Search PubMed⌕ Search

Biomedical subjects

S B VanLandingham

Publications and source records attributed to S B VanLandingham.

2 recordsLinked to original sources

Gallstone ileus.

Gallstone ileus, although uncommon, requires urgent and appropriate surgical therapy if unacceptable morbidity and mortality are to be avoided. Enterolithotomy alone remains the mainstay of operative treatment for gallstone ileus, but the additional performance of a one-stage cholecystectomy and repair of fistula if desirable if the condition of the patient will allow it. One must use good judgment in selecting a surgical procedure. It is imperative to recall that the primary goal in the surgical treatment of gallstone ileus is to save a life. Future complications of the diseased gallbladder and the cholecystoenteric fistula may be treated electively under more ideal circumstances when and if they occur. Gallstone ileus, like other complications of cholelithiasis, remains a strong argument for early cholecystectomy in patients with gallstones.

Aged↗

Nutritional support of the surgical patient.

Malnutrition, unfortunately, is not uncommon and malnourished patients suffer increased morbidity and mortality from surgery. Identification of protein-calorie deficient patients can be performed rapidly and inexpensively through standard techniques of nutritional assessment. If the gastrointestinal tract is available, safe and economic nutritional support may be provided by mouth or by tube feeding. If the gastrointestinal tract cannot be utilized, total parenteral nutrition (TPN) may be instituted via a central vein, or in selected instances peripheral amino acids, fat emulsions, or both may suffice. When failure of various organs (heart, kidneys, liver) complicates malnutrition and the underlying surgical condition, adequate nutritional support can and should be provided by adjustment of the amount and content of commercially available nutritional formulations. Optimal surgical care demands the identification and appropriate nutritional support of malnourished patients.

Amino Acids↗