Search PubMed⌕ Search

Biomedical subjects

T B Hugh

Publications and source records attributed to T B Hugh.

At least 37 records · Page 2Linked to original sources
PubMed1993

Carcinoma of the thyroid gland and Gardner's syndrome.

A patient known to be suffering from Gardner's syndrome who developed carcinoma of the thyroid gland is presented. A review of the literature reveals that this relationship is not fortuitous and that it has the following characteristics: female predominance (89%), youth (< 30 years in 78%), papillary form (88%), multicentricity (70%) and thyroid carcinoma preceding diagnosis of hereditary polyposis in 30%. Hereditary polyposis patients affected by familial polyposis coli are at significant risk of developing extracolonic malignant tumours, and require life-long surveillance. Palpation of the thyroid gland and possibly ultrasound examination of the neck should be part of the routine follow up of these patients.

Adult↗
PubMed1993

Cherry stalk in the common bile duct.

Ingested biliary foreign bodies occur most frequently in patients who have had previous biliary operations, which predisposes them to enterobiliary reflux. This report describes an unusual ingested foreign body of the common bile duct in a patient with no history of previous gastrointestinal surgery.

Common Bile Duct↗
PubMed1992

Laparoscopic cholecystectomy. A prospective study of outcome in 100 unselected patients.

OBJECTIVE: To describe the outcome of laparoscopic (percutaneous) cholecystectomy in the management of gallbladder stones. PATIENTS AND METHODS: One hundred unselected consecutive patients referred for cholecystectomy, or admitted as emergencies with complicated gallbladder disease. Ten patients had acute cholecystitis, three had empyema, three had gallstone pancreatitis, and 11 had a history of recent jaundice. Common bile duct stones were dealt with by endoscopic sphincterotomy. OUTCOME MEASURES: Intraoperative and postoperative complications, 30-day mortality rate, duration of hospital stay, and length of postoperative disability. RESULTS: Three patients were excluded and underwent open cholecystectomy. Laparoscopic cholecystectomy was attempted in the remaining 97, and successfully completed in 87; 10 were converted to open cholecystectomy. There were no significant intraoperative complications. Two patients had a postoperative haemorrhage and one had a transient bile leak; none required reoperation. There was one death from myocardial infarction 12 days after operation. Minor complications occurred in 12 patients. Mean operating time was 88 minutes. The average length of hospital stay was 72 hours, and most patients returned to normal activities after seven days. CONCLUSIONS: Laparoscopic cholecystectomy offers an outcome comparable to standard cholecystectomy and is applicable to 90% of patients requiring removal of the gallbladder. Laparoscopic cholecystectomy has significant advantages over open cholecystectomy in terms of reduced postoperative pain and disability.

Adolescent↗
PubMed1992

Laparoscopic anatomy of the cystic artery.

Uncontrolled arterial bleeding during laparoscopic cholecystectomy is a serious problem and may increase the risk of bile duct damage. Therefore, accurate identification of the anatomy of the cystic artery is important. We reviewed the anatomy of the cystic artery and its variations as seen through the video laparoscope. A "normal" cystic artery was found in only 72% of patients. The most important laparoscopically noted variations were doubling of the cystic artery (22%) and an artery that ran inferior to the cystic duct (6%). Small branches of the cystic artery, which we suggest be named Calot's arteries, supply the cystic duct and may cause troublesome bleeding during laparoscopic dissection in the hepatobiliary triangle. A scissor dissection technique was found most useful for identifying the arterial anatomy. Careful identification of arterial anomalies should help to reduce the incidence of bile duct injuries during laparoscopic cholecystectomy.

Arteries↗
PubMed1991

Empyema of the gallbladder treated by laparoscopic cholecystectomy.

PATIENT: A 52-year-old woman with an eight-year history of gallstones who had twice declined to have a cholecystectomy. CLINICAL FEATURES: The patient presented as an emergency with severe abdominal pain, hectic fevers and rigors. Results of examination showed an enlarged, tender and easily palpable gallbladder. A diagnosis of empyema of the gallbladder was made. INTERVENTIONS: Intravenous administration of antibiotics was started immediately and a laparoscopic cholecystectomy was performed 36 hours after admission. OUTCOME: Postoperative recovery was uncomplicated. The patient was discharged after 72 hours and returned to normal activities within one week. CONCLUSION: Laparoscopic cholecystectomy seems a useful technique to treat gallbladder disease in emergency as well as elective situations.

Cholecystectomy↗