and ALT values are not useful in the assessment of PI. Eighty liver allografts were studied to determine the (HEPATOLOGY 1997;25:184-189 .) predictive value of intraoperative biopsies and postoperative liver function tests for the development of preservation injury (PI). Peak transaminase (aspartate transaminase [AST] and alanine transaminase [ALT])Graft viability is of the utmost importance for successful and prothrombin time (PT) values achieved by each pa-orthotopic liver transplantation. Virtually all liver allografts tient during postoperative days (POD) 1 through 7 were are injured during transplantation, either as a result of determined. PI in day 0 preperfusion biopsies (0Pre) (ob-events leading to donor death, donor life support, or during tained immediately before implantation) and postperfu-the process of allograft extraction, cold preservation, implansion biopsies (0Post) (obtained immediately after revas-tation, hypoxic rewarming, and reperfusion. Allograft injury cularization) was categorized by histological criteria as resulting from the transplantation process is commonly represent or absent. PI in biopsies taken during POD 2 ferred to as preservation injury (PI). Preservation injury is through 14 was histologically graded as either moderate-a major contributor to primary allograft dysfunction, a term to-severe, mild, or absent. Of the 80 allografts, 8 were encompassing both primary nonfunction, defined as complete omitted because of primary nonfunction or postopera-allograft failure in the absence of apparent technical or imtive complications. 0Pre and 0Post biopsies were avail-munologic complications, and initial poor function (IPF), deable on 25 of 72 (35%) and 69 of 72 (96%) allografts, respec-fined as borderline graft function immediately after transtively. Only 2 (8%) of the 0Pre biopsies showed plantation. histological PI compared with 48 (70%) of the 0Post biop-Several studies have attempted to identify donor, intraopsies. Fifty-nine patients were biopsied between POD 2 erative, and recipient factors predictive of primary allograft through 14. Of these, 15, 28, and 16 patients developed dysfunction. Primary dysfunction has been consistently assomoderate-to-severe, mild, or no evidence of PI, respec-ciated with prolonged cold and warm ischemia, severe macrotively. The presence of PI in the 0Post biopsy strongly vesicular steatosis, ABO blood group incompatibility, and docorrelated with the development of PI during POD 2 nor age over 50 years. [1][2][3][4][5][6][7][8][9][10][11][12] Additional risk factors include through 14 (P õ .0005). Peak AST and ALT values in retransplantation, markedly elevated donor transaminase patients with moderate-to-severe PI on POD 2 through levels, the use of pressors in the donor, and the use of re-14 were significantly elevated compared with those pa-duced-size liver grafts. 1-12 Despite efforts to avoid using donor tients with either mild (P Å .01 and .03) or no PI (P Å .02 organs with these and other potentially adverse variables, and .006). Because of ext...
We report a case of biliary peritonitis caused by gall bladder perforation due to Taenia saginata induced gangrenous cholecystitis. Although parasites are not unusual causes of biliary tract disorders, especially in disease endemic areas, but this is for the first time that Taenia saginata has been reported to cause gall bladder perforation.
Background and aims Coronavirus (COVID-19) has surfaced as a global pandemic and has created an unprecedented global demand for medical equipment. The shortage of onsite workforce, need for social distancing and less time available for sourcing have further made it difficult for the governments and the medical professionals to combat the pandemic. This study’s prime objective is to review the advancements in the area of 3D printing to develop medical equipment and explore the potential of 3D printing in addressing the shortage of medical equipment mainly the personal protective equipment (PPE) amidst COVID-19 pandemic. Methods 3D printing or additive manufacturing has emerged as a new manufacturing process with tremendous potential to develop complex products in short time with minimal human interventions. The paper summarises 3D printing’s potential to serve the increasing need for medical equipment, mainly personal protective equipment (PPE) and ventilator equipment in the ongoing global COVID-19 pandemic. Results The minimum human interventions required to carry out production using 3D printing also make the technology an excellent option to deal with the current situation. Conclusions The recommendations and opinions presented in the paper shall act as a stimulant to develop components very critical for the pandemic and help save precious lives globally.
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 very important. Cystic artery is notoriously known to have a highly variable branching pattern. We reviewed the anatomy of the cystic artery and its branch to cystic duct as seen through the video laparoscope. A single artery to cystic duct with the classical “H-configuration” was demonstrated in 161 (91.47%) patients. This branch may cause troublesome bleeding during laparoscopic dissection in the hepatobiliary triangle. Careful identification of artery to cystic duct is helpful in the proper dissection of Calot's triangle as it reduces the chances of hemorrhage and thus may also be helpful in prevention of extrahepatic biliary radical injuries.
Overview Laparoscopic approach has changed the face of surgical care offered to patients. Almost all surgical procedures across specialties are now undertaken by the laparoscopic approach. Closure of port sites to prevent trocar-site hernias (TSHs) forms an integral part of the laparoscopic procedure. TSH is an area of preventable surgical morbidity. We hereby report our technique that is easily applicable, simple, safe, and highly cost-effective. It requires no additional instruments or retractors, is easy to learn, and has a very favorable safety profile. Materials and Methods This prospective case series enrolled a total of 454 port-site closures in 255 patients undergoing different laparoscopic procedures over a period of 2 years. The intraperitoneal tissue forceps were used in the reverse direction to lift the fascia up and a right-angled retractor was used to retract back the skin and subcutaneous tissue. The port-site closure is done under vision and no adverse events were reported. Results This technique was used in 454 port sites in 255 patients. No intraoperative incidents were noted. There is no requirement of any specialized instruments or retractors. No additional tissue trauma or dissection is required. There is no extension of operative time. The technique is simple to learn and easy to teach. No bowel injuries or TSHs were reported during a follow-up of 26 months. Conclusion The described technique is easy, simple, cost-effective, and has a good safety profile.
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