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PubMedDate not supplied

Helical CT of the abdomen after pancreaticoduodenectomy: usefulness for detecting postoperative complications.

BACKGROUND/AIMS: Helical (spiral) computed tomography (CT) decreases scanning time and respiratory motion artifact. These characteristics are convenient for the evaluation of postoperative intra-abdominal conditions. We investigated the usefulness of helical CT in detecting complications after pancreaticoduodenectomy. MATERIAL AND METHODS: Helical CT scans were carried out in 21 patients with symptoms suggesting postoperative complications after pancreaticoduodenectomy. Twenty-one patients who underwent pancreaticoduodenectomy were examined postoperatively by helical CT scans. Findings were correlated with the subsequent clinical course. RESULTS: Abnormal findings were detected by helical CT scan in 16 (76%) of 21 patients. These included 13 patients with fluid collection, 7-with localized liver infarction, 5 with intra-abdominal abscess, 3 with pleural effusion or ascites, and 2 with pseudoaneurysms or wound abscesses. Liver infarctions were found in 7 of 10 patients who underwent combined resection of the portal and/or superior mesenteric veins, but not in any of 11 patients without combined vascular resection. CONCLUSIONS: Helical CT was useful in evaluating intra-abdominal conditions and detecting complications after pancreaticoduodenectomy.

Adult↗
PubMed1998

Procalcitonin in early detection of postoperative complications.

BACKGROUND: A prospective clinical study was performed to assess the accuracy of procalcitonin in 70 patients with elective colorectal or aortal surgery and to compare it with inflammatory mediators. Also the early prediction of complications and the outcome of these patients was taken into account. METHODS: Laboratory variables and cytokine determination were obtained preoperatively, on the day of operation and postoperatively on a daily basis from day 1 to 5, and on days 7 and 10 in the colorectal group and in the aortal surgery group at different times on the operation day after aortal clamping. The main outcome criteria were early recognition of complications and alterations in the production of procalcitonin and cytokines in order to detect severe infective complications. RESULTS: Procalcitonin was closely related to postoperative complications with significantly elevated levels at day 1 after surgery. The plasma concentrations of IL-6 increase on days 1-3 without a difference in the groups, also C-reactive protein demonstrates no differences. CONCLUSION: Procalcitonin presents itself as a new parameter of infection and sepsis. In the postoperative period PCT seems to be an interesting marker of early prediction of infective complications when high postoperative levels are found. Under routine conditions procalcitonin is a valid reproducible and detectable parameter.

Adult↗
PubMed2005

[The role of laparoscopy in the diagnosis and treatment of early postoperative complications].

Results of 276 laparoscopic operations performed for diagnostic and therapeutic purposes in the early postoperative period in 198 patients are analyzed. All the patients had been previously operated on the organs of the abdominal cavity and retroperitoneal space: in 131 patients the investigations were performed with a diagnostic purpose; in 67 patients a laparoscopic method was used for treatment of complications of the early postoperative period. This problem can be solved by using the methods allowing diagnosing the complication as early as possible, before the development of irreversible alterations, and allowing to choose the most rational methods of treatment.

Abdominal Abscess↗
PubMed1999

Survival and postoperative complications after extended surgery for non-small-cell lung cancer. A retrospective study.

OBJECTIVE: We evaluated survival after extended surgery in patients with non-small-cell lung cancer and the effects of induction therapy on results and complications. SUBJECTS AND METHODS: Between April 1987 and March 1998, 127 patients with pathological T3 (pT3) or T4 (pT4) non-small-cell lung cancer underwent extended surgery combined with resection of neighboring organs. Of these, 35 received induction therapy. In the remaining 92, surgery preceded other therapy. Long-term results and postoperative respiratory complications were analyzed and compared between the patients with and without induction therapy. RESULTS: Overall 5-year survival after extended surgery was 37%. Five-year survival rates in the pT3 was 41% and that in the pT4 group 28% (p = 0.030). Five-year survival rate in the pN0-1 was 46% and that in the pN2-3 group 26% (p = 0.003). No significant difference was observed in survival curves between patients with and without induction therapy. Induction therapy responders showed better survival than nonresponders. To prevent postoperative fatal complications due to bronchopleural fistula, we prophylactically covered the bronchial stump using autologous tissue in 31 induction therapy patients, and no mortality due to complications was seen in this group. CONCLUSION: Long-term survival after extended surgery was observed in pT3 and pT4 patients, especially among those with a pN0-1 status. Induction therapy responders may be considered good candidates for extended surgery because of the favorable prognosis in contrast to that for nonresponders.

Carcinoma, Non-Small-Cell Lung↗
PubMed1992

[Postoperative complications of elective resection of the colon in diverticulitis].

Data on 142 patients (57 men, 85 women; mean age 64.2 [37-91] years) who had elective colon resection for diverticulitis were retrospectively analysed with respect to postoperative morbidity and mortality. Associated systemic disease was present in 47.9% of patients; intraabdominal complications were found preoperatively in 55.6%. Resection with primary anastomosis was performed in 97.9% of patients. Local postoperative complications were noted in 14.1%, general complications in 31.7%. Two patients died postoperatively of the consequences of local complications. In both cases diverticulitis had been complicated by fistulas (mortality rate 1.4%). With careful preparation, standardized operative technique and intensive perioperative supervision the risk of elective colon resection for diverticulitis is low. It can thus be undertaken, even after the first severe attack of diverticulitis, in patients without associated disease.

Adult↗
PubMed2006

[Can procalcitonin be used for the diagnosis and follow-up of postoperative complications after fracture surgery?].

OBJECTIVES: We investigated the effect of fracture surgery on serum procalcitonin levels and the value of procalcitonin in differentiating inflammatory reaction caused by fracture surgery from postoperative infective complications. METHODS: Twenty-one patients (8 women, 13 men; mean age 72.5 years; range 50 to 105 years) who underwent surgery for pertrochanteric hip fractures were evaluated according to the procedures employed, namely osteosynthesis, and hemiarthroplasty. Procalcitonin (PCT), C-reactive protein (CRP), white blood cell count (WBC), and body temperature were measured before surgery and for five days postoperatively. RESULTS: No postoperative wound infections occurred. Seven patients developed complications. The mean preoperative CRP level was five times above the normal. It made a peak on the second day and then began to decrease, but still was four times higher than the preoperative level on the fifth day. Preoperatively, the mean PCT level was lower than the normal in all the patients. It made a peak on the first postoperative day without exceeding the normal range and returned to the preoperative level on the fifth day. In contrast to CRP levels which were above the normal in all the patients, PCT levels were higher than the normal only in patients who developed complications. Taking the cut-off value as = or >0.5 ng/ml, the sensitivity and specificity of PCT to determine systemic complications were 100% and 100% on the first day, and 100% and 50% on the second day, respectively. CONCLUSION: Procalcitonin may prove to be a useful parameter to identify early postoperative systemic complications after fracture surgery.

Acute-Phase Reaction↗