Prevalence of postcholecystectomy symptoms: long-term outcome after open versus laparoscopic cholecystectomy.

After cholecystectomy a certain number of patients continue to suffer from abdominal symptoms or develop such symptoms postoperatively. The aim of this study was to compare the prevalence of postcholecystectomy symptoms with open cholecystectomy during the prelaparoscopic era and those with laparoscopic cholecystectomy 4 years after introduction of the laparoscopic technique. Between July 1988 and June 1989 a total of 163 consecutive patients with elective open cholecystectomy and between September 1994 and August 1995 a total of 234 consecutive patients with elective laparoscopic cholecystectomy were prospectively evaluated using a standard questionnaire about preoperative symptoms, diagnostic modalities, and intraoperative findings.

The learning curve of laparoscopic cholecystectomy and changes in indications: one institutions's experience with 2,650 cholecystectomies.

Purpose: In a prospective series of 2,650 consecutive patients undergoing cholecystectomy, we analyzed the learning curve since the introduction of laparoscopic cholecystectomy (LC) in terms of operating time, conversion rate, morbidity, mortality, and consequent changes in indications for either laparoscopic or open cholecystectomy (OC).

Patients And Methods: Between July 1990 and June 1997, LC was performed in 1,929 patients (73%), 203 of whom (7.5%) had to be converted to OC, while 518 patients (19.

[Increasing frequency of bariatric surgery interventions since replacement of gastroplasty by laparoscopic gastric banding in the treatment of morbid obesity].

Between 1984 and 1996 we performed a Mason gastroplasty for the treatment of morbid obesity: 14 patients (average age 40 (26-48) years, body mass index (BMI) 48 (37-71) kg/m2, excessive body weight 67 (41-116) kg). Since the end of 1996 we now apply adjustable laparoscopic gastric banding (lab band): 73 patients (average age 39 (22-64) years, BMI 45 (32-69) kg/m2, excessive body weight 66 (41-116) kg). We compared the early and late results of both methods.

[Postcholecystectomy complaints one year after laparoscopic cholecystectomy. Results of a prospective study of 253 patients].

Aims: We studied the nature and frequency of symptoms 1 year after laparoscopic cholecystectomy in order to define pre- and perioperative factors that influence the long-term outcome.

Method: Between September 1994 and August 1995 we prospectively evaluated 268 patients undergoing laparoscopic cholecystectomy using a standard questionnaire. After an average of 16 months (12-25 months) the patients were asked about their symptoms using a similar questionnaire by telephone or were followed up clinically if necessary.

[Results of anal sphincteroplasty in fecal incontinence--significance of intra-anal ultrasound imaging].

Unlabelled: The aim of the study was to evaluate the clinical, manometric and endosonographic results of overlapping sphincteroplasty for traumatic sphincter defects documented by endosonography.

Patients And Method: We performed an overlap repair in 10 women aged 34 to 68 with fecal incontinence due to sphincter defects after obstetric (n = 8) or iatrogenic (n = 2) trauma. The fecal incontinence was graded using the Miller Score (0-18 points).

[11 cases of anal Bowen's disease].

Bowen's disease of the anal region is a rare, slow-growing, intraepidermal squamous-cell carcinoma (carcinoma in situ). If surgical excision is incomplete, there is a risk of subsequent development of malignancy and metastasis. Between 1980 and 1995 we treated 11 patients (8 female, 3 male) with anal Bowen's disease.

[Preperitoneal prosthesis implantation in surgical management of recurrent inguinal hernia. Retrospective evaluation of our results 1989-1994].

Recurrent inguinal hernia represents a great problem in surgery given the frequency of this operation, with a recurrence rate of 0.5-8%. Re-recurrence after repair without implantation of a prosthesis occurs in 1-23% of cases.

[Treatment of rectum adenoma. Retrospective study of the treatment of inpatients (1987-1991)].

In carrying out an evaluation prior to acquisition of equipment for transanal endoscopic microsurgery (TEM), we wished to examine current concepts in the treatment of rectal adenoma, i.e.: What form of surgery was chosen in relation to the dimension and localization of the adenoma? Should the indications for the particular procedure be changed to render it less invasive? Should the new endoscopic surgical method TEM be introduced? 134 inpatients covering a 5-year period were evaluated.

[Initial results with laparoscopic fundoplication].

17 patients underwent laparoscopic Nissen fundoplication for gastroesophageal reflux disease not responding to medical treatment. Conversion to laparotomy was necessarily due to large paraesophageal hiatus hernia (3) or severe peri-esophagitis (1) in 4 patients. There was no perioperative morbidity or mortality.

[Reflux disease following gastropexy for para-esophageal hiatal hernia].

From 1984 to 1992 28 patients with paraesophageal hiatus hernia underwent elective operation with crural repair and gastropexy. In the absence of severe reflux disease (6 patients had mild to moderate reflux symptoms) and of esophagitis at endoscopy, no antireflux repair was performed in these patients. Follow-up of 19 patients after 3 years (12-72 months) revealed reflux symptoms in 11 patients (58%) and moderate or severe reflux disease (need for medical treatment) in 6 (32%).

[Abdominal cicatricial hernia--results of various surgical techniques].

Incisional hernias and recurrent hernias are frequent after abdominal operations. We studied possible reasons for the occurrence of recurrent hernia. From 1986 to 1990, 150 patients were operated for recurrent hernia in the St.

[Laparoscopic and open cholecystectomy in 954 patients. A prospective evaluation].

In 2 1/2 years we performed at the St. Clara Hospital in Basel 954 cholecystectomies; 661 were done laparoscopically. In the laparoscopic group we observed a morbidity of 2.

[Cholecystectomy today. A prospective study].

Between 13 June 1990 and 12 June 1993, we performed 1145 consecutive cholecystectomies. 127 patients who had undergone additional surgery were excluded from the prospective study. Of the remaining 1018 patients, 806 (78.

[Boerhaave syndrome. Differential diagnosis in acute chest pain].

Spontaneous perforation of the esophagus (Boerhaave syndrome) is a rare diagnosis in acute thoracic or epigastric pain. We present the case of a swiftly diagnosed and successfully treated rupture. Apart from pathophysiology, symptoms and diagnosis, the differential diagnosis and therapeutic options are discussed in more detail.

[Perioperative morbidity and mortality in colon resection for colon cancer].

The operative risk of colon resections was evaluated by a retrospective analysis of 231 according patients who were operated on between 1984 and 1988. Mean age of the patients was 70 years with a range from 37 to 91 years. Colonic resection consisted of ileocecal resection in 3 cases, right hemicolectomy in 144 cases, segmental resection of transverse colon in 10 cases, left hemicolectomy in 22 cases, resection of sigmoid colon in 77 cases and 5 times a subtotal colectomy was performed.

[Hemorrhage from pseudocysts caused by pseudoaneurysms in chronic pancreatitis. Diagnosis and management].

Bleeding pseudocysts respectively pseudoaneurysms represents a seldom complication of chronic pancreatitis in owing to erosion of pancreatic or peripancreatic arteries. The potential rupture into neighbouring organs or in the peritoneal cavity is accompanied with paramount life-threatening risks. During the last years we observed 3 patients with acute intestinal bleeding caused by pseudocysts converted to pseudoaneurysms.

[Cancer of the gastric stump. An independent disease picture? Consequences for follow-up].

In a retrospective study we analysed the clinical course of 13 patients from the St Clara's Hospital who had a gastric-stump cancer between the years of 1975 and 1989 and compared our figures with the literature. Our figures showed the average age of the patient at their first operation for the gastric ulcer was 35 and, at the second operation for gastric cancer the average age was 68.8 patients were male and 5 were female.

How accurate is endorectal ultrasound in the preoperative staging of rectal cancer?

In rectal cancer, depth of infiltration and metastatic involvement of lymph nodes are important prognostic factors. The correct choice of operative treatment depends on the extent of the disease. In a prospective study, the value of endorectal ultrasound in staging rectal cancer was evaluated, and factors affecting the method's accuracy are discussed.

[Perioperative morbidity and mortality of colon resection in colonic carcinoma].

An analysis of the local and systemic perioperative complications is conducted to explore the risk of resection of colon cancer. In a retrospective study we analyzed 231 consecutive patients operated on between 1984 and 1988. The mean age was 70 (37-91) years.

[Laparoscopic cholecystectomy. Initial experiences and results in 278 patients].

Of 467 cholecystectomies (performed between 13. 6. 1990 and 12.

[Acral vasospasm in Crohn's disease].

55 patients with Crohn's disease and 55 sex- and age-matched healthy controls were studied by nailfold capillary microscopy for evidence of microcirculatory abnormalities. Digital capillary blood flow measurements in combination with a local cooling test were assessed by videocapillaroscopy using the flying-sport technique. We found a blood flow stop with cold exposure in 44 of the 55 patients with Crohn's disease (mean duration 39 seconds) but in 5 of the 55 control subjects only (mean duration 19 seconds).

[What is the contribution of surgery in cholelithiasis today?].

1631 patients with cholelithiasis were operated on between 1984 and 1989 at the St. Clara Hospital in Basel. Mortality and rate of reinterventions were evaluated.