Acetabular fractures and seat belts.
نویسنده
چکیده
the enthusiasm, or lack thereof, of surgeons in the community to perform Whipple resections in this disease. If the residing philosophy is one of conservation (as is my current approach), the tendency for “preoperative” stenting will be more enthusiastic than in a centre where the surgical approach to palliation in this disease is more the rule than the exception. Clearly, the surgical approach to these patients is also significantly coloured by the availability in the community of skilled interventionalists, both radiologic and endoscopic. In my centre we are blessed with a competent team of radiologists who are prepared to perform fine-needle aspiration biopsy followed by percutaneous placement of an expandable metal stent, which remains internally fixed and, in most cases, provides excellent palliation for these unfortunate patients. If this management strategy is not available to the average general surgeon (as I suspect it is not), a more surgical approach to the disease is obviously mandatory. Regardless of one’s philosophy, it is essential that we as general surgeons identify individuals within our ranks who have the interests and skills required to accept these patients in referral from those of us with less experience and enthusiasm for surgery in this disease. The “designated hitter” for carcinoma of the head of the pancreas is an absolute must in our current surgical environment. Dr. Taylor is to be congratulated on tackling a serious surgical subject with considerable objectivity, and his sections on the ideal surgical palliation, the issue of curability and the future prospects in this disease require careful reading by all general surgeons rendering opinions in patients with putative malignant disease in the pancreatic head It remains for each of us to develop a philosophy of management for carcinoma of the head of the pancreas that keeps morbidity at the lowest possible level, that takes account of issues relating to quality of life in these patients and that dedicates itself to the improvement of the techniques to prevent, evaluate and ultimately cure this highly lethal tumour.
منابع مشابه
Seating position, seat belt wearing, and the consequences in facial fractures in car occupants.
INTRODUCTION Trauma caused by traffic accidents is among the main etiologies involved in the occurrence of facial fractures throughout the world. However, the trauma mechanisms involved are different according to the location where the study was performed, due to different conditions of development, legislation, and culture. A retrospective study was done between February 2001 and July 2006, wi...
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Distraction fractures of the upper lumbar spine are most often associated with the wearing of seat-belts. Twenty patients with this spinal fracture were reviewed and half of them had intra-abdominal injuries. Eight patients required an exploratory laparotomy. Three distinct patterns of distraction fractures have been identified. Open reduction, local spinal fusion and Harrington instrumentation...
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عنوان ژورنال:
- Canadian journal of surgery. Journal canadien de chirurgie
دوره 39 4 شماره
صفحات -
تاریخ انتشار 1996