Laparoscopic anatomical right hepatectomy using a four-incision anterior approach: Technical details and surgical outcomes (with Video).

With the continuous advancements of laparoscopic techniques, many surgeons have enhanced the feasibility and safety of this approach for carefully selected patients. This study aims to offer a comprehensive account of the technical aspects and surgical outcomes associated with laparoscopic anatomical right hepatectomy, explicitly utilizing a four-incision anterior approach. The surgical procedure involved several maneuvers, including blocking the Glissonean pedicle, ligation of the right hepatic artery, right branch of the portal vein, and the right hepatic duct, removal of the liver parenchyma along the ischemic line, and determination of the liver section based on four anatomical landmarks: the right anterior Glissonian pedicle, middle hepatic vein, root of the right hepatic vein, and retrohepatic inferior vena cava. The article provides clear visualization of these anatomical landmarks following right hepatectomy. Proper patient positioning and precise incision placement are crucial factors for ensuring the success of the laparoscopic right anterior hepatectomy procedure. The separation of the extrahepatic Glissonean pedicle at the liver hilum to determine the hepatic resection ischemia line, as well as the identification of liver sections using four anatomical landmarks are essential steps in the liver resection process. The laparoscopic anatomical right hepatectomy using a four-incision anterior approach was performed smoothly, with standard intraoperative techniques completed. Measures are in place to address any complications that may arise during the surgery.

Caracterización de la corioamnionitis en pacientes atendidas en el Hospital Susana López de Valencia (Popayán, Colombia) entre junio de 2013 y junio de 2014 / Chorioamnionitis characterization in patients treated in Hospital Susana Lopez de Valencia (Popayan, Colombia) between june 2013 and june 2014

Introducción: la corioamnionitis es la infección de las membranas del saco amniótico, el corion y el amnios. Objetivo: caracterizar clínicamente a las pacientes con diagnóstico de corioamnionitis atendidas en el Hospital Susana López de Valencia, en la ciudad de Popayán (Colombia), entre junio de 2013 y junio de 2014. Metodología: se realizó un estudio descriptivo de corte transversal basado en los registros de las historias clínicas de la institución cuyo diagnóstico fue corioamnionitis durante el periodo de estudio establecido. Resultados: se incluyeron 268 pacientes con edades promedio entre 19 y 34 años. El cuadro clínico más frecuente asociado a corioamnionitis fue la ruptura prematura de membranas (35,82%). Las pacientes fueron diagnosticadas clínicamente en su mayoría (77,24%) en el periodo posparto (hasta los primeros tres días después del parto), al presentar leucocitosis mayor que 15.000/µL (47,83%) y cavidad hipertérmica (40,58%). Finalmente, se realizó un cruce de variables para establecer cuál síntoma se había presentado conjuntamente con la fiebre de acuerdo a lo establecido en los criterios de Gibbs, en el que se demostró que durante el anteparto y el posparto la leucocitosis (68,18% y 76%, respectivamente) y la taquicardia materna (73% y 76%, respectivamente) fueron los dos síntomas más prevalentes. Conclusiones: la prevalencia indirecta de corioamnionitis en la muestra seleccionada fue del 8,05%. El principal factor de riesgo para esta enfermedad lo constituyó la ruptura prematura de membranas ovulares y su diagnóstico se hizo principalmente en el periodo posparto con la ayuda de los criterios de Gibbs. (AU)

Introduction: Chorioamnionitis is the infection of the membranes of the amniotic sac, chorion and amnion. Objetive: To characterize clinally the patients diagnosed with chorioamnionitis who were treated at the hospital Susana López de Valencia in the city of Popayan (Colombia) during June 2013 and June 2014 Methodology: A cross-sectional descriptive study was performed based on records of institutional clinical records with has diagnosis of chorioamnionitis during the established study period. Results: A total of 268 patients were included with an average age between 19 and 34 years old. The most frequent clinical syntomatology associated with chorioamnionitis was premature rupture of membranes (35.82%). Most patients (77.24%) were clinical diagnosed at the postpartum period (up to the first three days postpartum) presenting leukocytosis greater than 15,000/µL (47.83%) and hyperthermic cavity (40.58%). Finally, to establish which symptoms had been presented in conjunction with fever according with Gibbs criteria a cross-variable was performed, which stablishes that during antepartum and postpartum the leukocytosis (68.18% and 76%, respectively) and maternal tachycardia (73% and 76%, respectively) were the most two prevalent symptoms. Conclusions: The indirect prevalence of chorioamnionitis in the study sample was 8.05%. The main risk factor for this disease was the premature rupture of ovary membranes and their diagnosis was made mainly in the postpartum period with the help of Gibbs criteria. (AU)

[Inflammation mediators (C reactive protein) in children with proteic-energetic malnutrition and in eutrophic children]. / Mediadores de inflamación (proteína C reactiva) en el niño con desnutrición proteico-energética y en el niño eutrófico.

A multicentrical clinical study was designed with the purpose of measuring C-reactive protein (CRP) in normal and malnourished children, with and without infection. Blood samples were collected without anticoagulant from 109 venezuelan children, between the ages of 6 months and 6 years. The statistical analysis was carried out using the t Student and ANOVA. The values of CRP were higher (80.80 +/- 38.39 mg/L) in severe malnourished infected than non-infected malnourished children (8.17 +/- 3.06 mg/L, p < 0.001). There were statistical differences between severe malnourished infected and eutrophic infected children (p < 0.001). There was also a difference between the non infected, severely malnourished children and the rest of them, although they kept their values within a normal range. These findings indicate that the malnourished child is able to produce CRP in response to infection but in a different way that the eutrophic child. In children without infection, the CRP levels were kept within the normal range.