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Biomedical subjects

S Duca

Publications and source records attributed to S Duca.

At least 55 records · Page 3Linked to original sources

[Preservation of rat liver using prolonged perfusion with a complex solution lacking hemoglobin].

The author's aim was to investigate conservation of rat liver by continuous perfusion of the isolated organ in conditions of normal temperature, as well as in hypothermia. A complex solution was used, lacking hemoglobin. Over a period of 5 hours of conservation the authors evaluated the perfusion rate, the concentration of lactate and pyruvate in the conservation medium, while on histological preparations was investigated the formation of fibrin deposits in the intra-hepatic vessels. The results confirmed the positive effects of hypothermia, that is not due exclusively to a limiting of the metabolic necessities of the organ but also to a reduction of the fibrinogenesis and a slowing down of the formation of intra-hepatic microaggregates.

Animals↗

[Laparoscopic cholecystectomy: incidents and complications. Analysis of 8002 consecutive cholecystectomies performed at the Surgical Clinic III Cluj-Napoca].

Incidents and postoperative complications of laparoscopic cholecystectomy (LC) are analyzed based on a series of 8002 patients who underwent the procedure during a period of seven years. Conversion rate was 2.02% (161 cases) and 6 (0.07%) death were encountered. Intraoperative hemorrhage (2.43%) could be controlled by intraoperative haemostasis in all but 8 patients (bleeding from the hepatic bed and from the cystic artery) which required conversion. Lesions of the bile ducts occurred in 16 patients (0.2%), 13 of them being identified during the operation and solved by conversion or laparoscopic choledochorraphy (for a tangential lesion). Postoperative complications required re-intervention in 45 patients: 11 for bile leak, 19 for choleperitoneum, 6 for hemorrhage, 4 for subhepatic abscesses and 5 for remnant CBD lithiasis. There was 1 puncture of the Douglas pouch in a case of choleperitoneum, 7 laparoscopic re-interventions and 25 open surgery re-interventions. EST solved postoperative bile leaks (from the gallbladder bed) successfully in 7 cases and remnant CBD lithiasis (5 cases). So, 44% of the cases were treated by minimally invasive means (laparoscopic re-interventions or endoscopic procedures). The majority of the incidents and postoperative complications were linked to the presence of an acute cholecystitis and were partially due to some technical limits of the laparoscopic technique of the gallbladder bed peritonisation. The minimally invasive treatment of postoperative complications, was very efficient and offered optimum healing conditions.

Adult↗

[Mini invasive treatment of complications following laparoscopic cholecystectomy].

UNLABELLED: Miniinvasive treatment can be used in many early complications following laparoscopic cholecystectomy. In this article are analyzed the indications and the efficiency of these techniques. MATERIAL AND METHODS: We analyzed here a group of 9542 laparoscopic cholecystectomy operated in 9 years. The main postoperative complications were: bile leak (54 cases), haemorrhage (15 cases), subhepatic abscess (10 cases) and early diagnosed remnant lithiasis of CBD (11 cases). Miniinvasive techniques that were used were laparoscopic reinterventions (15 cases) and EST (22 cases). RESULTS: Classic reinterventions were practiced in 28.88% of cases with complications. Miniinvasive techniques were used in 42.2% of cases with complications: laparoscopic reinterventions (15 cases) for choleperitoneum, haemoperitoneum and subhepatic abscess and EST (22 cases) for prolonged bile leak on subhepatic drain and for early diagnosed remnant lithiasis of CBD. All cases were healed. DISCUSSION: Along with a precise diagnosis and a good indication, the miniinvasive treatment of complications proved to have good results, converting the bad operative outcome into a postoperative success.

Cholecystectomy, Laparoscopic↗

[Schizophrenia and multiple sclerosis].

On the basis of published data on the frequent incidence of psychiatric disorders in demyelinating diseases, the paper report the case of a 22 year old patient who was brought to the Authors' attention with a schizophrenia-type disorder, with prevalently negative symptoms, and suffering from the advanced stages of a demyelinating pathology. Anamnestic and clinical characteristics reported by other Authors were also evident in this patient: the absence of familiarity for schizophrenic disorders, the absence of earlier psychiatric pathologies, the constant progress of psychosis and limited response to pharmacological therapy. The main results of clinical and instrumental tests are discussed.

Adult↗

[Minimally invasive treatment of common bile duct calculi].

UNLABELLED: Miniinvasive treatment of lithiasis of the common bile duct hasn't reached yet a standard end point. There are multiple techniques used for it. In this study we evaluate its indications, possibilities and limits. MATERIAL AND METHOD: In a series of 14,024 biliary patients operated over 9 years 719 patients underwent open choledocolithotomy. In 173 (1.2%) of patients we used miniinvasive procedures as follows: 71 cases underwent sequential treatment, 91 laparoscopic treatment and in 11 cases the remnant calculi were extracted 1-6 days postoperative. RESULTS: Sequential treatment was the preferred treatment when the lithiasis of the common bile duct was detected preoperative. Transcistic extraction was more often performed for the lithiasis diagnosed intraoperative. The conversion to open surgery was performed in 13 cases, remnant calculi were early diagnosed in 11 patients and late diagnosed in 14 cases (the calculi were extracted by endoscopic sphyncterotomy). All patients were healed. DISCUSSIONS: The miniinvasive procedures have to be practiced as frequently as possible because of rapid healing and early recovery of the patients, despite some disadvantage of them. The choledocotomy and choledocoduodenostomy are exceptional techniques to be used in specific cases.

Cholecystectomy, Laparoscopic↗

[Laparoscopic management of Meckel's diverticulum].

We present our observations on two young patients with repeated digestive bleeding from hemorrhagic Meckel's diverticulum. In one patient examined by Tc99 scintigraphy, the hemorrhagic area was shown in the lower abdomen. The laparoscopic exploration showed the Meckel's diverticulum at 1 m distance from ileocecal angle. Both cases were treated by resection with a vascular stapler postoperative evolution was favorable.

Adolescent↗

[The reinsertion of the duodenum into the digestive circuit. The indications and surgical technics in operated stomach syndromes].

The authors analyse, retrospectively, the experience of the Clinic of Surgery III. Cluj-Napoca, in the indications and surgical methods for reintroducing the duodenum in the digestive circuit in the syndromes of the stomach operated for benign affections. Between 1974 and 1987, the duodenum was reinstated in the digestive circuit in 37 patients, operated previously for duodenal ulcer (32 cases), gastric ulcer (3 cases), syndrome of mesenteric clip (2 cases). The primary surgeries that led to the exclusions of the duodenum from the digestive tract were gastroenteroanastomosis in 4 cases, and the gastric resections with gastrojejunal anastomoses of the Billroth II type in 33 cases (Reichel-Polya in 28 cases. Hoffmeister-Finsterer in 3 cases, Roux in 2 cases). The reintroduction of the duodenum in the digestive circuit, based on clinical and paraclinical criteria, was indicated in anastomotic ulcer (in 17 cases), gastric ulcer following gastroenteroanastomoses (in 1 case), syndrome of afferent loop (in 11 cases), persistent "dumping" syndrome (in 8 cases), association of plurideficiency syndrome (in 54% of the cases). The way of reconstructing the duodenum was adapted to the type and correctness of the primary operation, to the dominant clinical syndrome and associated lesions to the biological background and possibilities offered by the intrasurgical situation: reconversion by direct gastroduodenal anastomosis after degastrogastrectomy was used in 31 cases, the indirect methods by transposition of the afferent loop (Soupault--Bucaille) in 4 cases, or of the afferent one (Henley)--1 case gastrography and segmentary enterectomy in 1 case. The postoperative complications appeared in 35.1% of case, with a mortality of 8.1%. The therapeutic results were good and very good in 89.3% of the cases. The authors insist on the importance of maintaining the duodenum in the digestive circuit, during the primary surgeries for preventing some severe postsurgical syndromes.

Anastomosis, Surgical↗

[Acute transverse myelitis. Clinical and neuroradiological follow-up of a case in a child].

The case of a ten years old boy who presented a sudden onset of tetraplegia is discussed. The benign clinical evolution, under corticosteroid therapy, the negativity of biohumoral examinations of the cerebrospinal fluid and the improvement of the NMR pictures allow the diagnosis of acute spinal myelitis. In the paper are also presented the neuroradiological pictures of myeloCT and NMR; the last one can, for its sensibility, discover little variations in the water contents of the nervous tissue and for its harmlessness can be used for serial examinations.

Child↗