The cholecystectomy by video laparoscopy has made a big revolution in biliary surgery during de last three or four years. We present the first 25 cases with acute cholecystitis operated on by this technique with very low morbidity a convalescence period and hospitalization time inferior to the one expected for open cholecystectomy and a conversion to open laparotomy in a relatively low percentage of the cases. In order to perform this procedures a basic training in surgery and laparoscopy is necessary groups of surgeons that work coordinated with adequate instrumentation as well as experience in laparoscopic cholecystectomy in non acute cases is always necessary.

Acute Disease↗

PubMedDate not supplied

[Angiographic aspects of tumors of the islet of the pancreas].

Four patients with islet cell tumours were explored with selective angiography. The radiological findings of 3 insulinomas and 1 nonfunctioning tumor are described. The typical hypervascular pattern of parenchimatose phase was found in all. The three insulinomas were successfully treated surgically. The nonfunctioning tumor was not removed due to the pathologists original impression that it was a maligant tumor involving the portal vein. Angiographic pattern, etiology, differential diagnosis and causes of errors are discussed. The method is diagnostically useful and offers important precperative information thus reducing operating time and minimizing the magnitude of the surgery.

Adenoma, Islet Cell↗

PubMedDate not supplied

[Carcinoma of the colon metastatic to the cervix uteri. Review of unusual metastases and report of one case].

Metastases from colon and rectal carcinoma are by direct extension, lymph node infiltration, haematogenous, perineural, intraluminal or by superficial spread. Diagnosis is based on carcinoembryogenic antigen levels, chest x-rays ultrasound, bone scan, laparoscopy or computerized axial tomography. Target organs are liver, lung, ovaries, brain, bone and muscles; other sites are rather uncommon and seldom reported. No other case of cervix metastases has been reported in the English or Spanish literature in the last 10 years.

Adenocarcinoma↗

PubMedDate not supplied

[Acute cholecystitis: is it a laparoscopic procedure?].

One-hundred and twenty-seven consecutive patients with acute cholecystitis were operated using laparoscopic technique. Average Surgical operating time was 113 minutes with an average of 127 minutes if operative cholangiogram was performed and 96 minutes when cholangiogram was not done. Technical difficulties related to gallbladder edema and hyperemia was seen in all cases (100%), also poor exposure and difficulty in grasping the gallbladder in 87%. The most common post operative complication was the wound infection of the entry trocar port, mainly at the umbilicus. One patient with gangrenous cholecystitis and multiple organ failure died after endoscopic attempt and converted to open technique. The total number conversions was 3%. In 28% of the patients a ERCP was done with ten positive for common duct stones. Operative cholangiogram was attempted in all cases with 83% success rate and 5% where positive for common duct stones. In cases where ERCP was done postoperatively for suspicious stones, seven cases were positive. Hospital stay averaged 1.6 days. Acute cholecystitis does not contraindicate laparoscopic technique and chances of having concomitant common duct stone is 16%, for that reason radiologic studies are mandatory.

Acute Disease↗

PubMedDate not supplied

[Parenteral hyperalimentation in the Surgical Service III].

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Gastrointestinal Diseases↗