摘要:

AbstractFifty‐two consecutive unselected duodenal ulcer patients (Group 1), who had failed to respond to cimetidine and who subsequently underwent elective vagotomy and drainage, were studied. All patients were symptomatic on cimetidine in full recommended dosage. This group has been compared with another group of 634 duodenal ulcer patients (Group 2) undergoing elective vagotomy and drainage in the ‘pre‐cimetidine era’. The groups were similar pre‐operatively with regard to age, sex, length of history and maximal acid output. Completeness of vagotomy and amount of acid reduction were similar in the two groups. The incidence of recurrent ulceration was 5 per cent in Group 1 and 5.7 per cent in Group 2. Although, of necessity, follow‐up is shorter in the cimetidine failures (mean 2.3 years), there is nothing to suggest that failure to respond to cimetidine precludes a satisfactory surg

ISSN:0007-1323    

DOI:10.1002/bjs.1800710122

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractEndoscopic sphincterotomy (ES) is widely used in the treatment of patients with common bile duct (CBD) stones following cholecystectomy. The technique has now been extended to patients with gallbladders still present and the results of ES in 100 such patients is reported. Fifty‐nine were considered unsuitable for surgery (Group A), in 38 ES was performed as a preliminary to cholecystectomy (Group B) and in 3 ES was performed following emergency cholecystostomy (Group C). ES was achieved in 98 patients and stones completely extracted in 91 patients. In Group A 5 patients required surgery, in 3 because of technical failure and in 2 because of empyema of the gallbladder. One patient who presented in extremis died following failure to extract a large CBD stone. On follow‐up (4‐50 months), 16 patients have died but in only one from gallbladder sepsis, and one has had a cholecystectomy for pain. In Group B choledochotomy was avoided in 29 of the 37 patients who agreed to cholecystectomy. In Group C no further surgery was required and all patients in Groups B and C remain well. These results indicate that ES is an effective technique for treating patients with CBD stones with the gallbladder in situ, either alone in patients considered unsuitable for surgery or as an adjunct to su

ISSN:0007-1323    

DOI:10.1002/bjs.1800710123

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractIntrahepatic bile duct papillomatosis associated with changes of nuclear atypia is described in a young man. Radical excision was performed by left hepatic lobectomy and removal of the common bile duct and left hepatic ducts. Fourteen previous cases of intrahepatic or diffuse intrahepatic and extrahepatic biliary papillomatosis are reviewed. While local recurrence and progression to death from obstructive jaundice and cholangitis is the rule, only two definite cases of malignant change have been reported. Radical surgery may be curative for this rare condition.

ISSN:0007-1323    

DOI:10.1002/bjs.1800710124

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractHyperinsulinaemic hypoglycaemia in infancy may be transient or persistent. Persistent hypoglycaemia is caused by nesidioblastosis of the pancreas, a diffuse pancreatic endocrine abnormality involving all the endocrine tissue, or by an islet cell adenoma. The cause of nesidioblastosis is not known but unless controlled its hypoglycaemic effects lead to convulsions, mental retardation or death. Patients with transient hyper‐insulinaemic hypoglycaemia, and some with persistent hypoglycaemia, respond to medical therapy but those with an adenoma and many of those with nesidioblastosis will require partial or total pancreatectomy. The surgical treatment of six infants and a child is discussed. Five infants had nesidioblastosis; one infant and one nine‐year‐old girl had an islet cell adenoma. It is suggested that in the very young when there is no evidence of an insulinoma, resection at the initial operation should be greater — up to 90 per cent — than the previously recommended 75

ISSN:0007-1323    

DOI:10.1002/bjs.1800710125

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710126

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710130

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710131

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710136

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710101

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY