Publications by authors named "Carlos E Rey Chaves"

Background: Splenectomy indications are well documented; however, several infectious complications and potentially life-threatening conditions could arise after splenectomy. We aim to describe a 20-year single-center experience of postoperative outcomes after splenectomy and perform a subgroup analysis according to approach and surgical setting with a 30-day, 90-day, and 1-year follow-up.

Study Design: A retrospective cohort study was conducted between 2003 and 2023.

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Article Synopsis
  • Acute pancreatitis is a serious condition with a risk of developing into a more severe form called necrotizing pancreatitis, which is often treated using a step-up approach, including video-assisted retroperitoneal debridement (VARD).
  • This study investigates the outcomes of VARD in a single-center facility in Colombia, including demographics, clinical outcomes, and long-term follow-up of patients who underwent the procedure from 2016 to 2024.
  • The results showed VARD had a low complication rate and comparable outcomes to previous studies, with most patients recovering without major issues, indicating its effectiveness as a treatment option for necrotizing pancreatitis.
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Introduction And Importance: Meckel's diverticulum (MD) is an unusual clinical condition that occurs in approximately 2-4 %. The complications are more common in children, with a low prevalence in adults, with the main complication in adults being intestinal obstruction followed by diverticulitis with or without perforation.

Case Presentation: We present a 30-year-old female patient with a history of an appendectomy.

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Background: The mesh fixation method is one of the multiple factors associated with chronic postoperative pain in inguinal hernia surgery. The aim of this study is to evaluate postoperative pain associated with the two available fixation strategies (staple fixation versus self-fixating mesh) used in our field.

Methods: We designed an observational study with retrospective cohorts to analyze postoperative pain in patients who underwent a laparoscopic transabdominal preperitoneal inguinal hernia repair with a self-fixating mesh or staple fixation, which are the two available techniques in our field.

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Article Synopsis
  • Delayed gastric emptying (DGE) is a common issue following pancreatoduodenectomy, prompting this study to look for related risk factors in a Colombian patient population.
  • The research included 205 patients, finding that 25.85% suffered from DGE, with significant associations linked to smoking, high doses of hydromorphone, elevated bilirubin levels, and type B pancreatic fistulas.
  • Key risk factors identified for developing DGE include a history of smoking, opioid use greater than 0.6 mg daily, bilirubin levels over 6 mg/dL, and the presence of a type B pancreatic fistula.
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Background: Hepatic angiosarcoma is a rare type of tumour. In adults, the diagnosis remains challenging as the clinical manifestations are generally nonspecific and are usually made too late when complications or metastases are already present, associated with a poor prognosis. Due to the lack of agreement regarding the optimal treatment approach, a comprehensive analysis of the evidence in the literature on the surgical and survival outcomes in terms of disease-free survival time (DFS) and overall survival (OS) for patients treated for primary hepatic angiosarcoma is needed.

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Introduction And Importance: Pneumatosis cystoides intestinalis (PCI) is an uncommon condition characterized by intramural gas accumulation in the intestinal submucosa. Idiopathic or secondary is presented with non-specific clinical signs; in some cases, diagnosis is incidental. Its acute presentation is uncommon, and surgical management could be performed in selected cases.

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  • Negative pressure wound therapy (NPWT) is used in temporary abdominal closure for patients with traumatic or vascular conditions, but its effectiveness during intestinal anastomosis is debated.
  • A study analyzed 97 patients receiving NPWT from 2014 to 2018 to identify risk factors for anastomotic dehiscence, including gender and surgical practices.
  • The findings indicated that female patients, those with delayed fascial closure, those using vasopressors, and NPWT pressures over 110 mmHg had a higher risk of dehiscence.
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  • Meckel's diverticulum is a rare congenital condition mostly seen in newborns but can also occur in adults; this study details surgical treatment for 27 cases from 2004 to 2022.* -
  • Of the 27 patients, 81.4% were male, with abdominal pain being the main symptom reported in 85%; only 9% had a positive diagnosis before surgery.* -
  • Surgical treatments included several resection techniques, with symptomatic patients having longer average diverticulum sizes and a hospital stay of about 7.3 days.*
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Penetrating aortic injuries are infrequent. Its incidence is unknown because most patients die of hemorrhage even before they receive adequate treatment. Aortic wounds generally require conventional thoracotomy/laparotomy repair and are related to high mortality rates.

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Unlabelled: The risk of choledocholithiasis should be assessed in every patient undergoing cholecystectomy to define the next step. The American Society for Gastrointestinal Endoscopy proposed a stratified predictor scale of choledocholithiasis. Therefore, we aimed to describe our experience managing patients with an intermediate risk of choledocholithiasis according to the American Society for Gastrointestinal Endoscopy guidelines and the actual presence of bile duct stones in magnetic resonance cholangiopancreatography.

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Introduction: Aortoesophageal fistulae are an uncommon pathology, primarily due to the aortic pathology in more than 50 % of the cases, followed by foreign body ingestion, and advanced malignancies. Recently it is recognized after surgical management of thoracic aortic pathologies either open or endovascular, with increased rates of morbidity and mortality.

Presentation Of The Case: We present a 62-year-old male patient with a previous history of thoracic endovascular aortic repair, who enters the emergency room with gastrointestinal bleeding and clinical signs of infection.

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Introduction And Importance: Pseudoaneurysms after pancreatoduodenectomy are an uncommon complication, but they are associated with life-threatening outcomes in up to 50 % due to the development of postoperative bleeding. They usually result as a consequence of local inflammatory processes, such as pancreatic fistula or intra-abdominal collections. The cornerstones of treatment are thus intraoperative management and early identification of the complication.

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Introduction And Importance: Abdominal pain (AP) is one of the main reasons for consultation in the emergency department worldwide. The causes of AP are gathered in a broad group of pathologies whose incidence and prevalence vary according to various factors. The great importance of an adequate approach to AP lies in ruling out or confirming the presence of acute abdomen that requires emergency surgical management.

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BACKGROUND Echinococcosis is a zoonosis caused by the echinococcus microorganism, a parasite with 6 described species in the literature, the main one in humans being Echinococcus granulosus. Transmission is via the fecal-oral route, with main hepatopulmonary involvement but with high risk of dissemination. Diagnosis is often incidental and patients present a wide range of non-specific symptoms, closely related to localization, size, and quantity of cysts.

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Article Synopsis
  • Radical gastrectomy is the standard treatment for advanced gastric cancer, but the effectiveness and safety of laparoscopic approaches are still debated, with a high volume of such surgeries performed at the authors' institution in Colombia.
  • The study analyzed 310 patients who underwent either laparoscopic or open gastrectomy, showing a significant preference for laparoscopic surgery (89%), which also yielded better results in lymph node dissection.
  • The overall survival rates at 1, 3, and 5 years were reported as 84.04%, 66.9%, and 65.47%, respectively, with complications negatively impacting 1-year survival rates.
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Spontaneous and traumatic pneumothorax are most often treated with chest tube (CT) thoracostomy. However, it appears that small-bore drainage systems have similar success rates with lower complications, pain, and discomfort for the patient. We present the description of the ultrasound-guided technique for pneumothorax drainage with an 8.

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Purpose: Thoracic endovascular aortic repair (TEVAR) has been described to be superior to an open surgical approach, and previous studies have found superiority in TEVAR by reducing overall morbidity and mortality rates. This study aimed to describe the outcomes of TEVAR for patients with thoracic aortic disease at a high complexity.

Materials And Methods: Descriptive study, developed by a retrospective review of a prospectively collected database.

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Background: Acute mesenteric ischemia is a lethal challenging pathology for surgeons in the emergency department due to its ambiguous clinical presentation and lack of early diagnostic markers. Serum lactate is considered a relevant biomarker in terms of bowel necrosis length and mortality prediction. Nevertheless, its association has been poorly studied.

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Background: Chronic pancreatitis is an inflammatory disease characterized by irreversible morphological changes due to chronic pancreatic fibrosis. The treatment goals are to relieve pain, preserve function, and prevent further pathological consequences. Endoscopic treatment, surgery, or both are options for untreatable pain or suspected malignancy.

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Background: Haemobilia is a rare cause of gastrointestinal bleeding. It can be related to iatrogenic injuries, inflammatory diseases, and, more recently, postoperative, or post-procedure complications. Porto-biliary fistula is an uncommon case of haemobilia and has been related to iatrogenic injury or chronic inflammatory processes.

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Background: Hemosuccus pancreaticus is a rare cause of upper gastrointestinal bleeding (1/1500) and represents the loss of blood through the main pancreatic duct and its exteriorization through the major duodenal papilla. It can lead to massive bleeding, which is potentially life-threatening. This condition most commonly follows pseudoaneurysm formation due to acute or chronic pancreatitis.

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Background: Since Gagner performed the first laparoscopic adrenalectomy in 1992, laparoscopy has become the gold-standard procedure in the treatment of adrenal surgical diseases. A review of the literature indicates that the rate of intra- and postoperative complications are not negligible. This study aims to describe the single-center experience of adrenalectomies; and explore the associations between body mass index (BMI) and tumor volume in main postoperative outcomes.

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Common bile duct injury is a severe complication. It is related to increased rates of morbidity and mortality. Early recognition and on-time diagnosis plus multidisciplinary management of this disease led by a hepatobiliary surgeon show fewer complications rate and best postoperative outcomes.

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