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11.
ngela Rodríguez-Padilla Germn Morales-Martín Rocío Prez-Quintero Juan Gmez-Salgado Rafael Balongo-García Carlos Ruiz-Frutos 《Nutrients》2021,13(2)
Loop ileostomy closure after colorectal surgery is often associated with Postoperative ileus, with an incidence between 13–20%. The aim of this study is to evaluate the efficacy and safety of preoperative stimulation of the efferent loop with probiotics prior to ileostomy closure in patients operated on for colorectal carcinoma. For this, a prospective, randomized, double-blind, controlled study is designed. All patients who underwent surgery for colorectal carcinoma with loop ileostomy were included. Randomized and divided into two groups, 34 cases and 35 controls were included in the study. Postoperative ileus, the need for nasogastric tube insertion, the time required to begin tolerating a diet, restoration of bowel function, and duration of hospital stay were evaluated. The incidence of Postoperative ileus was similar in both groups, 9/34 patients stimulated with probiotics and 10/35 in the control group (CG) with a p = 0.192. The comparative analysis showed a direct relationship between Postoperative ileus after oncological surgery and Postoperative ileus after reconstruction surgery, independently of stimulation. Postoperative ileus after closure ileostomy is independent of stimulation of the ileostomy with probiotics through the efferent loop. There seem to be a relationship between Postoperative ileus after reconstruction and the previous existence of Postoperative ileus after colorectal cancer surgery. 相似文献
12.
为研究肝脂酶及脂蛋白脂酶在胆固醇结石成石过程中的变化及其对成石的影响,采用高胆固醇膳食诱发兔胆囊胆固醇结石模型,观测对照组及高胆固醇膳食1、2 、3、4周组动物血浆脂蛋白脂酶(LPL)、肝脂酶(HL)活性、血浆脂蛋白胆固醇及胆汁中甘氨胆酸(GCA)、甘氨脱氧胆酸(GDCA)、胆固醇的变化.结果显示:随着进食高胆固醇膳食时间的增加,血中LPL活性增高明显(P<0.05);HL活性也逐渐升高,3周组及4 周组与对照组差异显著(P<0.05);血中VLDL-C、LDL-C及胆汁中胆固醇也明显升高(P <0.05);而血中 HDL-C、HDL2-C及HDL3-C以及胆汁中GCA、GDCA无明显变化(P>0.05).结果表明:LPL及HL活性升高可能使肝脏摄取及向胆汁中排泌胆固醇增加,进而影响结石形成. 相似文献
13.
兔胆囊结石成石过程中脂代谢的变化及高密度脂蛋白制剂对其影响的研究 总被引:2,自引:0,他引:2
为研究高胆固醇膳食诱发兔胆囊胆固醇结石模型的脂代谢变化,以及高密度脂蛋白(HDL)对其脂代谢及成石的影响,将动物随机分为对照组、高胆固醇膳食组及高胆固醇膳食+HDL注射组,观察各组血浆脂质、胆汁中胆固醇、血卵磷脂胆固醇酰基转移酶(LCAT)活性及血和胆汁中胆汁酸及成石率的变化。结果显示:动物体内胆固醇等脂质的消除障碍导致体内脂质的大量堆积以及清除紊乱,是高胆固醇膳食诱发兔胆囊结石脂代谢变化的主要特点,胆汁中胆固醇与胆汁酸的清除比例失调可能导致成石性胆汁形成;尽管外源性HDL制剂能够升高血浆HDL2-C/HDL3-C的比值,增加LCAT的活性从而促使HDL成熟,并能降低肝脏的胆固醇含量,但未能降低成石率。结果表明外源性HDL制剂对兔胆囊结石形成中脂代谢有一定的影响,但抗成石作用不明显 相似文献
14.
为揭示胆囊结石病与遗传因素的关系,运用聚合酶链反应技术(PCR)和基因限制性片段长度多态性分析法(RFLPs)对104例胆囊结石患者和68例健康人进行了研究。结果显示:胆囊结石组B1等位基因频率52.3%,B1B1基因型频率28.8%,大于对照组B1等位基因频率34.6%(P<0.05),B1B1基因型频率11.76%(P<0.05),胆囊结石组B2等位基因频率47.7%,B2B2基因型频率24.2%小于对照组B2等位基因频率65.4%(P<0.05),B2B2基因型频率42.6%(P<0.05)。胆囊结石组H1等位基因频率20%,H1H1基因型频率5%,H2H2基因型频率65%,H2等位基因频率80%与对照组H1等位基因频率17.9%,H1H1基因型频率2%,H2H2基因型频率65.9%,H2等位基因频率82.1%比较无显著性差异(P>0.05)。提示:B1等位基因是胆囊结石患者主导基因。B2等位基因是对照组的主导基因。H1及H2等位基因频率在胆囊结石患者及对照组中分布相同,无显著性差异(P>0.05)。 相似文献
15.
Impaired glucose tolerance, diabetes mellitus, and gallstone disease: An extended study of male self-defense officials in Japan 总被引:2,自引:0,他引:2
Shizuka Sasazuki Suminori Kono Isao Todoroki Satoshi Honjo Yutaka Sakurai Kazuo Wakabayashi Masato Nishiwaki Hiroaki Hamada Hiroshi Nishikawa Hiroko Koga Shinsaku Ogawa Katsuya Nakagawa 《European journal of epidemiology》1999,15(3):245-251
Few studies have investigated the relation between glucose tolerance status and ultrasonographically determined gallstone disease. Using a 75-g oral glucose tolerance test, we examined the association of impaired glucose tolerance (IGT) and non-insulin-dependent diabetes mellitus (NIDDM) with gallstone disease in Japanese men. Subjects were men aged 48 to 59 of the Japan Self-Defense Forces who received a preretirement health examination between October 1986 to December 1994. After exclusion of 12 men under insulin treatment in the consecutive series of 7637 men, 174 were found to have gallstones; 103 were at the state of postcholecystectomy, and 6899 had normal gallbladder. IGT and NIDDM were associated with a modestly increased risk of gallstone disease; adjusted odds ratios were 1.3 (95% confidence interval [CI]: 0.9–1.8) for IGT and 1.3 (95% CI: 0.8–2.0) for NIDDM after adjustment for hospital, rank, smoking, alcohol use, and body mass index. Adjusted odds ratio for IGT and NIDDM combined was 1.3 (95% CI: 1.0–1.7, p=0.08). When prevalent gallstones and postcholecystectomy were considered separately, NIDDM showed a significant, positive association with postcholecystectomy, but not with prevalent gallstones. The findings add to evidence that glucose intolerance is associated with a modest increase in the risk of gallstone disease. 相似文献
16.
K. Gründel W. Schwenk B. Böhm J. M. Müller 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1996,381(3):160-164
Zusammenfassung In einer prospektiv randomisierten Studie wurden bei 100 Patienten mit elektiven konventionellen (n=66) oder laparoskopischen (n=34) kolorektalen Resektionen die präoperative Darmvorbereitung mit einer 2 1-Polyäthylenglykol(PEG)-haltigen Lösung plus Prepacol® (Gruppe A, n=50) und die mit einer 4 1-PEG-Lösung (Gruppe B, n=50) verglichen. Im Rahmen der Studie wurde auch der Einfluß der Art und Qualität der Darmvorbereitung auf die Dauer des postoperativen Ileus untersucht. Die Qualität der Darmvorbereitung wurde wührend der Resektion am eröffneten Darm mit einem 4-Punkte-Score durch den Chirurgen bestimmt. Das Zeitintervall vom Ende der Operation bis zum ersten postoperativen Windabgang und dem ersten Stuhlgang wurden dokumentiert. Die Qualität der Darmvorbereitung wurde in beiden Gruppen als gleich gut beurteilt (Gruppe A: 94%; Gruppe B: 84%; p=0,5). Das postoperative Intervall bis zum Abgang von Winden (A: 3,1 ± 1,2 Tage; B: 3,2 ± 13 Tage; p = 0,6) und zum ersten Stuhlgang (A: 3,9 ± 1,3 Tage; B: 4,1 ± 1,3 Tage; p=0,5) war in beiden Patientengruppen etwa gleich lang. Als einziger Faktor mit eigenständigem Einfluß auf die Dauer des postoperativen Ileus in der multivariaten Analyse (Alter, Geschlecht, Vorbereitung, Operationsdauer, Operation, Operationstechnik) wurde die Operationstechnik (laparoskopisch oder konventionell) identifiziert. Der erste Stuhlgang trat nach laparoskopischeu Resektionen bereits nach durchschnittlich 3,2±1,1 Tagen auf, nach konventionellen Operationen dagegen erst nach 4,3±1,2 Tagen (p=0,001). Die Art (41 PEG oder 21 FEG plus Prepacol®) und Qualität der Darmvorbereitung beeinflußten die Dauer der postoperativen Motilitätsstörung nicht.
Effect of bowel lavage with prepacol and polyethylene glycol on the duration of postoperative ileus following colorectal resection
In a prospective randomized study in 100 patients undergoing conventional (n=66) or laparoscopic (n=34) colorectal resection, mechanical lavage with 2 1 of a polyethylene glycol (PEG) solution (group A, n=50) combined with a laxative was compared with lavage with 4 1 of PEG alone (group B, n=50). The influence of bowel preparation on postoperative Hens was investigated. The efficacy of bowel preparation was determined intraoperatively by a surgeon blind to the type of preparation. The time interval between the end of the operation an first flatus or bowel movement was recorded. The efficacy of preparation was no different between the groups (group A: 94%, group B: 84%; P=0.5). The time lapse before first flatus (A: 3.1 ± 1.2 days, B: 3.2 ± 1.3 days; P = 0.6) or bowel movement (A: 3.9 ± 1.3 days, B: 4.1 ± 1.3 days; P = 0.5) also did not differ between the groups. The only factor found in multivariate analysis (age, sex, operation, duration and type of surgery, bowel preparation) to prolong the duration of postoperative ileus was the type of surgery. The first bowel movement occurred 3.2 ± 1.1 days after conventional surgery and 4.3±1.2 days (P<0.001) after laparoscopic surgery. The type of preoperative bowel preparation had no influence on the duration of postoperative Hens. The postoperative interval before the first bowel movement was shorter after laparoscopic surgery.相似文献
17.
目的探讨胆结石并发冠心病患者的临床特点。方法对103例经冠状动脉造影检查者,并按B超检查是否有胆结石或是否有胆结石手术者分为三组A组35例无胆结石,且造影正常;B组25例有胆结石,而造影正常;C组43例有胆结石,且造影异常。分析各组的临床特点。结果胆结石并发冠心病组年龄大,直接胆红素低,吸烟多,有高血压病者多,血脂有增高趋势。结论与单纯胆结石患者相比,胆结石并发冠心病患者的危险因素更多。 相似文献
18.
Raissaki M Hatzidakis AA Prassopoulos P Bakandaki A Vrachassotakis N Vasilakis SJ Gourtsoyiannis NC 《European radiology》2000,10(8):1284-1286
A case of recurrent abdominal wall abscess following percutaneous cholecystostomy (PC) is presented. Transperitoneal PC was
performed in an 82-year-old female with calculous cholecystitis. Symptoms resolved and the catheter was removed 29 days later.
The patient came back 5 months later with a superficial abscess that was drained and 8 months post PC with a fistula discharging
clear fluid. Ultrasonography revealed the tract adjacent to an area of inflammation containing a calculus, whereas CT failed
to depict the stone. Subsequent surgery confirmed US findings. To our knowledge, this is the first report of a dislodged bile
stone following percutaneous cholecystostomy.
Received: 27 August 1999; Revised: 7 December 1999; Accepted: 9 December 1999 相似文献
19.
20.
Arif Zafar Gemma Ingham Jainudeen K.A. Jameel 《International journal of surgery case reports》2013,4(5):528-530
INTRODUCTIONBouveret's syndrome is a rare variant of gallstone ileus and describes gastric outlet obstruction secondary to an impacted stone in the duodenum. Its presentation is vague and clinical diagnosis is often difficult resulting in a delay in diagnosis.PRESENTATION OF CASEWe report a patient who presented initially with non-specific symptoms and subsequently with features in keeping with acute pancreatitis, but eventually was found to have Bouveret's syndrome.DISCUSSIONDifferent treatment strategies are discussed. Although endoscopic treatment combined with many newer modalities like lithotripsy have been tried, surgery remains the definitive management in the vast majority of cases.CONCLUSIONBouveret's syndrome is a rare condition, can also present as pancreatitis and often difficult to diagnose initially, but with appropriate treatment has a good outcome. 相似文献