Pre-Operative Group and Save in Elective and Emergency Laparoscopic Cholecystectomy: Necessity, Cost-Effectiveness, and Own Experience.

: Laparoscopic cholecystectomy is associated with a high safety profile. This study seeks to quantify the incidence of blood transfusion in both the elective and emergency settings, examine related patient outcomes, and investigate selection criteria for pre-operative Group and Save (G&S) sampling. A prospective multi-centre observational study was conducted to investigate patients undergoing either elective or emergency laparoscopic cholecystectomy in the UK between January 2020 and May 2021.

Anti-inflammatory effects of ischemic preconditioning on rat small bowel allografts.

Introduction: Minimizing the inflammatory events that follow intestinal transplantation may influence immediate graft function and improve outcome. Ischemic preconditioning (IPc) has been shown to ameliorate early inflammatory responses, and it may also attenuate the potentially damaging inflammation after intestinal transplantation. Herein, we examine the influence of intestinal IPc on inflammatory indices (tissue expression of ICAM-1, CD11a, and CD44 and serum levels of the soluble ICAM-1, sICAM-1) after heterotopic intestinal transplantation.

Strategy to reduce the risk of positive pancreatic resection margin at pancreatico-duodenectomy.

Background: The accuracy of histological assessment of frozen section (FS) of the pancreatic resection margin (PRM) at pancreatico-duodenectomy can be improved by concurrent FS examination of a sample of the suspected pancreatic lesion.

Methods: A prospective trial was conducted using archived material. FS of all the PRM and suspected pancreatic lesion of 12 patients randomly selected from a historical group who underwent pancreatico-duodenectomy for suspected malignancy were examined by five histopathologists.

CMV colitis presenting as acute abdomen requires early diagnosis and treatment to avoid mortality.

Objective: Acute CMV-colitis is an unusual cause of emergency colectomy in a general surgical department. The aim of this article is to report our experience on CMV colitis as a cause of acute abdomen.

Methods: Five patients were referred to general surgery during a three-year period with acute abdomen due to gastrointestinal CMV disease.

Colocutaneous fistula complicating therapeutic mesenteric embolisation.

Percutaneous embolotherapy has now assumed an important role in the management of massive colonic haemorrhage. However, this therapeutic option is associated with a significant risk of irreversible segmental colonic ischaemia. We present a case where distal segmental ischaemia led to a colocutaneous fistula, a complication not reported so far in the literature.

Perioperative analgesia in experimental small bowel transplantation.

Background: Despite numerous studies in experimental rat small bowel transplantation (SBT), few authors make reference to perioperative analgesia. Recent changes to the Animals (Scientific Procedures) Act 1986 in the United Kingdom have made the use of analgesia in laboratory animals compulsory because pain is unnecessary in the majority of scientific procedures.

Methods: Heterotopic SBT (PVG-->DA) was performed on male rat recipients weighing 220 to 250 mg under isoflurane with a mean anesthetic time of 100 minutes.

An experimental technique to assess the immunologic consequences of segmental small bowel transplantation.

Background: The amount of native small bowel required for adequate nutrition is variable, but lies between 10% and 20% of full length. Currently, for patients requiring small bowel transplantation (SBT), standard practice is to transplant the entire small bowel if space permits. Few experimental studies have addressed the effect of the length of small bowel transplanted on immune responses and in those that have, the amount of mesenteric lymph node (MLN) transplanted has always been a potential confounding factor, as have differences between jejunum and ileum.

Endoscopic sympathectomy in the treatment of facial blushing.

Introduction: Bilateral endoscopic thoracic sympathectomy (BETS) has been shown to be an effective, permanent, and safe treatment for severe upper limb hyperhydrosis. More recently, the possibility of using BETS to treat facial blushing, a redness of the face bought on by emotional or social stress, has been raised. This followed incidental reports from patients of relief from their blushing following this procedure for hyperhydrosis.

Abdominal complications from crack cocaine.

Not only is cocaine a powerfully addictive and dangerous drug of abuse, the use of the purified cocaine derivative crack has also reached epidemic proportions. Apart from causing fatal cardiorespiratory complications, crack cocaine is capable of producing surgical emergencies, which may or may not be associated with the pharmacology of cocaine itself. This is a report of crack-induced pneumoperitoneum, the mechanism of which seemed to be related to the prolonged Valsalva manoeuvre during crack smoking.

Transgastric surgery for posterior juxtacardial ulcers: a minimal and safe approach.

Hypothesis: A transgastric approach may be used succesfully for the treatment of posterior juxtacardial ulcers presenting with massive bleeding.

Methods: Eight patients were admitted during a 6-year period with acute massive upper gastrointestinal bleeding caused by posterior juxtacardial ulcers. All patients had signs of profound hypovolemic shock, and initial endoscopic control was achieved in 3 patients.

Use of the renal pelvis as exocrine drainage in segmental pancreatic transplantation. A preliminary report.

A new technique for exocrine drainage in segmental pancreatic transplantation has been developed in which the renal pelvis is anastomosed to the pancreatic capsule in an end-to-end fashion, after nephrectomy. This technique can be used only in uraemic patients without renal function. The procedure was performed on a uraemic patient who was free of major problems until his death due to an intracranial haemorrhage, 41 days after transplantation.

Current status in the management of proximal bile duct carcinoma.

The confluence of the biliary duct constitutes the most common location of the bile duct neoplasms. Resection of the tumor is the only procedure which has met with long-term survival rates (more than 5 years). An enhanced exposure of the tumor in surgical intervention contributes to increasing the number of resectable cases.

Successful long-term results with resection of pancreatic carcinoma in children: favorable prognosis for an uncommon neoplasm.

Carcinoma of the pancreas is increasing in incidence and affecting a younger population. However, pancreatic carcinoma in children under 15 years of age is a rarity. Only 28 cases were reported in the literature from 1885 to 1981.

Changes in circulating glycerol, free fatty acids and glucose levels following liver transplant in the pig.

Female pigs, fasted overnight, received an orthotopic liver transplant. During the nonhepatic phase, both blood glycerol and plasma free fatty acid concentrations increased, returning to basal values after the transplant, indicating that the liver is the main receptor of these products released in the blood from the glyceride breakdown in peripheral fat deposits. Blood glucose level rose during the nonhepatic phase, probably due in part to the perfusion of glucosated saline received by the animals during this phase.

Giant diverticula of the colon.

A case of a gas-filled intra-abdominal abscess cavity is reported. The literature is reviewed for similar cases and with reference to the cause and differential diagnosis of abdominal air cysts.

Intrahepatic vascular division in the pig: basis for partial hepatectomies.

Transplantation of resected hepatic fragments, with the attendant vascular and biliary tract reconstruction, presents difficulties. We have studied the intraparenchymal vascular division in the pig with a view to performing partial hepatectomies with the greastest possible anatomical support. Forty-six molds of the various vascular territories were obtained from the 31 porcine livers.