Evaluation of routine upper digestive tract endoscopy before laparoscopic cholecystectomy
✍ Scribed by L. Basso; A. Tocchi
- Publisher
- John Wiley and Sons
- Year
- 1993
- Tongue
- English
- Weight
- 140 KB
- Volume
- 80
- Category
- Article
- ISSN
- 0007-1323
No coin nor oath required. For personal study only.
✦ Synopsis
Sir
Some years have elapsed since we first questioned the dogma that the value of total parenteral nutrition for perioperative support was so logical as to make any clinical trial unethical'. I congratulate Messrs Moran and Jackson for their balanced Leading Article on this subject (Br J Surg 1993; 80: 4-5). I agree that parenteral nutrition can be life-saving in patients with intestinal failure. The statement that it may be helpful in those who are severely malnourished needs to be qualified. When malnutrition is secondary to advanced malignant disease, there is no evidence that perioperative support is beneficial. Indeed, in our own study2 it was clear that all patients with upper gastrointestinal malignancy whose serum albumin level at presentation was <30 g/l died within 1 year, had an operative mortality rate of 30 per cent and a major complication rate also 30 per cent.