Predicting Successful Laparoendoscopic Transhiatal Esophagectomy (THE) by Mediastinal Height Measurement.

Background: Laparoendoscopic transhiatal esophagectomy (THE) provides advantages over traditional THE by not only avoiding laparotomy but by also allowing more precise esophageal mobilization. Occasionally, the length of the gastric conduit is insufficient to allow delivery into the neck after laparoscopic mobilization and requires laparotomy to complete the procedure. We hypothesize that the need for laparotomy will correlate with the measurement of mediastinal height (distance from thoracic vertebrae T1-T12) on chest CT.

Pilot Randomized Controlled Trial of Laparoscopic Cholecystectomy vs Active Nonoperative Therapy for the Treatment of Biliary Dyskinesia.

Background: Despite widespread adoption by the surgical community, high-quality prospective data supporting the practice of laparoscopic cholecystectomy (LC) for the treatment of biliary dyskinesia (BD) are lacking.

Study Design: Adult patients meeting criteria for diagnosis of BD (Rome III symptoms, normal ultrasound, gallbladder ejection fraction < 38%) were randomized to either LC or a trial of nonoperative (NO) therapy with a low-dose neuromodulator (amitriptyline 25 mg/day). Patients in the NO arm were allowed to cross over to the surgical arm and remain in the study for any reason.

Iatrogenic pseudoaneurysms: comparison of treatment modalities, including duplex-guided thrombin injection.

The purpose of our study was to review the results of the three treatment modalities currently used at Charleston Area Medical Center (CAMC) for iatrogenic pseudoaneuryms. Retrospective records were reviewed of patients treated for pseudoaneurysms (PSA) from July 1, 2001 to June 30, 2002. In the 12-month period, 69 psedoaneurysms were treated with either ultrasound-guided compression (UGC), duplex-guided thrombin injection, or open operative repair.