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Introduction: The rational use of resources and the need to standardize procedures are today’s priorities for the sustainability of health care, and a drive force to raise surgical results. The aims of this study are to evaluate the adoption of a low cost laparoscopic cholecystectomy protocol, identify predictive factors for difficult cases, and evaluate the economical impact of this strategy. Material an...
Damage control surgery is one of the major advances in surgical technique in the past 20 years. The concept has developed in the trauma surgery context. It consists on the management of unstable patients in a fast, efficient and provisional way. The objective is an haemorrhage control, limiting contamination, and temporary closure of the abdomen. The defi- nitive repair is performed after patient stabilization....
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The number and severity of bile duct injuries has increased since the introduction of laparoscopic cholecystectomy. This study determines their incidence, clinical presentation and management in the setting of Portuguese public hospitals, by means of a national inquiry promoted by the HPB chapter of the Portuguese Surgical Society. A 37% response rate was obtained from 29 hospitals having performed collectively...
The introduction of laparoscopy in the treatment of gallstones in the late eighties, early nineties in Portugal, raised new challenges in training of surgeons, mainly in treatment of patients with bile duct stones, where it’s an advanced procedure, but also in it’s evaluation. Limitations on training and technical availability, have made endoscopy take advantage to increased costs and further patient complicati...
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First described in 1962, Gangliocytic Paraganglioma (GP) is a rare tumor that has been increasingly reported in the lite- rature since then. It almost occurs in the second part of the duodenum, often at the Ampulla of Vater and the most common presenting sympton is, gastrointestinal bleeding. Its characteristic histologic appearance consists of a mixture of three types in varying proportion: epithelioid, spindl...