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J L Ponsky

Publications and source records attributed to J L Ponsky.

112 records · Page 7Linked to original sources
PubMedDate not supplied

Endoscopic retrograde hemorrhoidal sclerotherapy using 23.4% saline: a preliminary report.

Historically, injection sclerotherapy has had a prominent role in the treatment of symptomatic hemorrhoids. Concern over sclerosant-related morbidity and dissatisfaction with anoscopic injection techniques has limited the application of this modality in the United States. This study reports an initial evaluation of 23.4% saline, used as a nonallergenic sclerosant, in the flexible endoscopic treatment of symptomatic internal hemorrhoids. Initial results in 19 patients with symptomatic grade I, II, or III hemorrhoids suggest that the technique is very effective in relieving bleeding, and frequently alleviates prolapse as well. The technique has proven to be well tolerated and associated with high patient satisfaction and low complication rates, with no serious complications noted. This modality is eminently suited for single session examination and therapy of the patient undergoing endoscopic evaluation for lower gastrointestinal bleeding whose findings are limited to hemorrhoidal disease.

Colonoscopy↗
PubMedDate not supplied

Trends in bile duct injuries from laparoscopic cholecystectomy.

Bile duct injuries are a serious complication of cholecystectomy. Laparoscopic cholecystectomies (LC) were originally associated with an increased incidence of injuries. Patients referred to a tertiary center were reviewed to assess the trends in the number, presentation, and management. Seventy-three patients were referred over a 6-year period with a maximum of 17 patients referred in 1992, but the number has not declined substantially over time. The persistent number of referrals is a consequence of ongoing injuries. One third of injuries were diagnosed at LC, and the use of cholangiography has not increased. The number of cystic duct leaks has not decreased and they represent 25% of all cases. The level of injury has remained unchanged with Bismuth types I and II in 37% and types III and IV in 38%. Excluding patients with cystic duct leaks, 58% were referred after a failed ductal repair. Definitive treatment with biliary stenting was successful in 37%, and 34 patients (47%) required a biliary-enteric anastomosis. Complications occurred in 18 patients (25%) including seven with postoperative stricture or cholangitis. No biliary reoperations have been performed at a mean follow-up of 36 months.

Acute Disease↗