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Biomedical subjects

H Orozco

Publications and source records attributed to H Orozco.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

[Is it necessary to routinely use nasogastric intubation and subhepatic (Penrose) drainage after an uncomplicated cholecystectomy?].

140 surgical patients were studied at the Navy Medical Center in Mexico City. All of them had a cholecystectomy performed. In addition, 29 patients were treated for hiatal hernia with troncular vagotomy, pyloroplasty and hiatal repair. 7 of them had a prophylactic appendectomy. Group A was treated with gastric intubation and subhepatic drainage. Group B received neither. Postoperative morbidity and hospitalization time less in Group B. It is suggested by the authors not to be use nasogastric intubation nor subhepatic drainage after elective cholecystectomy, although there are special circumstances where one or both procedures are indicated.

Adult↗
PubMedDate not supplied

[Percutaneous splenoportogammagraphy in the study of patients with portal hypertension].

Percutaneous esplenoportogammagraphy in 28 patients with portal hypertension, was carried out; in three patients studies were done before and after a derivative operation; in nine only after operation for portal hypertension and thirteen patients were not surgically treated. Hepatic maximal opacification was obtained in 4.35 seconds. In the operated patients the tecnesium reached right cardiac chambers in 2.91 seconds. In three of the thirteen patients with the test, there were intrahepatic circulatory pattern changes, average spleen-liver was 6 seconds and spleen-heart, 7 seconds, that is, esplenoportal perfussion was poor. In all the operated patients the decreased circulation time spleen-heart and the typical image showed anastomosis permeability.

Humans↗
PubMedDate not supplied

[Meso-renal derivation. A surgical alternative in the treatment of portal hypertension].

Meso-renal shunt (MRS) has been designed for patients with biliary cirrhosis and portal hypertension, in whom the derivation of the portal flow must be done prior to the biliary surgery. We performed the MRS in five patients. In three due to secondary biliary cirrhosis, one case due to criptogenic cirrhosis and the last presenting cavernomatous degeneration of the portal vein. After the MRS one patient died 33 days later due to acute liver failure and hepatorenal syndrome. Of the survivors three are enjoying normal lifestyle, one of them was underwent colecistectomy and coledocostomy without any surgical problems. One patient was lost to follow up out presenting at that time chronic porta-systemic encephalopathy. When necessary the MRS may offer a satisfactory choice, since can be performed far from the subhepatic area, thus allowing to perform further biliary surgery.

Adolescent↗
PubMedDate not supplied

[Evaluation of the minilaparotomy in the diagnosis of hepato biliary diseases].

The "minilap" an integrated procedure is described. With local anesthesia one can achieve omental and liver punch biopsy, transhepatic cholangiography, visualization of th portal venous system and at the same time determine its pressure. The procedure is carried out in the X-ray department in a short period of time and it is quite innocous for the patient. This paper reports on the results obtained by this procedure in forty patients. The anatomic diagnosis was made in the 97.5%. It leads to a precise diagnosis in all and there were not secondary complications, and no mortality at all.

Adult↗
PubMedDate not supplied

[Complications of splenectomy in the Sugiura-Futagawa procedure].

UNLABELLED: Evaluation of the complications of splenectomy in the Sugiura-Futawaga operation. BACKGROUND: Splenectomy in portal hypertension is a more difficult procedure and probably has a higher morbidity and mortality. METHOD: A retrospective study of 155 patients with hemorrhagic portal hypertension treated by means of the Sugiura-Futawaga operation was conducted to evaluate the complications related to splenectomy. RESULTS: Mean age of the patients was 42 years: 81 patients were male and 74 female. In 87 cases liver cirrhosis was shown, 39 cases with portal fibrosis, 23 cases with primary biliary cirrhosis and 6 cases with normal liver (idiopathic portal hypertension). No patient received preoperative immunization against pneumococcus, but received antibiotic prophylaxis. Complications were found in 16 cases (10.3%): 13 of them related to the surgical procedure (peritonitis 3.9%, subphrenic collection 1.9%, pancreatic pseudocyst 1.9% and pancreatic fistula 0.6%) and three related to the absence of spleen (1.9%) with septic shock as manifestation. CONCLUSIONS: The complications related to splenectomy in the Sugiura-Futagawa procedure are low, as well as the overwhelming post-splenectomy infection rate. Splenectomy in the Sugiura-Futagawa operation has no important role in the post-operative morbidity.

Adolescent↗
PubMedDate not supplied

[Comparison of two antimicrobial prophylaxis regimens in biliary tract surgery: a randomized controlled clinical trial].

OBJECTIVE: The aim of this study was to analyze the efficacy in prophylaxis during biliary tract and gallbladder surgery with amoxicillin/clavulanate and to compare it with the combination of cephalothin and clindamycin. DESIGN: A randomized nonblinded clinical trial with a blind independent observer. PLACE: Tertiary-care center. PATIENTS: Forty-two patients were included. All had undergone biliary tract and/or gallbladder surgery. They were divided in two groups: 22 in group A (cephalothin and clindamycin), and 20 in group B (amoxicillin/clavulanate). INTERVENTIONS: Patients from group A were intravenously treated with three doses of cephalothin (2 g at anesthetic induction and two additional doses of 1 g at six-hour intervals), and three of clindamycin (600 mg every six hours). Patients from group B received three doses of amoxicillin/clavulanate (1000/200 mg IV, one during the induction of the anesthesia followed by two more at six-hour intervals). RESULTS: In group A six wound infections were recorded, one of them with secondary bacteremia. In group B we did not record any infection (Fisher p < 0.01). One case of phlebitis was recorded in each group. CONCLUSIONS: Our results indicate that amoxicillin/clavulanate is useful in the prophylaxis of gallbladder and biliary tract surgery, and more effective than the combination of cephalothin and clindamycin.

Adult↗
PubMedDate not supplied

[Laparoscopic cholecystectomy. First year experience at the Salvador Zubirán National Institute of Nutrition].

UNLABELLED: The results at our institution with laparoscopic cholecystectomy in its first year are informed. The patients included in this study were routinely evaluated for an open procedure. The operation was done with the standard technique and equipment. In the postoperative period, ultrasound was done. Seventy-eight patients were included, 63 of them females. Age averaged 49.5 years (range 20-77). In three cases, choledocholithiasis was also demonstrated; these patients were treated with transendoscopic sphincterotomy. In 74 cases only cholelithiasis was demonstrated, two of them with shrinked gallbladder. In one case adenomyosis was found. Sixty-five cases had associated diseases which did not preclude the operation. Six cases were converted to an open cholecystectomy: two because of bleeding, the two cases with shrinked gallbladders, one with intrahepatic gallbladder, and the last one because of a Mirizzi syndrome with bile duct injury. In all cases, the conversion resolved the indication including the Mirizzi syndrome that required biliary reconstruction. No operative mortality was recorded. COMPLICATIONS: wound infection four, wound hematoma one, subhepatic hematoma two, and bile duct injury one.

Adult↗
PubMedDate not supplied

[Surgery in portal hypertension. Which patient and which operation?].

A prospective trial of a cohort of patients (N = 94) with portal hypertension and history of bleeding was selected for surgery based on strict clinical and laboratory criteria. All of them were treated with portal blood flow preserving procedures. The following selection criteria were used: good cardiopulmonary function without pulmonary hypertension and good liver function (Child-Pugh A). All patients were operated in an elective fashion and the operations performed were: selective shunts (N = 38) (distal splenorenal and splenocaval), low diameter mesocaval shunts (N = 13) and the esophagogastric devascularization with esophageal transection (Sugiura-Futagawa) (N = 43). Patients were selected for each operation according to their anatomical conditions. Sixty-one of the patients were cirrhotics. Operative mortality was 8% and rebleeding was observed in 5% of the cases. Postoperative encephalopathy was seen in seven patients (three selective shunts, two low diameter mesocaval shunts and two devascularizations). In 13 of 62 patients postoperatively evaluated by means of angiography, portal vein thrombosis was shown (seven selective shunts, two low diameter shunts and four devascularizations). Twenty-two patients with preoperative portal vein thrombosis (and treated with a Sugiura-Futagawa operation) were excluded from postoperative angiographic evaluation. Survival (Kaplan-Meier) was 85% at 60 months. Portal blood flow preserving procedures are the treatment of choice for patients with hemorrhagic portal hypertension and good liver function. The kind of operation is selected according to the individual anatomical status of the patient.

Adolescent↗