No abstract

Background: Sentinel lymph node biopsy has become routine in the staging of patients with cutaneous melanoma and is presumed to have fewer complications than elective regional lymph node dissection (RLND). However, little information is available to refute or support this assumption. Hypothesis: Risk factors for complications following sentinel lymph node biopsy (SLNBX) can be identified. Design: Retrospective medical record review. Patients and Methods: The medical records of 339 consecutive patients undergoing SLNBX for melanoma between 1996 and 2003 at our institution were reviewed for complications. Results: In our series of 339 patients, 20 complications (5.9%) were observed following SLNBX compared with 15 (19.5%) of 77 patients undergoing RLND during the same period (PϽ.001). Seroma formation, transient nerve injuries, and minor wound infections were the most fre

The purpose of this study was to compare laparoscopic intracorporeal ultrasound (LICU) examination of the biliary duct system with cholangiography for delineation of duct anatomy and determination of presence or absence of ductal calculi. Thirty-one patients had LICU examination of the extrahepatic bile ducts after exposure of the gallbladder but prior to dissection of the cystic duct. After LICU examination, cystic duct dissection and cholangiography were done. Evaluation of duct anatomy and decision for duct exploration were based on findings of both tests. All patients had successful LICU examination and 30 had successful cholangiography. Duct size as determined by LICU corresponded precisely with cholangiography. LICU provided useful anatomical information in two patients with aberrant anatomy and detected cholangiogram. LICU aids in delineation of biliary duct anatomy and accurately determines presence or absence of duct calculi.

Proximal ligation usually controls bleeding from a tumor-eroded carotid artery. When this maneuver failed, two intraluminal balloon catheters were passed distally into the vessel, after which they were inflated and left in place for six weeks. The patient had no neurologic sequelae or further bleeding before succumbing to tumor progression 10 months later.