RESUMEN
To confirm the importance of preoperative evaluation of a patient's health state, to reduce perioperative morbidity and mortality after laparoscopic surgery. A total number of 1,070 patients were selected into groups based on a type of intervention, gender, ASA and NYHA classification. The most common laparoscopic procedure that was performed was cholecystectomy in 920 (86%) patients. Cardiovascular disease had been presented in 952 (89%) patients, 1006 (94 %) of patients were ASA class I- III, while 1049 (98%) patients were NYHA class I and II. Frequency of lethal outcome was 0.1% due to postoperative thromboembolic complications. A lower mortality rate is a result of prescribed protocol and adequate preoperative examination.
Asunto(s)
Colecistectomía Laparoscópica/estadística & datos numéricos , Cuidados Preoperatorios , Colecistectomía Laparoscópica/mortalidad , Femenino , Humanos , Laparoscopía/estadística & datos numéricos , Masculino , Cuidados Preoperatorios/métodos , Factores de Riesgo , Serbia/epidemiología , Tasa de SupervivenciaRESUMEN
Blunt trauma of the thoracic aorta is the second leading cause of death in traffic accidents, after head injuries. A polytraumatized patient, aged 40, was admitted, with trauma of the thoracic aortic isthmus, after a traffic accident. Adequate resuscitation and intensive therapy, angiographic and MSCT diagnostics enabled the urgent surgical treatment. On the sixty-seventh day of surgery, the patient was successfully transferred to a regional health center in good general condition. Blunt aortic injury occurs in 1% of casualties in traffic and causes 16% mortality. More than 80% of patients die before arrival to hospital. In conclusion, we point out with satisfaction the successful surgical treatment and survival of injured patients admitted to our hospital.
Asunto(s)
Accidentes de Tránsito , Aorta Torácica/lesiones , Aorta Torácica/cirugía , Traumatismo Múltiple/etiología , Traumatismo Múltiple/cirugía , Heridas no Penetrantes/etiología , Heridas no Penetrantes/cirugía , Adulto , Aorta Torácica/patología , Tratamiento de Urgencia , Humanos , Masculino , Traumatismo Múltiple/diagnóstico , Resultado del Tratamiento , Procedimientos Quirúrgicos Vasculares/métodos , Heridas no Penetrantes/diagnósticoRESUMEN
A 68-year old patient, who had had cholecistectomy when he was 30 years old and had been hospitalized in several occasions, with clinical presentation of recidivant cholangitis was admitted to county hospital. Computed tomography was performed, where a bile duct dilatation was noted, with suspected 12 mm concrement. After that the patient was referred to the hospital in order to undergo therapeutic endoscopic retrograde cholangiopancreatography. After performing the procedure, the presence of the concrement, 12x25mm in size was confirmed. It was evacuated during mechanical lithotripsy along with a part of surgical thread, which could not have been extracted entirely. A surgery had to be performed because the patient developed cholestasis. Forming of choledocholith most likely developed on the matrix of surgical thread, which is a rare cause of choledocholithiasis.