Strasberg proposed classifying subtotal cholecystectomy techniques into fenestrating (fSC) and reconstituting (rSC) subtypes. The aim of this study is to compare our outcomes of laparoscopic subtotal ...cholecystectomies of both subtypes against laparoscopic total cholecystectomy (TC) in difficult emergency laparoscopic cholecystectomies.
Patients undergoing emergency laparoscopic cholecystectomy were identified over 2 years and all Nassar scale 3 and 4 cholecystectomies were included for analysis.
108 fSC and 24 rSC were compared against 317 TC. Patients undergoing fSC and rSC were older and more likely to be male. fSC (128 min) and rSC (141 min) recorded longer median operative times than TC (109). Post-operative ERCP was more common after rSC (16.7%). Patients undergoing fSC (2 days) and rSC (3.5 days) had longer post-operative stays. Bile leaks were more likely in fSC (9.3%) and rSC (8.3%) compared to TC (1.9%), Long term morbidity was higher in the rSC group (12.5% vs 10%). And these were solely due to gallbladder remnant complications.
Laparoscopic fSC and rSC techniques are associated with a higher rate of bile leaks and rSC has more long term morbidty as compared to TC.
Introduction. Metal-on-metal (MoM) hip resurfacings have been associated with a variety of complications resulting from adverse reaction to metal debris. Pseudotumors have rarely been reported to ...cause deep venous thrombosis (DVT). Study Design. A case report and a review of the literature. Case Presentation. A 75-year-old female who had left metal-on-metal hip resurfacing 6 years ago presented with left groin pain associated with unilateral lower limb edema and swelling. By duplex and MRI studies, our patient had an extensive soft tissue necrosis associated with a large pelvic mass causing extensive DVT of the lower limb secondary to mechanical compression of the left iliac vein. Results. Our case was initially treated for DVT followed by dual surgical approach. The pseudotumor was excised through a separate iliofemoral approach and revision of the hip implant was undertaken through a posterior approach in the same setting. An inferior vena cava (IVC) filter was inserted to minimise the perioperative risks of handling the iliac veins. Conclusion. A combined approach with vascular surgeons is required. Combined resection of the pseudotumor and revision of the metal bearing surfaces is essential, in order to achieve a good surgical outcome in this rare complication.
An Object Grammar is a variation on traditional BNF grammars, where the notation is extended to support declarative bidirectional mappings between text and object graphs. The two directions for ...interpreting Object Grammars are parsing and formatting. Parsing transforms text into an object graph by recognizing syntactic features and creating the corresponding object structure. In the reverse direction, formatting recognizes object graph features and generates an appropriate textual presentation. The key to Object Grammars is the expressive power of the mapping, which decouples the syntactic structure from the graph structure. To handle graphs, Object Grammars support declarative annotations for resolving textual names that refer to arbitrary objects in the graph structure. Predicates on the semantic structure provide additional control over the mapping. Furthermore, Object Grammars are compositional so that languages may be defined in a modular fashion. We have implemented our approach to Object Grammars as one of the foundations of the Ensō system and illustrate the utility of our approach by showing how it enables definition and composition of domain-specific languages (DSLs).
•We introduce Object Grammars to parse textual syntax into object graphs.•Cross references in the object structure are resolved using declarative paths.•Complex mappings can be further controlled using predicates.•We show that Object Grammars are both compositional and bidirectional.•The entire system is self-describing and bootstrapped within itself.
Language workbenches are environments for simplifying the creation and use of computer languages. The annual Language Workbench Challenge (LWC) was launched in 2011 to allow the many academic and ...industrial researchers in this area an opportunity to quantitatively and qualitatively compare their approaches. We first describe all four LWCs to date, before focussing on the approaches used, and results generated, during the third LWC. We give various empirical data for ten approaches from the third LWC. We present a generic feature model within which the approaches can be understood and contrasted. Finally, based on our experiences of the existing LWCs, we propose a number of benchmark problems for future LWCs.
Microsurgery training – A home diy model Tiong, Vincent; Loh, Alex; Loh, Meiling ...
International journal of surgery,
November 2014, Letnik:
12
Journal Article
Pinnaplasty – A porcine training model Tiong, Vincent; Loh, Alex; Loh, Meiling ...
International journal of surgery,
November 2014, Letnik:
12
Journal Article
A novel method for repairing the dog ear Loh, Charles Yuen Yung; Loh, Alex Yuen Hua; Mashhadi, Syed Abuzar
Journal of plastic, reconstructive & aesthetic surgery,
11/2013, Letnik:
66, Številka:
11
Journal Article
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