The British journal of surgery
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Comment Letter Randomized Controlled Trial Clinical Trial
Rectus sheath bupivacaine analgesia after aortic surgery.
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Comparative Study
Local resection or pancreaticoduodenectomy for villous adenoma of the ampulla of Vater diagnosed before operation.
Treatment of ampullary adenoma is complicated by difficult preoperative staging, malignant potential and a high recurrence rate. This study was designed to assess the accuracy of diagnosis and staging by endoscopic biopsy and endosonography, and to compare the results of local resection and pancreaticoduodenectomy (Whipple procedure). ⋯ Diagnosis and staging of ampullary adenomas by endoscopic biopsy and endosonography was unreliable. Local resection seems a viable alternative for patients whose general condition does not allow a Whipple procedure.
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The aim of this study was to determine current UK practice with regard to thromboembolism prophylaxis during laparoscopic cholecystectomy. ⋯ The rate of thromboembolism after laparoscopic cholecystectomy is unknown but most surgeons believe the risk is very low. Surgeons' attitudes towards thromboembolism prophylaxis are variable, but most experienced surgeons use low-dose heparin.
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The results of laparoscopic cholecystectomy performed as an outpatient procedure were evaluated in a prospective study. ⋯ This high achievement of day-case treatment, even in patients with ASA grade III, is explained by a new anaesthetic regimen together with good surgical technique and close follow-up.
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Erythromycin has been shown to be a powerful prokinetic of the gastrointestinal tract. Little is known about its value to improve motility and transit in gastrectomized patients. ⋯ Oral erythromycin improves gastrointestinal transit and motility after subtotal gastrectomy. The findings after total gastrectomy are controversial.