[ECG Holter monitoring during endoscopic examination]. / Monitorowanie zapisu EKG systemem Holtera w czasie badan endoskopowych.

The aim of the study was an evaluation of ECG changes during endoscopy. In 57 hospitalized patients (34 female, 18 male, mean age 54) who had gastroscopy (n = 23), endoscopic retro-cholangiopancreatography (ERCP) (n = 17) or colonoscopy (n = 17) two hours before and two hours after the examination, an ECG monitoring by Holter method was done. The patients also filled a questionnaire to measure their level of anxiety. Arrhythmias and ST depression/elevation were seen in 37 (65%) patients during endoscopy. In 12% complex arrhythmias (III, IV A and IV B type Lown) were recorded. Complex arrhythmias and/or horizontal ST depression greater than 1 mm were observed more frequently (p less than 0.01) in the group of patients with clinically evident diseases of the cardiovascular system; this group was older than the group without cardiac symptoms. There was no correlation between ECG changes and the level of anxiety before the examination. During ERCP ECG changes were more complex than during colonoscopy (p less than 0.01) or gastroscopy (p less than 0.05).

Evaluation of the laparoscopic cholecystectomy on patients with simple and complicated cholecystolithiasis.

Laparoscopic cholecystectomy is now a well described method for the treatment of cholelithiasis. The purpose of this paper is to define its implementation, limits, risks and indications. Following a prospective method, the results of this treatment were compared in 187 patients with simple cholelithiasis and 75 patients with complicated cholelithiasis. Cholecystectomy was performed with a straight optic introduced through the paraumbilical region, and coupled with video camera. Two, 3, or 4 other trocars were inserted and placed as required by anatomic conditions. In the group with simple cholelithiasis, laparoscopic cholecystectomy was performed in 99% of the patients while in the group with complicated cholelithiasis the procedure was achieved in 75% of the patients. Immediate laparotomy was done in 1% and 25% of cases respectively in both groups. No interventional mortality occurred. Postoperative complications have been acceptable (1.6% and 2.7%), with no late complications reported. Our study shows that laparoscopic cholecystectomy is feasible in the majority of cases of complicated cholelithiasis and that the main advantages of this method were retained.