Surgery

Advances in Abdominal Surgery 2002 by Giovanna Branca, Teresa Spanu, Fiammetta Leone, Patrizia

By Giovanna Branca, Teresa Spanu, Fiammetta Leone, Patrizia Mazzella, Giovanni Fadda (auth.), Attilio Maria Farinon (eds.)

Advances in belly surgical procedure 2002 comprises papers from a bunch of Italian educational surgeons who give a contribution to a countrywide study software entitled `Progress in belly Surgery'. The learn is supported via the Italian Ministry of the college. the first aim of the gang is to mix experimental and scientific methods within the learn of numerous surgical stomach ailments. The authors of the person chapters have been asked to give an replace of their personal fields of analysis. This quantity summarizes a number of vital updates in stomach surgical procedure and pathophysiology. The contributions are grouped into six sections, particularly Surgical an infection, Hepatobiliary and Pancreatic and Splenic surgical procedure, Colorectal surgical procedure, Fecal Incontinence, Minimally-Invasive surgical procedure, and Transplantation.

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Tyden G, Malmborg AS. Penetration of antibiotics into pancreatic juice. Lancet 1985; 1046. 61. McClelland P, Murray A, Yaqoob M, Van Saene HKF, Bone JM, Mostafa SM. Prevention of bacterial infection and sepsis in acute severe pancreatitis. Ann R Coli Surg Eng/1992; 74: 329-34. 62. Durr GHK. Enteral and parenteral nutrition in acute pancreatitis. In: Beger HG, BUchler M. Acute pancreatitis. Berlin- Heidelberg: Springer-Verlag, 1987: 285-8. 63. Latifi R, Mcintosh JK, Dudrick SJ. Nutritional management of acute and chronic pancreatitis.

CT-guided drainage should never be considered as a first procedure, and should instead be applied in adequately selected cases: in critical patients at very high surgical risk, and in previously operated patients with recurrent abscesses, for whom revision surgery is more risky due to the presence of firm adhesions and local degeneration. It should be undoubtedly used whenever ultrasound and CT examinations show a liquid collection of pus, since a mixture of necrotic tissue and pus may not be effectively removed by means of a thin CT-guided drainage tube (generally 14-20 F) [89-90].

SURGICAL TREATMENT The distinction between IN and PA is important not only in terms of prognosis, since IN mortality rate is twice that ofPA, but also because surgical treatment may differ considerably in the two conditions [1-4, 11]. In PA, treatment is based on early and effective surgical drainage of the collection of pus [3-4, 70-71] and, as an alternative, on radiologically guided percutaneous drainage in selected cases [72, 73]. In expert hands, both surgical and radiologically guided drainage are easily performed, and are not controversial.

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