AIM:To compare the recurrence rate following initial antibiotic management to that following laparoscopic treatment for suspected uncomplicated cecal diverticulitis. METHODS: We examined the records of 132 patients wh...AIM:To compare the recurrence rate following initial antibiotic management to that following laparoscopic treatment for suspected uncomplicated cecal diverticulitis. METHODS: We examined the records of 132 patients who were diagnosed with uncomplicated cecal diverticulitis and a first attack during an 8-year period. The diagnosis of uncomplicated diverticulitis was made based on imaging findings, such as inflamed diverticulum or a phlegmon with cecal wall thickening. Concurrent appendiceal dilatation from 8 to 12 mm was observed in 36 patients (27%). One hundred and two patients were treated initially with antibiotics only, whereas 30 underwent laparoscopic treatment, including partial cecectomy (n=8) or appendectomy with diverticulectomy (n=9) or appendectomy alone (n =13). We compared clinical outcomes in both groups over a median follow-up period of 46 mo. RESULTS: All patients were successfully treated with initial therapy. Of the 102 patients who initially received only antibiotic treatment, 6 (6%) had a recurrence (3 in the cecum and 3 in the ascending colon or transverse colon) during the follow-up period. Five of these pa-tients were managed with repeated antibiotic treatmentand 1 underwent ileocolic resection for perforation. Of the 30 patients treated by the laparoscopic approach, 2 (7%) had a recurrence (ascending colon) which was treated with antibiotics. CONCLUSION: Initial antibiotic management for suspected uncomplicated cecal diverticulitis showed comparable effi cacy to laparoscopic treatment in the prevention of recurrence.展开更多
Gallbladder cancer is the most common malignant tumor of the biliary tract and often diagnosed incidentally during laparoscopic cholecystectomy for gallbladder disease. This underscores the importance of considering t...Gallbladder cancer is the most common malignant tumor of the biliary tract and often diagnosed incidentally during laparoscopic cholecystectomy for gallbladder disease. This underscores the importance of considering the diagnosis of gallbladder cancer when confronted with atypical findings and understanding cancer management guidelines that may impact patient outcome. Potentially curable early stage gallbladder lesions are often missed during preoperative workup and discovered incidentally during difficult cholecystectomy or afterwards on pathologic diagnosis. We will review current strategies to diagnose early stage disease and discuss clinical management issues to optimize the outcome of patients with gallbladder cancer.展开更多
文摘AIM:To compare the recurrence rate following initial antibiotic management to that following laparoscopic treatment for suspected uncomplicated cecal diverticulitis. METHODS: We examined the records of 132 patients who were diagnosed with uncomplicated cecal diverticulitis and a first attack during an 8-year period. The diagnosis of uncomplicated diverticulitis was made based on imaging findings, such as inflamed diverticulum or a phlegmon with cecal wall thickening. Concurrent appendiceal dilatation from 8 to 12 mm was observed in 36 patients (27%). One hundred and two patients were treated initially with antibiotics only, whereas 30 underwent laparoscopic treatment, including partial cecectomy (n=8) or appendectomy with diverticulectomy (n=9) or appendectomy alone (n =13). We compared clinical outcomes in both groups over a median follow-up period of 46 mo. RESULTS: All patients were successfully treated with initial therapy. Of the 102 patients who initially received only antibiotic treatment, 6 (6%) had a recurrence (3 in the cecum and 3 in the ascending colon or transverse colon) during the follow-up period. Five of these pa-tients were managed with repeated antibiotic treatmentand 1 underwent ileocolic resection for perforation. Of the 30 patients treated by the laparoscopic approach, 2 (7%) had a recurrence (ascending colon) which was treated with antibiotics. CONCLUSION: Initial antibiotic management for suspected uncomplicated cecal diverticulitis showed comparable effi cacy to laparoscopic treatment in the prevention of recurrence.
文摘Gallbladder cancer is the most common malignant tumor of the biliary tract and often diagnosed incidentally during laparoscopic cholecystectomy for gallbladder disease. This underscores the importance of considering the diagnosis of gallbladder cancer when confronted with atypical findings and understanding cancer management guidelines that may impact patient outcome. Potentially curable early stage gallbladder lesions are often missed during preoperative workup and discovered incidentally during difficult cholecystectomy or afterwards on pathologic diagnosis. We will review current strategies to diagnose early stage disease and discuss clinical management issues to optimize the outcome of patients with gallbladder cancer.
