摘要:

AbstractWe have been able to place prosthetic tubes in the bile duct at duodenoscopy in 17 of 23 patients with malignant obstructive jaundice. Initial problems with sepsis and tube migration appear to have been overcome by using tubes with double pigtails, and by inserting two tubes simultaneously. Effective palliation of jaundice has been achieved in 10 of the last 12 patients. The technique has potential advantages over the percutaneous transhepatic route, and is now ready for wider evaluation.

ISSN:0007-1323    

DOI:10.1002/bjs.1800690902

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractThirty‐one patients who had been admitted with acute pancreatitis underwent endoscopic retrograde cholangiopancreatography (ERCP) following initial investigation by cholecystogram or intravenous cholangiogram and by biochemical screening. Previously undiagnosed gallstones were demonstrated at ERCP in 4 patients, and in 2 others known gallstones were effectively treated by endoscopic sphincterotomy. Changes of chronic pancreatitis were found in 8 pancreatograms and no patient in whom a normal pancreatic duct was demonstrated has suffered a further recurrence of acute pancreatitis. ERCP was valuable in the management of patients with acute pancreatitis, both in the diagnosis and management of biliary disease and in the recognition of underlying chronic pancreatiti

ISSN:0007-1323    

DOI:10.1002/bjs.1800690903

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractThis study examines the value of endoscopic pancreatography in chronic pancreatitis. With the cooperation of nine departments in Italy, the authors examined the pancreatograms of 1179 patients with chronic pancreatitis. The pancreatograms were abnormal in 80·6 per cent. There were difficulties in distinguishing between cancer and pancreatitis in 11·3 per cent, and difficulty in deciding whether the radiographs were normal or slightly abnormal in 6·8 per cent. The ability of pancreatography to diagnose chronic pancreatitis increased with the duration of the disease, reaching 92·3 per cent in those patients who had had chronic pancreatitis for 5 or more years. However, the failure to obtain a pancreatogram increased as calcification increased. A good correlation between abnormalities of the pancreatogram and of the pancreatic function tests was demonstra

ISSN:0007-1323    

DOI:10.1002/bjs.1800690904

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractSeventy‐one patients with peritonitis due to perforation of the appendix were treated by preoperative rectal metronidazole, appendicectomy and omission of skin closure. They were then randomized to have either no further antibacterial treatment, or rectal metronidazole twice‐daily for 5 days. No major wound infections occurred, but 8 patients developed intraperitoneal abscesses. In addition, I died of a pulmonary embolus and 1 required further laparotomy for intestinal obstruction.Patients in the 5‐day‐metronidazole group suffered fewer intraperitoneal abscesses and less pyrexia, but the differences did not achieve statistical significance. This series shows a considerable improvement over a previously published series in terms of morbidity, duration of pyrexia and length of hospit

ISSN:0007-1323    

DOI:10.1002/bjs.1800690905

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractIn a multicentre study, 824 patients with operable rectal cancer were randomized to receive surgery alone, surgery plus a single fraction of 500 rad (5 Gy) and surgery plus 2000 rad (20 Gy) in 10 equal daily, i.e. multiple, fractions. The ratio of abdominoperineal excision to anterior restorative operations was 3:1. There was no evidence of an increased morbidity or mortality following irradiation. The multiple fraction 2000 rad group had tumours which were significantly smaller than those of the other groups. There was also a reduction in the Dukes' C cases in the multiple fraction group. Neither the tumour size nor the lymph node status was altered in the single fraction group.

ISSN:0007-1323    

DOI:10.1002/bjs.1800690906

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractVagal denervation of the stomach and, in most cases, intermittent dilatation for a limited time after the operation have been employed in the treatment of 14 patients with fibrous stricture and shortening of the oesophagus due to chronic gastro‐oesophageal reflux. In 2 patients the stricture was widened by means of a gastric patch at the same operation.The results have been quite encouraging, all patients being able to swallow solid food, most of them normally, and the improvement appears to be permanent. The change in the quality of the refluxed fluid brought about by gastric denervation seems to play a leading role in improving local oesophageal conditions and rendering the stricture amenable to dilatation by bougies or by ingested solid foo

ISSN:0007-1323    

DOI:10.1002/bjs.1800690907

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractTwo patients with linear ulcers of the greater curvature of the stomach are reported. These patients formed part of a series of 18 patients with mucosal pyloric stenosis seen between 1963 and 1981. The mechanisms that may be important in the pathogenesis of these unusual ulcers are discussed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800690908

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractThe fate of 22 adolescents (mean age 14 years) with proved peptic ulceration is reported. Five presened as an emergency with performation of haemorrhage, whilst the remining 17 had typical ulcer dyspepsia. Despite intensive medical measures 17 patients required difinitive surgery. Ten patients were under 18 years of age at the time of operation and all were opearted on at under 25 years of age. the results were excellent in 14 out of 17 patients at 5‐year followup, suggesting that surgery should not be withheld on the grounds of age alone. The role of histamine H2receptor antagonists needs to be assessed in this type of patien

ISSN:0007-1323    

DOI:10.1002/bjs.1800690909

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractEight patients with intractable dumping symptoms following truncal vagotomy and Heineke–Mikulicz pyloroplasty for duodenal ulcer had the pyloroplasty reversed. These patients were assessed, both clinically and by a dumping provocation test, before operation, within 3 months of reversal of the pyloroplasty, and again at 1 year postoperatively. Six of them had no symptoms during the year and results of their dumping provocation tests have reverted to normal. Five have been followed up for a further year and in all the clinical improvement is maintained. Two patients developed recurrent dumping symptoms within 6 months of the reversal procedur

ISSN:0007-1323    

DOI:10.1002/bjs.1800690910

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractImplantation of autologous splenic tissue was performed in 2 patients after splenectomy for trauma. In order to demonstrate some function of the implanted splenic tissue, spleen scintigraphy, using99Tcm‐labelled heat‐damaged autologous erythrocytes, and measurement of the percentage of circulating vacuolated erythrocytes were carried out 1 and 3 months after splenectomy. The spleen scans were positive after 1 month and the isotope uptake increased after 3 months, demonstrating splenic phagocytic function. The number of vacuolated erythrocytes also indicated some restoration of the pitting function of the implanted splenic tissue. No alterations in serum immunoglobulins were seen, but a moderate thrombocytosis and monocytosis persisted for 3 months. Future improvements in the implantation procedure are discus

ISSN:0007-1323    

DOI:10.1002/bjs.1800690911

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY