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E Trondsen

Publications and source records attributed to E Trondsen.

35 records · Page 2Linked to original sources
PubMed1993

Laparoscopic and open cholecystectomy. A prospective, randomized study.

OBJECTIVE: To compare laparoscopic with open cholecystectomy. DESIGN: Prospective random control trial. SETTING: Central Hospital of Akershus, Nordbyhagen, Norway. SUBJECTS: 74 consecutive patients due to undergo elective cholecystecomy between October 1990 and June 1991. INTERVENTIONS: Two patients were excluded from randomisation, and two were withdrawn after randomisation. The remaining 70 were randomly allocated to open or laparoscopic cholecystectomy (n = 35 in each group). MAIN OUTCOME MEASURES: Duration of operation and postoperative stay in hospital, amount of postoperative pain, incidence of complications, and duration of convalescence and sick leave. RESULTS: Laparoscopic cholecystectomy took twice as long as open (median [range] 100 [52-180] minutes compared with 50 [15-115], p < 0.01), but patients stayed in hospital half the time (2 [1-9] days compared with 4 [2-22], p < 0.01); required less opiate analgesia (4 [0-20] doses compared with 6 [0-13], p = 0.02; took less sick leave (11 [4-267] days (n = 18) compared with 34 [20-48] (n = 22), p < 0.01); and spent less time in convalescence (8 [3-40] days (n = 17) compared with 49 [10-247] (n = 12), p < 0.01). There were six complications in the laparoscopy group and seven in the open cholecystectomy group. CONCLUSION: Because of the significant differences between laparoscopic and open cholecystectomy we have now adopted the laparoscopic method as our standard, but we think that we can improve our results further by refining our operative techniques and giving our patients more information.

Adult↗
PubMed1992

[Laparoscopic closure and tegmentation of perforated ulcer].

Laparoscopy is fully recognized for diagnosis and even treatment of various acute abdominal conditions. In a 42-year-old woman with intense lower abdominal pain, laparoscopy revealed a perforated peptic ulcer. The ulcer was closed and patched with omentum and the abdomen was irrigated, all by laparoscopic techniques. Except for a minor wound infection recovery was uneventful.

Abdomen, Acute↗
PubMed1992

Serum carcinoembryonic antigen in relation to survival, DNA ploidy pattern, and recurrent disease in 406 colorectal carcinoma patients.

Serum carcinoembryonic antigen (CEA) levels in relation to survival, flow cytometric DNA ploidy pattern, Dukes stage, and recurrent disease was prospectively evaluated in 406 patients with colorectal carcinoma. In 246 patients (61%) the carcinomas were DNA aneuploid. Increased preoperative CEA levels (> 5 micrograms/l) were found in 151 of 363 evaluable patients (42%). Dukes stage-B patients with preoperative CEA elevation showed significantly poorer prognosis than those with normal CEA values (p = 0.001). A weak but significant correlation was found between preoperative CEA level and Dukes stage (Kendall's tau = 0.25, p < 0.01). Of 50 evaluable patients with clinical recurrence and postoperative normal or normalized CEA levels, 28 (56%) had a rise in CEA before or at the time of clinical recurrence. The sensitivity of the CEA test for primary and for recurrent disease was not significantly different in the DNA aneuploid and the DNA near-diploid groups.

Adenocarcinoma↗
PubMed1991

[Endoscopic bile duct drainage--technique].

The authors describe the technique of endoscopic implantation of endoprosthesis in the bile duct. From 1978 to 1989 implantation of endoprosthesis was successful in 88.7% of 212 patients. One to three procedures per patient were required for primary implantation. 407 procedures were performed; primary implantation, replacement of endoprosthesis and implantation of additional endoprosthesis. The success rate increased from 55% in the first third of the period to 82.4% in the last third. Ten patients had been previously operated with Billroth II gastrectomy and one with Whipple's operation. Implantation was successful in seven of these patients.

Bile Ducts↗
PubMed1991

[Endoscopic bile duct drainage--results].

212 patients were treated with endoscopic endoprosthetic drainage for bile duct obstruction. 137 patients had inoperable malignant obstruction, ten operable malignant tumor, 35 bile duct stones and 30 various benign strictures. Endoprosthetic stenting was successful in 188 patients (88.7%). The remaining 24 patients were treated with percutaneous transhepatic drainage or biliaryintestinal anastomosis, or received no treatment. In patients with successful implantation of endoprostheses, jaundice was relieved in 81% of the cases and pain in 89.6%. Cholangitis was treated with good results in 93.5%. Biliocutanous fistulas closed in two patients. Patency of the endoprostheses was 87 days on average. Replacement of endoprostheses or insertion of additional endoprostheses was performed 130 times. Complications occurred in 52 of 407 procedures (12.6%). Mortality related to the endoscopic endoprosthetic treatment was 4.2%.

Adult↗
PubMed1991

[Laparoscopic appendectomy].

Laparoscopic techniques have extended into the operative field of surgery. Appendectomies can be performed laparoscopically. The diagnosis of appendicitis is established and the inflamed organ removed directly. The laparoscopic technique reduces the incidence of unnecessary appendectomies and corresponding morbidity. Compared with conventional appendectomy, laparoscopy leads to less post-operative pain and inability to work. We discuss the first nine patients we treated in this way.

Adult↗
PubMed1991

[Laparoscopic cholecystectomy].

Techniques and instruments have recently been developed to perform laparoscopic cholecystectomy. Compared with conventional cholecystectomy, laparoscopic cholecystectomy results in significantly less post-operative pain and a shorter stay in hospital. We describe the procedure for laparoscopic cholecystectomy, with reference to the first patients treated in this way.

Adult↗
PubMed1990

[Pancreatic duct prosthesis].

Endoprothetic stenting of the pancreatic duct is reported in limited series. Twelve patients are presented here. In five patients with confirmed or suspected pancreatic malignancy, pain and diarrhea subsided or disappeared, and two patients had a temporary gain in weight. Four patients with chronic pancreatitis all experienced relief of symptoms. One patient with a pancreatic abscess improved temporarily. A postoperative pancreatic fistula healed within two weeks. One patient with a stone in the pancreatic duct became temporarily free from pain. Two patients had minor complications. Efficiency of pancreatic drainage is difficult to evaluate. However, all our patients seemed to benefit from the treatment.

Aged↗
PubMed1990

Surgical management of duodenal diverticula.

Surgical treatment of duodenal diverticula, although infrequently indicated, implies a high risk of postoperative complications. Diverticuloplasty was performed on five patients, four of whom had biliary or pancreatic duct obstruction and also underwent cholecystectomy and sphincteroplasty. The fifth patient had chronic abdominal pain. Complications occurred in three cases--postoperative diverticular bleeding, retroperitoneal hematoma and peroperative perforation of the common bile duct. The long-term results (3-10 years) were excellent in all cases.

Aged↗
PubMedDate not supplied

Selection criteria for endoscopic retrograde cholangiopancreaticography (ERCP) in patients with gallstone disease.

Endoscopic retrograde cholangiopancreatography (ERCP) has been used in patients referred to cholecystectomy when clinical information, biochemical values, or ultrasonography (clinical characterization) have indicated possible presence of common bile duct stones. A retrospective study of 599 patients treated for gallstone disease was used to develop a characterization procedure for predicting common bile duct stones by a discriminant analysis procedure. The variables selected by the analysis as the best combination for CBDS prediction were age (years), the values of bilirubin (micromol/l), ALAT (U/l) and gamma GT (U/l). The characterization was false positive in 22 cases (3.7%) and false negative in 11 cases (1.8%), compared to 198 false positive cases (33.1%) and three false negative cases (0.5%) by the clinical characterization. A leaving-one-out correction did not change the results. In a test set of 157 cholecystectomy patients, clinical characterization was false positive in 44.6% of the patients, compared to 4.5% false positive results when using the discriminant analysis procedure. The discriminant analysis procedure would have missed one patient with common bile duct stones. Selection by the discriminant analysis characterization procedure seems to reduce the frequency of preoperative ERCP significantly without an increase in undetected common bile duct stones.

Adolescent↗
PubMedDate not supplied

Prospective nonrandomized study of conventional versus laparoscopic appendectomy.

With the introduction of laparoscopic appendectomy a prospective study was started. Patients with suspected appendicitis were selected for conventional appendectomy or laparoscopy according to the preference of the surgeon on call. During a 1-year period 233 patients were included, of whom 97 underwent conventional appendectomy and 136 laparoscopy. Among the patients selected to laparoscopy, laparoscopic appendectomy was carried out in 72 cases, conventional appendectomy in 32, and only diagnostic laparoscopy in the remaining 32. Removal of a normal appendix was significantly more common in the group of patients directly selected for conventional appendectomy compared to laparoscopy (p < 0.01). The duration of the operation was shorter (p < 0.05) and the postoperative hospital stay and the convalescence longer (p < 0.05) with conventional than with laparoscopic appendectomy. Peroperative problems and minor postoperative complications were more common (p < 0.01) with laparoscopic than conventional appendectomy. However, the clinical impact of these problems were limited. The difference between the procedures regarding major complications was not significant. Laparoscopic appendectomy seems to be at least as good as conventional appendectomy. However, randomized controlled trials are needed to decide which of the procedures to recommend.

Adolescent↗