Biomedical subjects

P Lampe

Publications and source records attributed to P Lampe.

39 records · Page 3Linked to original sources

PubMedDate not supplied

Management of necrotizing pancreatitis: flexible approach depending on intra-operative assessment of necrosis.

INTRODUCTION: The surgical management of necrotizing pancreatitis (NP) has changed over the years. MATERIAL AND METHODS: Among 144 patients, 12.5% (n = 18) were treated conservatively and 87.5% (n = 126) underwent surgery. The choice of operative method depended on the intra-operative assessment of consistency and on the extent of necrosis. A group of 126 patients underwent necrosectomy, followed by laparostomy with open packing in 80% (n = 101) cases, drainage in 14% (n = 18) and continuous closed lavage in 6% (n = 7). RESULTS: Postoperative complications occurred in 42.8% (n = 54) of the patients who underwent the surgery. Hospital mortality rate over all patients was 18% and 20.6% (n = 26) in the group of patients who underwent the surgery. Mean hospital stay was 61 +/- 36 days. Patients managed conservatively (n = 18) were discharged without surgical intervention. In this group no complications or deaths were observed. CONCLUSION: Using the three different surgical techniques in the management of NP, depending on intra-operative assessment of necrosis, showed promising results. A flexible approach targeted at a single patient and tailored to the clinical course and intra-operative situation should be considered in the treatment of NP.

Adult↗

PubMedDate not supplied

Necrosectomy with an ultrasonic dissector in the treatment of necrotizing pancreatitis.

BACKGROUND: The surgical techniques for the treatment of necrotizing pancreatitis (NP) are varied and the ideal method is still debated. METHODS: Necrosectomy with an ultrasound dissector was performed. After the necrotic tissue was removed the bed was filled with a gentamicin-containing sponge. In the upper part of the abdominal wound a laparostomy was formed. The laparostomic cavity was packed with Mikulicz pads with physiological saline. Packs were changed every 24-48 h. RESULTS: There were 43 patients in the study with a mean age of 54 years (range 33-77). Reasons for surgical treatment were sterile necrosis- 53.5% (n = 23), infected necrosis- 39.5% (n = 17), abscess- 7% (n = 3). The mean number of packing changes under sedation was 5 (range 1-19). Postoperative complications occurred in 25.6% of patients (n = 11). There were five deaths (11.6%) after surgery. CONCLUSION: Necrosectomy with an ultrasonic dissector and gentamicin-containing sponge inserted into the post-necrotic bed are effective and well tolerated in the open packing treatment of NP.

Adult↗

PubMedDate not supplied

Neuroendocrine pancreatic carcinoma causing sinistral portal hypertension.

BACKGROUND: Non-functioning neuroendocrine pancreatic tumors are usually connected with non-specific syndromes. CASE REPORT: This case history presents the diagnosis and treatment of a non-functioning neuroendocrine pancreatic tumor causing sinistral portal hypertension and gastrointestinal bleeding in a 36-year-old man. RESULTS: A peripheral resection of the pancreas with splenectomy was performed. Intraoperative examination of the specimen revealed a malignant neoplasm, probably neuroendocrinal carcinoma. CONCLUSIONS: Peripheral resection of the pancreas with splenectomy treats not only the symptoms of segmental portal hypertension caused by pathology of this organ, but also allows the etiology of the disease to be determined.

Adult↗