine whether or not it could serve as an acceptable microvenous substitute. Forty Long-Evans rats were divided into four groups: Group 1-10 rats with autotransplant of an inferior vena cava segment; Group 2-10 rats with a segment substitution of the inferior vena cava by a 2 mm i.d. PFTE microprosthesis; Group 3-10 rats with a laterolateral portacaval shunt; and Group 4-10 rats with a portacaval shunt and interposition of a 2 mm i.d. PTFE microprosthesis (new model). The rats were sacrificed at different time intervals up to 100 days, with cavography (femoral access) in Groups 1 and 2 and spleenoportography (direct puncture of the spleen) in Groups 3 and 4, before sacrifice. In Group 1, a 100 percent patency was observed at a mean of 49 days; in Group 2, a 70 percent patency with a 30 percent stenosis at a mean of 39.4 days (p less than 0.05); in Group 3, a 100 percent patency at a mean of 42.5 days; and in Group 4, a 30 percent patency at a mean of 38.4 days (p less than 0.01). Results showed that the 2 mm i.d. PTFE microprosthesis placed in the venous system of the rat is not an efficacious procedure, and that the search for better microvenous substitutes should focus on those of biologic origin.

Animals↗
PubMedDate not supplied

[Hemodynamic changes in hypoglycemic shock].

Severe hypoglycemia may be present in seriously ill patients; if it is not corrected opportunely a series of neuroendocrinal mechanisms take place aimed at correcting metabolic alterations. These mechanisms can produce hemodynamic alterations as well. Nine mongrel dogs were studied with continuous registration of: blood pressure, central venous pressure, cardiac frequency, respiratory frequency, electrocardiogram and first derivative (Dp/Dt). Six dogs received crystalline (fast acting) insuline intravenously (group 1). After hemodynamic changes were registered hypoglycemia was corrected with 50 per cent glucose solution. Complementary insuline doses were administered to three dogs (group 2); in this group hypoglycemia was not corrected. In group 1 during hypoglycemia there was an increase in blood pressure, central venous pressure, cardiac frequency, respiratory frequency and Dp/Dt, and changes in QT and T wave on the EKG; these changes were partially reversible after hypoglycemia was corrected. The above mentioned alterations persisted in group 2, breathing became irregular irregular and respiratory arrest supervened. It can be inferred that the hemodynamic response to hypoglycemia is predominantly adrenergic. The role of catecolamines, glucocorticoides, glucagon, insuline, cyclic AMP in metabolic and hemodynamic alterations consecutive to hypoglycemia are discussed.

Animals↗