RESUMO
BACKGROUND: Clips are endoscopic mechanical devices with tensile and closure strength that can approximate tissue and provide hemostasis through a tamponade effect. Clips are ubiquitously used in endoscopic practice, and numerous studies have validated the clinical efficacy of clips, with recent guidelines recommending them as a first-line intervention for recurrent and persistent nonvariceal gastrointestinal bleeding. However, the safety profile for these devices has yet to be delineated, thus, we aim to investigate this feature by examining the adverse events reported to the Food and Drug Administration. METHODS: Postmarketing surveillance data from the Food and Drug Administration Manufacturer And User Facility Device Experience database were analyzed from January 2012 to January 2021. The Manufacturer And User Facility Device Experience database is a reporting software and does not independently verify the details of complications. RESULTS: Two thousand five hundred forty reports were issued, of which 287 were patient adverse events and 2766 were device problems. Activation, separation, and positioning issues were most common. No consequences or clinically significant impact on patients were seen in 1968 reports. Foreign bodies were seen in 97 cases, hemorrhage in 57 cases, tissue damage in 42 cases, embedded clips in tissues/plaques in 16 cases, perforation in 15 cases, lacerations in 6 cases, and infection in 3 cases. CONCLUSIONS: While the most commonly reported device problems involved activation, separation, and positioning, most patients were clinically unaffected. Moreover, perforation and infection were exceedingly rare, further highlighting the safety profile of endoscopic clips.
Assuntos
Endoscopia , Hemorragia Gastrointestinal , Humanos , Estados Unidos , Hemorragia Gastrointestinal/epidemiologia , Hemorragia Gastrointestinal/etiologia , Resultado do Tratamento , Instrumentos Cirúrgicos/efeitos adversos , Bases de Dados FactuaisRESUMO
BACKGROUND: The current literature supports the closure of trocar sites ≥10-mm for the risk of developing incisional hernias, while there is no need to suture the abdominal fascia when using 5-mm trocars. To date, evidence regarding the closure of 8-mm trocars that are use by new robotic systems is weak. The aim of our study was to investigate the incidence of incisional hernia for 8-mm trocars. METHODS: We prospectively collected data on all patients undergoing robotic-assisted abdominal wall surgery from 2020 to 2023, in whom the abdominal fascia of all 8-mm trocars was not closed. The enrolled patients underwent a follow-up visit during which we conducted clinical and sonographic evaluations of all 8-mm trocars, in addition to assessing the satisfaction levels of the patients. The primary outcome was the incidence of port-site hernia. RESULTS: We enrolled 166 patients, 155 men and 11 women, for a total of 513 trocars accessed. Mean age was 61.1 ± 14.0 years, and mean BMI was 27.0 ± 3.9 kg/m2. The follow-up visits were carried out after a median follow-up of 14.5 (9.0-23.2) months. Only one case developed an asymptomatic 1 × 1 cm supra-umbilical hernia that was not treated. Patient reported a satisfaction regarding the 8-mm trocars and skin sutures of 9.8 ± 0.5 out of 10 points. CONCLUSIONS: The occurrence of a trocar-site hernia after 8-mm robotic access is extremely low. Hence, the fascia closure may not be necessary.
Assuntos
Hérnia Incisional , Procedimentos Cirúrgicos Robóticos , Instrumentos Cirúrgicos , Humanos , Hérnia Incisional/etiologia , Hérnia Incisional/epidemiologia , Masculino , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Robóticos/métodos , Feminino , Estudos Prospectivos , Pessoa de Meia-Idade , Idoso , Instrumentos Cirúrgicos/efeitos adversos , Incidência , Parede Abdominal/cirurgia , Adulto , Desenho de EquipamentoRESUMO
OBJECTIVES: Topic treatment can be useful to improve short and long-term nasal outcomes after nasal surgery, reducing discomfort and risk of synechia. This study aimed at evaluating the effect on clinical outcomes of nasal packaging using Fitostimoline® gauze in FESS and septoplasty. METHODS: A case-control study on hospitalized patients was performed in a tertiary referral center. The control group included 20 patients treated with the standard surgical protocol for septoplasty and standard nasal packaging; treatment group included 21 patients underwent same surgical procedure but in whom the nasal tampon was wrapped with a gauze containing Fitostimoline® before being placed into the nose. RESULTS: Patients in treatment group had better outcomes than control; nasal mucosa showed better healing - recovery of normal color- in those patients in whom we applied the Fitostimoline® gauze around tampons. Moreover, 100 % patients in the treatment group did not refer discomfort during at tampon removal versus 60 % subjects in the control group who referred pain, tension or tearing during the same action. CONCLUSION: Our results, although preliminary because of the small cohort of subjects included, suggest that the apposition of a gauze with Fitostimoline® after nasal surgery might improve the mucosal healing with consequent reduction of patients discomfort during the post-surgical period.
Assuntos
Obstrução Nasal , Rinoplastia , Humanos , Estudos de Casos e Controles , Septo Nasal/cirurgia , Rinoplastia/métodos , Endoscopia/efeitos adversos , Instrumentos Cirúrgicos/efeitos adversos , Resultado do Tratamento , Obstrução Nasal/cirurgiaRESUMO
Oral anticoagulants for atrial fibrillation are the standard approach to prevent stroke in patients with atrial fibrillation. However, oral anticoagulant therapy carries the risk of cerebral infarction recurrence, not to mention hemorrhagic complications, even under appropriate drug therapy. Surgical treatments targeting the left atrial appendage include left atrial appendage closure( LAAO) and left atrial appendage resection (LAAR). Our hospital uses AtriClip (approved and available in Japan since 2018) as a device for LAAO, and we investigated the early and long-term results of LAAO using AtriClip in our hospital. As a result, stable early to long-term results were expected for left atrial appendage closure using AtriClip device, suggesting that it may be an option that can be considered as a method for preventing stroke in patients with atrial fibrillation. But further investigation is required in the future.
Assuntos
Apêndice Atrial , Fibrilação Atrial , Acidente Vascular Cerebral , Humanos , Fibrilação Atrial/complicações , Fibrilação Atrial/cirurgia , Fibrilação Atrial/tratamento farmacológico , Oclusão do Apêndice Atrial Esquerdo , Apêndice Atrial/cirurgia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle , Anticoagulantes/uso terapêutico , Instrumentos Cirúrgicos/efeitos adversos , Resultado do TratamentoRESUMO
OBJECTIVES: To investigate the factors that contribute to the development of cerebral edema after aneurysm clipping in individuals with aneurysmal subarachnoid hemorrhage (aSAH). METHODS: A total of 232 patients with aSAH caused by rupture and treated with aneurysm clipping were included in the retrospective analysis of clinical data. Postoperatively, the participants were categorized into two groups based on the presence or absence of cerebral edema: a complication group (n=33) and a non-complication group (n=199).A comparison was made between the overall data of the 2 groups. RESULTS: In the complication group, there were higher proportions of patients experiencing recurrent bleeding, aneurysm in the posterior circulation, Fisher grade III-IV, World Federation of Neurosurgical Societies (WFNS) grade II, Hunt-Hess grade III-IV, concomitant hypertension, duration from onset to operation ≥12 h, and concomitant hematoma compared to the non-complication group (p<0.05). Cerebral edema after aneurysm clipping was associated with several risk factors including repeated bleeding, aneurysm in the back of the brain, Fisher grade III-IV, WFNS grade II, Hunt-Hess grade III-IV, simultaneous high blood pressure and hematoma, and a duration of at least 12 hours from the start of symptoms to the surgical procedure (p<0.05). CONCLUSION: In patients with aSAH, the risk of cerebral edema after aneurysm clipping is increased by recurrent bleeding, aneurysm in the posterior circulation, Fisher grade III-IV, WFNS grade II, Hunt-Hess grade III-IV, concomitant hypertension and hematoma, and duration of ≥12 h from onset to operation.
Assuntos
Edema Encefálico , Hemorragia Subaracnóidea , Humanos , Hemorragia Subaracnóidea/cirurgia , Hemorragia Subaracnóidea/complicações , Masculino , Feminino , Pessoa de Meia-Idade , Edema Encefálico/etiologia , Fatores de Risco , Estudos Retrospectivos , Adulto , Idoso , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Aneurisma Intracraniano/cirurgia , Aneurisma Intracraniano/complicações , Procedimentos Neurocirúrgicos/efeitos adversos , Instrumentos Cirúrgicos/efeitos adversos , Aneurisma Roto/cirurgia , Aneurisma Roto/complicaçõesAssuntos
Doenças do Colo , Fístula Gástrica , Doença Iatrogênica , Fístula Intestinal , Humanos , Fístula Gástrica/etiologia , Fístula Gástrica/cirurgia , Fístula Intestinal/etiologia , Fístula Intestinal/cirurgia , Doenças do Colo/cirurgia , Doenças do Colo/etiologia , Instrumentos Cirúrgicos/efeitos adversos , Masculino , Feminino , Colonoscopia/efeitos adversos , Colonoscopia/instrumentação , Colonoscopia/métodosRESUMO
INTRODUCTION: With an incidence of 0-5.2%, trocar site hernias frequently occur following laparoscopy. It is unclear to what extent the angle of trocar insertion affects the size of the fascial defect caused. Hence, we performed a porcine model. METHODS: In October 2022, a total of five female pigs were euthanized. In alternating order, three bladeless and two bladed conical 12-mm trocars were inserted at an angle of 45° on each side for 60 min twice each pig. For this purpose, an epoxy resin handmade cuboid with a central channel that runs at an angle of 45° was used. Subsequently, photo imaging and defect size measurement took place. The results were compared with those of our previously conducted and published porcine model, in which the trocars were inserted at an angle of 90°. Effects of trocar type (bladed vs. bladeless) and angle on defect size were analyzed using a mixed model regression analysis. RESULTS: The bladeless trocars caused statistically significant smaller defects at the fascia than the bladed (23.4 (SD = 16.9) mm2 vs. 41.3 (SD = 14.8) mm2, p < 0.001). The bladeless VersaOne trocar caused the smallest defect of 16.0 (SD = 6.1) mm2. The bladed VersaOne trocar caused the largest defect of 47.7 (SD = 10.5) mm2. The defect size of the trocars used at a 45° angle averaged 30.5 (SD = 18.3) mm2. The defect size of trocars used at a 90° angle was significantly larger, averaging 58.3 (SD = 20.2) mm2 (p = 0.007). CONCLUSION: When conical 12-mm trocars are inserted at a 45° angle, especially bladeless ones, they appear to cause small fascial defects compared with insertion at a 90° angle. This might lead also to a lower rate of trocar hernias. Bladeless trocars might cause smaller fascial defects than bladed trocars.
Assuntos
Herniorrafia , Laparoscopia , Feminino , Suínos , Animais , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Instrumentos Cirúrgicos/efeitos adversos , Fáscia , HérniaRESUMO
Analyses of registries and medical imaging suggest that laparoscopic surgery may be penalized with a high incidence of trocar-site hernias (TSH). In addition to trocar diameter, the location of the surgical wound (SW) may affect TSH incidence. The intra-abdominal pressure (IAP) exerted on the abdominal wall (AW) might also influence the appearance of TSH. In the present study, we used finite element (FE) simulations to predict the influence of trocar location and SW characteristics (stiffness) on the mechanical behavior of the AW subject to an IAP. Two models of laparoscopy patterns on the AW, with trocars in the 5-12 mm range, were generated. FE simulations for IAP values within the 4 kPa-20 kPa range were carried out using the Code Aster open-source software. Different stiffness levels of the SW tissue were considered. We found that midline-located surgical wounds barely deformed, even though they moved outwards along with the regular LA tissue. Laterally located SWs hardly changed their location but they experienced significant variations in their volume and shape. The amount of deformation of lateral SWs was found to strongly depend on their stiffness. Trocar incisions placed in a LA with non-diastatic dimensions do not compromise its mechanical integrity. The more lateral the trocars are placed, the greater is their deformation, regardless of their size. Thus, to prevent TSH it might be advisable to close lateral trocars with a suture, or even use a prosthetic reinforcement depending on the patient's risk factors (e.g., obesity).
Assuntos
Parede Abdominal , Laparoscopia , Humanos , Parede Abdominal/cirurgia , Fenômenos Biomecânicos , Cicatriz/etiologia , Laparoscopia/efeitos adversos , Instrumentos Cirúrgicos/efeitos adversos , TireotropinaRESUMO
BACKGROUND: The aim of this study was to investigate 8-mm robotic trocar site hernia (TSH) rate over the short and long term, providing aids to manage the related fascial wounds. METHODS: A retrospective analysis of 320 patients undergoing robotic surgery was conducted. The primary outcome was 8-mm TSH rate with a minimum follow-up of 12 months. The secondary outcome was the rate of haematomas and infections related to 8-mm wounds and their association with patient comorbidities and trocar position. RESULTS: One case of TSH was observed (0.31%). There were 15 cases of wound infection (4.68%) and 22 cases of wound haematoma (6.87%). Trocar related complications were significantly associated with patient comorbidities, not with trocar position. CONCLUSIONS: Our results do not justify the 8-mm fascial wound closure. Data concerning the association between trocar-related complications and patient comorbidities strengthen the need to implement the control of metabolic state and correct administration of perioperative therapy in high-risk patients.
Assuntos
Laparoscopia , Procedimentos Cirúrgicos Robóticos , Humanos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Estudos Retrospectivos , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Instrumentos Cirúrgicos/efeitos adversos , TireotropinaRESUMO
BACKGROUND: Acute non-variceal upper gastrointestinal bleeding (UGIB) is challenging in patients at high risk of re-bleeding in whom standard endoscopic treatment (ST) has limited effectiveness. Over-the-scope clips (OTSC) have shown promise in these patients although their precise role remains uncertain. AIMS: To confirm the role of OTSC in patients with UGIB at high risk of re-bleeding. METHODS: We systematically searched CENTRAL, MEDLINE and Embase from January 1st, 1970 to April 24, 2024 for randomised controlled trials (RCTs) comparing OTSC and ST in acute non-variceal UGIB with high re-bleeding risk. The GRADE framework assessed evidence certainty, while trial sequential analysis (TSA) controlled random errors and evaluated conclusion validity. RESULTS: We analysed four RCTs (319 patients); pooled risk ratio (RR) for clinical success at initial endoscopy favoured OTSC (RR = 1.30, 95% CI = 1.08-1.56, p = 0.006, I2 = 58%, moderate certainty of evidence). TSA showed the desired sample size was 410 and the cumulative Z curve crossing the trial sequential monitoring boundary. The pooled RR for re-bleeding within 30 days favoured OTSC (RR = 0.53, 95% CI = 0.30-0.94, p = 0.03, I2 = 0%, moderate certainty of evidence). There was no significant difference in 30-day mortality, or length of hospital or ICU stay. CONCLUSIONS: Moderate certainty evidence supports OTSC as a superior initial treatment for acute non-variceal UGIB with high re-bleeding risk. Further large-scale studies are needed to confirm OTSCs' role by exploring other prognostic outcomes and assessing cost-effectiveness and potential complications.
Assuntos
Hemorragia Gastrointestinal , Instrumentos Cirúrgicos , Humanos , Hemorragia Gastrointestinal/etiologia , Instrumentos Cirúrgicos/efeitos adversos , Recidiva , Ensaios Clínicos Controlados Aleatórios como Assunto , Endoscopia Gastrointestinal/métodos , Hemostase Endoscópica/instrumentação , Hemostase Endoscópica/métodos , Resultado do Tratamento , Trato Gastrointestinal SuperiorRESUMO
RATIONALE: Raney clips are commonly used in neurosurgical procedures to hold the scalp in place and stop bleeding during surgery. The removal of Raney clips is often the last process during cranial surgery prior to the closure of skin incision. Thus, a Raney clip found underneath the titanium mesh resulting in fever is a very rare occurrence. PATIENT CONCERNS: An 18-year-old male patient underwent cranial surgery due to intracranial abscess in the frontal lobe and subsequently underwent frontal skull repair using titanium mesh during which a Raney clip was unintentional left underneath the titanium mesh resulting in fever. DIAGNOSIS: A thin-slice computed tomography (CT) scan was used to identify the Raney clip. INTERVENTION: A third surgery was performed to remove the Raney clip. OUTCOMES: The patient fever total resolved after the third surgery with no further neurological deficits and 2-years follow-up revealed the patient is well and go about his daily activities. LESSONS: It is crucial to ensure that all foreign objects are removed after the surgery by counting all instruments used at and after each step during the operation, including all Raney clips. This will help prevent complications and ensure the safety as well as the well-being of the patient.
Assuntos
Instrumentos Cirúrgicos , Telas Cirúrgicas , Titânio , Humanos , Masculino , Adolescente , Telas Cirúrgicas/efeitos adversos , Titânio/efeitos adversos , Instrumentos Cirúrgicos/efeitos adversos , Corpos Estranhos/cirurgia , Tomografia Computadorizada por Raios X , Abscesso Encefálico/cirurgia , Abscesso Encefálico/etiologia , Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Neurocirúrgicos/métodos , Febre/etiologia , Complicações Pós-Operatórias/cirurgia , Complicações Pós-Operatórias/etiologia , Craniotomia/efeitos adversos , Craniotomia/instrumentaçãoRESUMO
BACKGROUND: The method of transecting the pancreatic parenchyma during pancreatic resection may influence the rate of complications, including pancreatic fistula and bleeding. The objective of this study was to compare the transection of the pancreatic parenchyma during pancreatoduodenectomy with monopolar electrocautery versus scalpel in terms of postoperative complications. METHODS: A retrospective analysis of patients with open pancreatoduodenectomy from the German DGAV StuDoQ|Pancreas registry (January 2013 to December 2021) was performed. Transection of the pancreatic parenchyma with a scalpel versus monopolar electrocautery was compared regarding postoperative pancreatic fistula B/C, post-pancreatectomy hemorrhage B/C, and major complications (Clavien-Dindo classification ≥3) rates. Multivariable analysis with adjustment for potential confounders and surgical center cluster effect was performed. RESULTS: Overall, 6,752 patients were included in the study. In 4,072 (60.3%), transection was performed with a scalpel and, in 2,680 (39.7%), with electrocautery. Transection with electrocautery was associated with higher postoperative pancreatic fistula B/C (15.4% vs 12.8%; P = .003), post-pancreatectomy hemorrhage B/C (11% vs 7.4%; P < .001), and major complications (33.4% vs 29.6%; P = .001) rates. In the multivariable analysis, after adjustment for potential confounders and surgical center, the association of the transection method with postoperative pancreatic fistula B/C (odds ratio = 1.01; 95% CI, 0.79-1.2; P = .962), post-pancreatectomy hemorrhage B/C (odds ratio = 1.23; 95% CI, 0.94-1.6; P = .127), and major complications (odds ratio = 1.09; 95% CI, 0.93-1.27; P = .297) was not significant. CONCLUSION: The study found no significant association between transection of the pancreatic parenchyma during open pancreatoduodenectomy with a scalpel compared with monopolar electrocautery regarding pancreatic fistula, postoperative bleeding, or overall major complication rates.
Assuntos
Eletrocoagulação , Pâncreas , Fístula Pancreática , Pancreaticoduodenectomia , Complicações Pós-Operatórias , Sistema de Registros , Humanos , Pancreaticoduodenectomia/efeitos adversos , Pancreaticoduodenectomia/métodos , Estudos Retrospectivos , Masculino , Feminino , Eletrocoagulação/efeitos adversos , Eletrocoagulação/instrumentação , Eletrocoagulação/métodos , Pessoa de Meia-Idade , Idoso , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Fístula Pancreática/etiologia , Fístula Pancreática/epidemiologia , Pâncreas/cirurgia , Hemorragia Pós-Operatória/etiologia , Hemorragia Pós-Operatória/epidemiologia , Neoplasias Pancreáticas/cirurgia , Instrumentos Cirúrgicos/efeitos adversosAssuntos
Apendicectomia , Drenagem , Hérnia Incisional , Laparoscopia , Humanos , Apendicectomia/métodos , Apendicite/cirurgia , Remoção de Dispositivo/métodos , Drenagem/métodos , Drenagem/instrumentação , Hérnia Incisional/etiologia , Hérnia Incisional/cirurgia , Laparoscopia/métodos , Instrumentos Cirúrgicos/efeitos adversosRESUMO
Introducción: La cirugía laparoscópica tiene como avance importante el abordaje monopuerto, que está en constante perfeccionamiento y donde influye para su éxito el dispositivo de acceso del que se disponga. Estos procederes de cirugía laparoscópica por un puerto único se realizan con el uso de dispositivos monopuerto, a través de un guante quirúrgico, por endoscopia flexible o por múltiples trócares en una incisión, pero la primera opción facilita el trabajo y disminuye complicaciones. Objetivo: Actualizar la información existente sobre dispositivos monopuerto para tenerla en consideración a la hora de realizar el proceder. Métodos: Se realizó una revisión bibliográfica sobre dispositivos monopuerto en la cirugía mínimamente invasiva desde marzo hasta abril del año 2020. Se revisaron artículos, libros especializados y citas bibliográficas de estudios elegidos de los cuales fueron seleccionados 25 para esta revisión. Desarrollo: Después de la revisión de 25 bibliografías citadas se detallaron las características de los principales dispositivos. Conclusiones: Existe una amplia gama de dispositivos monopuerto, cuya eficacia se evidencia en la bibliografía consultada, y que la revisión de este tema debe ser tomada en cuenta por los especialistas a la hora de realizar esta cirugía(AU)
Introduction: Laparoscopic surgery has as an important advance the single-port approach, which is in constant improvement and where the available access device influences its success. These procedures of laparoscopic surgery by a single port are performed with the use of single port devices, through a surgical glove, by flexible endoscopy or by multiple trocars in an incision, but the first option facilitates the work and reduces complications. Objective: Update the existing information on single-port devices to take it into consideration when carrying out the procedure. Methods: A bibliographic review on single port devices in minimally invasive surgery was carried out from March to April 2020. Articles, specialized books and bibliographic citations of selected studies were reviewed, of which 25 were selected for this review. Development: After reviewing 25 cited bibliographies, the characteristics of the main devices were detailed. Conclusions: There is a wide range of single-port devices, whose effectiveness is evidenced in the consulted bibliography, and that the review of this topic should be taken into account by specialists when performing this surgery(AU)
Assuntos
Humanos , Instrumentos Cirúrgicos/efeitos adversos , Laparoscopia/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Bibliografias como Assunto , Literatura de Revisão como AssuntoRESUMO
La artroscopía de rodilla es un procedimiento quirúrgico frecuente con baja incidencia de complicaciones. La rotura de instrumental y retención intraarticular del mismo son sumamente infrecuentes. Presentamos un caso de rotura por fatiga de una cánula de irrigación y retención intraarticular de parte de la misma en una paciente intervenida quirúrgicamente por una artroscopía de rodilla. En la bibliografía encontramos un solo caso similar. El fragmento presentaba bordes netos que impresionaban fatiga en zona de soldadura de fábrica. Es probable que la falla haya ocurrido durante una maniobra que se realiza "a ciegas" al final del procedimiento. Consideramos fundamental ser meticulosos en la supervisión del instrumental tanto antes como al final del procedimiento quirúrgico. En caso de encontrarnos con esta complicación, resolverla utilizando todas las herramientas al alcance. Nivel de evidencia: IV. Tipo de estudio: Reporte de caso
Assuntos
Artroscopia/efeitos adversos , Ruptura , Instrumentos Cirúrgicos/efeitos adversos , Complicações Intraoperatórias , Articulação do Joelho/cirurgiaRESUMO
No disponible
Assuntos
Humanos , Hérnia Incisional/epidemiologia , Laparoscopia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Instrumentos Cirúrgicos/efeitos adversos , Incidência , Hérnia Incisional/etiologia , Laparoscopia/instrumentação , Laparoscopia/métodos , Complicações Pós-Operatórias/etiologiaRESUMO
RESUMEN Se presentó un caso con complicación tardía de una colecistectomía video-laparoscópica, cuatro años después de una colecistectomía laparoscópica. Se procedió a realizar la colangiopancreatografia retrograda endoscópica mediante la técnica convencional, por un especialista en Gastroenterología. Se procedió a realizar pre-corte papilar y se logró extraer el clip con pinza de biopsia. Se produjo la expulsión espontánea de un litio oscuro de aproximadamente 1 cm de diámetro (AU).
ABSTRACT We presented a case with late complication of a video-laparoscopic cholecystectomy, occurring four years after a laparoscopic cholecystectomy. A specialist in Gastroenterology carried out an endoscopic retrograde cholangiopancreatography using the conventional technique. A papillary pre-cut was done and the clip was extracted with biopsy clamp. A dark stone of around 1 cm of diameter was spontaneously passed (AU).
Assuntos
Humanos , Feminino , Instrumentos Cirúrgicos/efeitos adversos , Colecistectomia Laparoscópica/efeitos adversos , Pacientes , Procedimentos Cirúrgicos Operatórios/reabilitação , Cálculos Biliares/complicações , Colangiopancreatografia Retrógrada Endoscópica/métodos , Corpos Estranhos/complicaçõesRESUMO
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Colecistectomia Laparoscópica/efeitos adversos , Ducto Colédoco/lesões , Instrumentos Cirúrgicos/efeitos adversos , Migração de Corpo Estranho/complicaçõesRESUMO
No disponible