background there has been resurg interest recent year preoper infus cholangiographi pic the role routin pic compar routin intraop cholangiographi ioc has been clear defin studi design our depart between 1985 1991 1042 1576 consecut patient biliari calcul diseas had elect cholecystectomi 694 patient were prospect schedul pic 348 patient were random alloc ioc the patient pic ioc group were similar regard age histori biliopancreat complic laboratori find the cost pic sweden near five time greater than cost ioc result satisfactori opacif biliari system obtain 901 968 percent patient who underw pic ioc respect preoper infus cholangiographi requir support ioc 195 percent patient there were statist signific differ between pic ioc group regard incid 7 percent both group posit predict valu 68 80 percent respect bile duct stone rate retain stone 6 20 percent respect intraop 56 63 percent respect postop 133 159 percent respect morbid incid bile duct anomali 09 03 percent respect median oper time longer patient 95 minut compar those without 75 minut ioc 0001 more postop complic occur after bile duct explor 26 75 patient compar cholecystectomi alon 114 917 patient 0001 the 30day mortal zero minor bile duct injuri occur two patient 02 percent cholecystectomi one one without bile duct explor patient cholangiograph find biliari anomali crucial safe execut cholecystectomi conclus our studi pic ioc were compar routin use either method did promot safeti cholecystectomi thus routin use warrant the shorter oper time preoper identif common bile duct cbd stone provid pic might favor examin when appli select patient increas risk have cbd stone howev potenti advantag offset need pic support ioc approxim 20 percent patient also cost pic greater than cost ioc

W. Y. Lau

Arthur K. C. Li

Is there a Role for Preoperative Infusion or Intraoperative Cholangiography&#63;

assess efficaci ultrasound guid percutan acet acid concentr 15 20 30 40 50 inject small hepatocellular carcinoma hccs longterm prognosi percutan acet acid inject use 15 50 acet acid perform 91 patient one four hccs smaller than 3 dure past 65 year dure seri treatment session each patient same concentr acet acid use all tumor could treat success percutan acet acid inject despit differ acet acid concentr use the number treatment session treat similar size tumor less when higher concentr acet acid use serious complic occur direct sequela percutan acet acid inject none tumor treat regrew the 1 2 3 4 5year surviv rate 91 patient were 95 87 80 63 49 respect the 1 2 3 4 5year cancerfre surviv rate patient were 83 54 50 37 29 respect both liver function size tumor affect both surviv rate cancerfre surviv rate signific number tumor did the concentr acet acid did affect surviv rate percutan acet acid use 15 50 acet acid effect therapi small hccs longterm prognosi

S.-T.  Fan

Can Small Hepatocellular Carcinoma be Cured by Percutaneous Acetic Acid Injection Therapy&#63;

background report prospect randomis comparison between laparoscop smallincis cholecystectomi 200 patient which design elimin bias against either techniqu method patient were randomis oper theatr anaesthet techniqu paincontrol method were standardis four experienc surgeon did both type procedur identic wound dress were appli both group carer could kept blind type oper find there signific differ between group age sex bodi mass index american societi anaesthesiologist grade laparoscop cholecystectomi took signific longer than smallincis cholecystectomi median 65 rang 27140 min 40 18142 min 0001 the oper time includ oper cholangiographi which attempt all patient found signific differ between group hospit stay postop night hospit median 30 117 night laparoscop 30 114 night smallincis 074 time back work employ person median 50 week 40 week 039 time full activ median 30 week 30 week 015 interpret laparoscop cholecystectomi take longer than smallincis cholecystectomi doe have ani signific advantag term hostit stay 13 ostop recoveri

Charles J. Yeo

Mini-Incision Versus Laparoscopic Cholecystectomy

fortyfour patient advanc gallbladd carcinoma 18 stage 3 26 stage 4 union internacion contra cancrum classif were aggress manag extend heptat resect 33 patient bile duct resect 28 pancreaticoduodenectomi seven gastrointestin resect eleven portal vein resect reconstruct seven adjacent organ involv classifi follow type hepat involv without gastrointestin invas type bile duct involv without gastrointestin invas iia iib type iii hepat bile duct involv without gastrointestin invas iiia iiib type gastrointestin involv without hepat bile duct invas fourteen 15 patient type tumour had curat resect compar seven 26 type iii lesion 00001 the surgic mortal rate two 15 patient type tumour seven 26 type iii tumour nine 44 whole group the longterm surviv rate after curat resect four two 23 3 5 year respect signific better than two none 21 2 year after noncur resect 001 the surviv rate after curat resect patient type tumour four two 14 3 5 year respect signific better than other type 005 this classif advanc gallbladd carcinoma accord involv adjac organ might help plan surgeri condit particular type tumour should treat radic surgic procedur achiev favour outcom

M. Margaret Kemeny

Is there a Role for Radical Surgery in Advanced Gallbladder Carcinoma&#63;

portal hypertens gastropathi vascular disord gastric mucosa distinguish ectasia mucos capillari submucos vein without inflamm dure 1988 1993 12 patient biopsyproven cirrhosi 10 alcohol 2 posthepatit were evalu treat prospect portacav shunt activ bleed from sever portal hypertens gastropathi eleven patient had been hospit bleed three nine time previous one bleed uncontrol first time requir blood transfus rang from 11 39 unit cumul which 8 30 unit were requir specif replac blood lost from portal hypertens gastropathi admission find were ascit 9 patient jaundic 8 sever muscl wast 10 hyperdynam state 9 child risk class 7 4 1 ten 12 patient had previous receiv repetit endoscop sclerotherapi esophag varic which has been report precipit portal hypertens gastropathi eight patient had fail propranolol therapi bleed portacav shunt perform emerg 11 patient elect 1 perman stop bleed all reduc mean portal veininferior vena cava pressur gradient from 251 16 salin there were oper death two unrel late death after 13 24 month dure 1 675 year followup all shunt remain patent ultrasonographi gastric mucosa revert normal serial endoscopi gastrointestin bleed recurr portalsystem encephalopathi develop onli 8 patient qualiti life general good conclud portacav shunt provid definit treatment bleed portal hypertens gastropathi elimin under caus make possibl prolong surviv accept qualiti life

John Craig Collins

I. James Sarfeh

Portacaval Shunt for Portal Hypertensive Gastropathy

45yearold alcohol male patient present hypovolem shock intens anemia hemoglobin 047 oper bleed retroperiton varix locat near right colon respons clinic pictur sutur after oper patient develop haemodynam instabl pneumonia situat which revert intens medic therapi the patient now do well

M.  Molina-Perez

F.  Rodriguez-Moreno

E.  Gonzalez-Reimers

J.  Perez-Palma

F.  Santolaria-Fernandez

H.  Essardas-Daryanani

A.  Martinez-Riera

Haemoperitoneurn Secondary to Rupture of Retroperitoneal Variceal

congenit absenc left portal vein rare vascular anomali report preval vari from one 62 one 507 case patient admit recurr cholang secondari extens dilat left biliari ductal system associ caroli diseas determin preoper dynam have excess larg right portal vein left portal vein the surgeon must awar ani variat portal vascular anatomi patient undergo hepat resect order prevent potenti fatal postop complic

C. K. Charny

P.  Ling

J.  Botet

L. H. Blumgart

Clinical Observation: Congenital Absence of the Left Portal Vein in a Patient Undergoing Hepatic Resection

solid cystic tumor sct pancrea predomin occur women occurr men extrem rare experienc male case sct 38yearold man admit complaint upper abdomin pain scan show presenc mass head pancrea the mass compos high densiti area low densiti area ultrasonogram reveal mass be compos high echoic area low echoic area the mass hypovascular angiographi sct suspect pancreaticoduodenectomi perform the cut surfac tumor show main cystic degen area contain dark red hemorrhag materi microscop were solid area peripheri pseudopapillari area center metastasi found remov lymph node the tumor cell were stain grimelius silver stain the tumor cell were posit alphalantitrypsin aat neuronspecif enolas nse pancreat hormon insulin glucagon somatostatin were all negat electron micrograph show tumor cell were rich mitochondria zymogen granul neurosecretori granul were detect estrogen receptor progesteron receptor were both negat

K.  Ohiwa

M.  Igarashi

N.  Nagasue

M.  Nagasaki

T.  Harada

Solid and Cystic Tumor (SCT) of the Pancreas in an Adult Man

hepat arterioport fistula rare caus portal hypertens the case report twoyear old girl congenit arterioport fistula who present splenomegali ascit colour doppler ultrasound show larg shunt between left hepat arteri branch left portal vein produc revers flow main portal vein she treat formal left hemihepatectomi which has been success elimin fistula it consequ portal hypertens long term the literatur regard arterioport fistula treatment review

J. S. Billing

N. V. Jamieson

Hepatic Arterioportal Fistula: A Curable Cause of Portal Hypertension in Infancy

although oper mortal pancreaticoduoden resect has decreas recent oper morbid result from leak pancreat anastomosi remain high describ our experi 50 consecut case simpl secur end side pancreaticojejunostomi use paediatr nasogastr tube pancreat remnant duct temporari extern pancreat drain there were 29 men 21 women rang from 12 84 year median age 61 year fortytwo patient underw standard whippl procedur eight pylorus preserv pancreaticoduodenectomi averag oper time 270 minut rang 170 480 minut the pancreaticojejunostomi could construct mean 8 minut intraoper blood loss rang from 150 3500 mean 910ml twentyf patient 50 receiv blood transfus the consist pancreat remnant hard 12 patient 24 normal 38 patient 76 the pancreat duct dilat 4mm 15 patient 30 there oper mortal onli three 60 minor leak from pancreat anastomosi which heal spontan difficult determin leak were relat consist pancreat remnant size pancreat duct amount intraop blood loss oper time sex patient experi surgeon were onli three leak conclud our techniqu pancreaticojejun anastomosi follow pancreaticoduodenectomi safe applic standard whippl pylorus preserv pancreaticoduodenectomi small dilat pancreat duct normal fibrot pancrea

P.-W.  Lin

J.-C.  Lee

P.-C.  Lee

T.-W.  Chang

C.-J.  Hung

Y.-C.  Chang

A Simple, Secure and Universal Pancreaticojejunostomy following Pancreaticoduodenectomy

twentythre patient symptomat giant hemangioma liver were treat surgeri between 1979 1996 depart gener surgeri faculti medicin univers Çukurova twentythre enucl were perform 21 patient left later segmentectomi one patient enucl plus left lobectomi one patient the tumor were enucl along interfac between hemangioma normal liver tissu the diamet tumor rang from 5 5 25 15 the mean blood loss enucl 525 rang 5001000 there mortal postop bleed three patient had postop complic enucleat best surgic techniqu symptomat giant hemangioma liver may perform mortal low morbid preserv all normal liver parenchyma

H.  Demiryürek

Ö.  Alabaz

D.  Ağdemir

I.  Sungur

E. U. Erkoçak

A.  Akinoğlu

A.  Alparslan

S.  Źorludemir

Symptomatic Giant Cavernous Haemangioma of the Liver: Is Enucleation a Safe Method&#63;

haemorrhag via pancreat duct rare caus upper gastrointestin bleed gib often pose diagnost dilemma analys our experi 10 patient 8 men 2 women mean age 44 year rang 34 62 treat dure 12 year period all had histori alcohol abus present major upper gib requir median 8 unit rang 2 40 blood transfus nine had upper abdomin pain time admiss nine had histori pancreat upper gastroduoden endoscopi median 4 rang 1 9 diagnost onli one sideview endoscopi show bleed from pancreat duct 7 8 patient viscer aneurysm were demonstr 7 9 patient whom coeliac angiographi carri out splenic arteri 4 gastroduoden arteri 2 pancreaticoduoden arteri 1 two 4 select embolis were success six patient underw distal pancreatectomi 1 had gastroduoden arteri ligat 1 die coagulopathi follow total pancreatectomi pancreat duct haemorrhag should consid patient unexplain recurr upper gib alcohol abus epigastr pain particular those establish chronic pancreat select angiographi essenti diagnosi manag for bleed site head pancrea embolis should attempt avoid major resect distal pancreatectomi prefer splenic arteri lesion

P. J. Gallagher

G.  Mclauchlin

P. C. Bornman

J. E. J. Krige

J.  Thomson

I. N. Marks

J.  Terblanche

Diagnostic Pitfalls and Therapeutic Strategies in the Treatment of Pancreatic Duct Haemorrhage

there increas evid septic complic occur after major hepatectomi may caus gram negat bacteria transloc from gut investig rat effect extend hepatectomi structur morpholog intestin mucosa well transloc intestin bacteria endotoxin also examin effect nonabsorb antibiot reduc intestin flora consequ phenomenon transloc administ neomycin sulphat cefazolin hepatectomi found increas transloc while administr nonabsorb antibiot decreas signific addit hepatectomi increas aerob cecal bacteri popul which normalis group receiv antibiot among histolog paramet evalu villus height demonstr signific reduct after hepatectomi while number villi per number mitos per crypt remain unchang our result indic administr nonabsorb antibiot present posit effect bacteri endotoxin transloc after extend hepatectomi may relat reduct colon bacteri load intralumin effect antibiot

S. K. Kakkos

J.  Kirkilesis

C. D. Scopa

A.  Arvaniti

T.  Alexandrides

C. E. Vagianos

Nonabsorbable Antibiotics Reduce Bacterial and Endotoxin Translocation in Hepatectomised Rats

objectiv determin drip infus should discontinu after full recoveri patient from anaesthesia after minilaparotomi cholecystectomi uncompl case design randomis control clinic trial 60 patient from wait list cholelithiasi cholecyst oper minilaparotomi cholecystectomi between novemb 1995 march 1996 30 patient did receiv postop drip infus 30 patient 1224 hour standard drip transfus continu accord current practic set singl surgic unit hospit banara hindu univers varanasi india main outcom measur recognit clinic indic continu drip infus after full recoveri from anaesthesia result cohort 30 patient each who were were given drip infus after full recoveri from anaesthesia follow minilaparotomi cholecystectomi observ puls rate blood pressur time first void urin time start first oral intak fluid were ident howev postop urinari retent occur 6 20 patient whom drip infus given conclus there clinic indic continu drip infus after full recoveri from anaesthesia patient oper minilaparotomi cholecystectomi

N.  Kumar

K. B. Annudath

H. S. Shukla

A.  Singh

K.  Kumar

Postoperative Intravenous Drip Infusion is not Required after Minilaparotomy Cholecystectomy

this review describ some mechan which thought import causat pain chronic pancreat both medic surgic techniqu treat pain describ

A. S. Salim

Perspectives in Pancreatic Pain

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