Special Issue on “Advances in Image-Guided Diagnosis and Treatment of Abdominal Diseases”

Marra, Paolo; Giurazza, Francesco

doi:10.3390/diagnostics13020169

Cited by 1 publication

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“…Если диагностика сосудистых аневризм успешно проводится с помощью компьютерной томографии и такие пациенты стратифицируются в группу высокого риска, то оценка риска развития интраоперационных кровотечений вызывает затруднения [22][23][24][25]. К тому же метод компьютерной томографии имеет определенные ограничения в частоте применения, в частности, из-за лучевой нагрузки [26,27]. Следует отметить то, что после проведенных оперативных вмешательствах на поджелудочной железе и парапанкреатической клетчатке информативность трансабдоминального ультразвукового исследования снижается.…”

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Possibilities of Transfistula Ultrasound in Predicting Intraoperative Bleeding in Patients with Infected Pancreatic Necrosis

Remizov,

Andreev,

Durleshter

et al. 2024

Урал. мед. журнал

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Introduction. Assessing the risk of intraoperative bleeding is of great importance in the treatment of patients with infected pancreatic necrosis.The aim of the study — determine the role of transfistula ultrasound in assessing the risk of intraoperative bleeding in patients with infected pancreatic necrosis.Materials and methods. From 2015 to 2019, 193 people with infected pancreatic necrosis were treated at Regional Clinical Hospital No. 2 (Krasnodar). At stage 1, drains of various diameters were installed in all patients; at stage 2, necrotic tissue was removed using transfistula videoscopic necrosequestrectomy in 48 patients (24.9 %). Before performing instrumental necrosequestrectomy, a developed diagnostic method was used — transfistula ultrasound scanning — to determine the relationship between the location of foci of necrosis in the pancreas and blood vessels in 22 patients (11.4 %; group 1); the method was not used in 26 people (13.5 %; group 2).Results. The number of accesses created into the omental bursa was as follows: 141 patients (73.1 %) had 3 accesses, 52 people (26.9 %) had 2 accesses; into the retroperitoneal space: 102 patients (52.8 %) had 2 accesses, 51 people (26.4 %) had 1 access. Transfistula videoscopic necrosequestrectomy was performed 35 and 37 times in groups 1 and 2, respectively (p > 0.05). Transfistula ultrasound scanning to assess the risk of intraoperative bleeding was used 33 times in patients in group 1. In group 1, intraoperative bleeding was observed in 5 patients (23.8 %), in group 2 — in 7 patients (26.9 %) (p > 0.05). The volume of blood loss was (436.0±83.6) and (887.0±41.8) ml in groups 1 and 2, respectively (p < 0.05). There were no cases of death due to intraoperative bleeding in either group.Discussion. Transfistula ultrasound scanning makes it possible to stratify patients: into a high-risk group (with intimate adjacency of necrosis to vessels), medium (at a distance of up to 15 mm) and low-risk (with a distant location). In this regard, interventions in high-risk patients were carried out in the X-ray operating room to allow for endovascular hemostasis, which made it possible to reduce the volume of blood loss, as well as to create a supply of transfusion media in advance to replenish the volume of blood volume.Conclusion. The developed method of direct transfistula ultrasound scanning makes it possible to assess the risk of intraoperative bleeding in patients with infected pancreatic necrosis to achieve timely hemostasis and compensate for acute blood loss.

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Possibilities of Transfistula Ultrasound in Predicting Intraoperative Bleeding in Patients with Infected Pancreatic Necrosis

Remizov,

Andreev,

Durleshter

et al. 2024

Урал. мед. журнал

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Special Issue on “Advances in Image-Guided Diagnosis and Treatment of Abdominal Diseases”

Abstract: This Special Issue is a collection of five scientific papers and five reviews concerning current topics in abdominal imaging with attention on the diagnosis and interventional management of specific diseases [...]

Cited by 1 publication

References 10 publications

Possibilities of Transfistula Ultrasound in Predicting Intraoperative Bleeding in Patients with Infected Pancreatic Necrosis

Possibilities of Transfistula Ultrasound in Predicting Intraoperative Bleeding in Patients with Infected Pancreatic Necrosis

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