Surgical endoscopy enters the era of electronic publication
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Journal Article↗
Biomedical subjects
BV MacFadyen
Publications and source records attributed to BV MacFadyen.
The Role of Endoscopic Retrograde Cholangiopancreatography in the Era of Laparoscopic Cholecystectomy.
The technique of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES), for removal of bile duct (BD) stones have been highly successful (>90%). The preoperative indications include cholangitis, worsening gallstone pancreatitis, patients with jaundice, and in those patients who have common bile duct stones seen on ultrasonography. Intraoperatively ERCP/ES has been used along with the placement of a papillotome through the cystic duct and papilla and performing a sphincterotomy in an antegrade fashion. The approach with the least complications is with the antegrade passage of the papillotome, and both techniques are efficient and safe in removal of proximal and distal BD stones. The postoperative indications for ERCP include retained common bile duct stones, bile duct injury, bile leak, and in patients who have developed a bile duct stricture. A success rate of 90% to 95% for complete removal of bile duct stones has been achieved. Overall, ERCP/ES is a highly effective procedure for removing bile duct stones, but it should be used only in selected patients preoperatively, intraoperatively, and postoperatively.
Journal Article↗
Inguinal Herniorrhaphy: Complications and Recurrences.
Because laparoscopic surgical techniques have been applied to inguinal hernia repair, the surgeon has been forced to re-evaluate his particular open technique and its resultant complications and recurrences to determine what is the best procedure for patients. In this article, complication rates for open inguinal herniorrhaphy varied from 7% to 12% with some reports as low as 1% using the anterior mesh technique. The most frequent complications were wound problems and scrotal and testicular swelling. In the laparoscopic series using retroperitoneal mesh or the "onlay" technique, the number of complications in 3,288 inguinal herniorrhaphies was 522 (16.8%). On the other hand, recurrence rates for open inguinal herniorrhaphy ranged from 1% to 10% for primary repair to as high as 35% for the repair of recurrent hernias. The laparoscopic series involved 3,178 repairs using the retroperitoneal and onlay techniques, and 61 recurrences (1.92%) were noted in a follow-up greater than 6 months. These data emphasize that complication and recurrence rates are similar between open and laparoscopic inguinal herniorrhaphy.
Journal Article↗