Combining intra-abdominal arterial grafting with gastrointestinal or biliary tract procedures

Tompkins, William C.; Chavez, Carlos M.; Conn, J. Harold; Hardy, James D.

doi:10.1016/s0002-9610(73)80005-4

Cited by 40 publications

(8 citation statements)

References 3 publications

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“…Those physicians who advocate cholecystectomy at the time of other procedures (cholecystectomy en passant) argue that the procedure can be performed rapidly and safely without adding significantly to morbidity or mortality rates, provided that no enlargement of the incision is made (67-72). For instance, several studies found no increase in risk for aortic graft infection when cholecystectomy en passant was performed with aortic surgery (67,(73)(74)(75) control group without cholecystectomy (77). Therefore a role for prophylactic treatment of asymptomatic stones during major nonbiliary abdominal surgery must still be convincingly demonstrated.…”

mentioning

confidence: 99%

Cholecystolithiasis: Lithotherapy for the 1990S

Strasberg

Clavien

1992

Hepatology

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Cholelithiasis afTects from 10% to 15% of the adult population in industrialized Western countries, with higher prevalence in women, in women with high parity, in the obese, in patients with hypertriglyceridemia and in older patients (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). In the United States, it has been estimated that 20 to 25 million people have gallstones, and more than 500,000 cholecystectomies are performed annually. Cholecystectomy is the most frequently performed surgical procedure, after cesarean section in this country (141, with an annual cost estimated at $4 to 5 billion. About a quarter of all women will experience cholelithiasis by age 60 in industrialized Western societies; the prevalence in men is about half that of womenThe fist effective treatment for cholelithiasis was cholecystostomy (15, 161, a procedure that was abandoned in the early decades of this century because of the high incidence of stone recurrence. Open cholecystectomy (OC) was introduced more than 100 yr ago (17) and remained the sole effective treatment of this disease for about 90 yr. During this period, the only decision that was required for a patient with cholelithiasis was whether treatment was indicated or not. In the last two decades several new treatments, such as oral bile acid therapy (BAT), extracorporeal shock wave lithotripsy (ESWL) and, more recently, laparoscopic cholecystectomy (LC) have become available. Therefore, it is now not only necessary for physicians to decide whether to treat gallstones but also to recommend the most suitable type of treatment. The purpose of this work is to present an evaluation of the newer therapies (mainly in comparison with OC) including the basis for selection of therapy in individual patients. CLINICAL STAGES OF CHOLELITHIASISCholelithiasis has three clinical stages: the asymptomatic and symptomatic stages and the stage of complications. Complicated forms of cholecystolithiasis include acute cholecystitis and its complications, choledocholithiasis and its complications, gallstone ileus and gallbladder cancer. These complications are much 31/1/40081 more serious than symptomatic cholelithiasis and usually require prompt and invasive treatment. Treatment of the complicated forms of cholelithiasis will not be considered in this work, but it should be noted that it is the avoidance of such complications that constitutes an important rationale for therapy in the symptomatic stage or even under special circumstances in the asymptomatic stage (18)(19)(20)(21)(22)(23)(24)(25).Of critical importance in making recommendations about treatment is knowledge of the natural history of cholelithiasis (i.e., the rate of conversion from the asymptomatic stage to the other stages). Such information is necessary to weigh the risk of expectant management against the hazards of treatment. Historical series on the natural history of gallstones have yielded controversial results, mainly because of the inclusion of many patients with biliary symptoms at the start of the study; this distorts the resu...

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confidence: 99%

Cholecystolithiasis: Lithotherapy for the 1990S

Strasberg

Clavien

1992

Hepatology

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“…There were 24 cases of CRC in 23 patients. The sites of the CRC were right colon (three), transverse colon (one), descending colon (one), sigmoid colon (seven) and rectum ( 12). Using the Australian Clinico-Pathological Staging System the tumour stages were four stage A cases, nine stage B cases, eight stage C cases, and three stage D cases.…”

Section: Resultsmentioning

confidence: 99%

Abdominal Aortic Aneurysm and Associated Colorectal Carcinoma: A Management Problem

Robinson

Hughes

Lippey

1994

Australian and New Zealand Journal of Surgery

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The increasing age of the population has led to the more common occurrence of multi-organ disease. Colorectal cancer (CRC) and abdominal aortic aneurysm (AAA) in the same patient is a difficult management problem. Over 10 years, 23 patients with CRC and AAA were treated at Concord Hospital. The management and outcome of these patients was reviewed to identify an optimum plan for patients with both conditions. The average age of patients was 71 years, ranging from 52 to 90 years. There was only one female patient in the series. In 19 of the patients, the AAA and CRC were synchronous, while in the other four patients the AAA and CRC were remote events. Within the group of patients with synchronous AAA and CRC, 12 had the diagnosis of both conditions made pre-operatively. However, in seven cases an unexpected AAA or CRC was found at operation for the other condition. Sixteen patients underwent resection of the CRC, while only eight underwent repair of the AAA. There were three deaths following CRC resection, two following AAA resection, and one following simultaneous CRC resection and AAA repair. Two of 10 patients with large (> 6cm) AAA, who underwent CRC resection, ruptured the AAA in the postoperative period. A further patient ruptured 10 months following CRC resection. Colorectal cancer was given priority over AAA when these conditions were found simultaneously.The present study suggests that a large AAA (> 6cm) should be either given preferential treatment, or resected simultaneously, in view of the high risk of rupture.

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“…Tompkins et al . 26 reported on a group of 22 patients with aortic reconstruction and concomitant GI procedures and found no significant differences in postoperative problems when compared ivith their AAA repairs alone. One consistent finding in both studies, including their own literature review, is the lack of postoperative complications directly related to infections.…”

Section: Malignancies and Aaa-priority Of Resectionmentioning

confidence: 98%

“…In addition, there were no reports of late graft infection in either stud y. 25,26 Nora et al24 described the Mayo Clinic experience and provided a comprehensive literature review on AAA repair and colon carcinoma in 1989. In their series, 17 patients were evaluated retrospectively for outcomes analysis.…”

Section: Malignancies and Aaa-priority Of Resectionmentioning

confidence: 99%

Abdominal Aortic Aneurysms and Abdominal Malignancies

Shafritz¹,

Feuer²,

Graham³

1999

Perspectives in Vascular Surgery and Endovascular Therapy

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Abdominal aortic aneurysms (AAA) have been reported in 5% of males between the ages 65 and 79. The most common malignancies have their highest incidence in the same age group. Coexistence of AAA and malignancy is estimated to be 1-4%. Because of the relative infrequency of the problem, no consensus opinion exists about its management. This article reviews the literature on the subject of AAA and concomitant abdominal malignancies. We describe the current indications and surgical management of AAA, review the population studies describing a link between cancer and AAA, and examine the proposed mechanisms and risk factors behind this association. We also discuss how to determine priority of resection and provide recommendations and guidelines regarding the surgical management of this complex problem.

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Combining intra-abdominal arterial grafting with gastrointestinal or biliary tract procedures

Cited by 40 publications

References 3 publications

Cholecystolithiasis: Lithotherapy for the 1990S

Cholecystolithiasis: Lithotherapy for the 1990S

Abdominal Aortic Aneurysm and Associated Colorectal Carcinoma: A Management Problem

Abdominal Aortic Aneurysms and Abdominal Malignancies

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