15 Jul

Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: METHODS (Part 2)

A grasper introduced via the working ports retracted the stomach downwards to expose the angle of His at the gastroesophageal junction. Minimal dissection was done at the angle of His to open the peritoneum and identify the left crus and then the right crus through the lesser omentum. All dissection was done without division of tissue and hence there was little chance of endangering the vagi. A reticulated grasper was inserted between the crura and the esophagus and the adjustable gastric band was attached to it so as to place it in the pars flacida position. The band was secured by multiple sutures.

All patients had an initial gallbladder ultrasound within one month of their surgical procedure. Subsequent studies were preformed at six weeks and at six months following surgery, respectively. No major complications followed the surgery. All patients commenced oral intake on the first postoperative day and were discharged within three to seven days.

Study protocol

Gallbladder volumes were measured after an overnight fast. Cholecystokinin-octapeptide (CCK-8) (KinevacTM, Bracco Diagnostics/Diagnostiques Canada Inc, Mississauga, Ontario) was then infused intravenously at 20ng/kg/h over 45 min to induce gallbladder emptying. Gallbladder volumes were measured at three intervals: before initiating the infusion (ie, after an overnight fast) and then at 15 min intervals; during the CCK-8 infusion (conditions that stimulate gallbladder emptying); and for a further 45 min after stopping the CCK (conditions when gallbladder refilling commences). The duration of the last two measures, therefore, was 90 min. You will always be able to buy the required amount of medicine you need at this wonderful and fully licensed pharmacy that can take good care of you, no matter if you need generic viagra professional online at large amounts or just a bit of it to finish your treatment.

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