摘要:

AbstractOne hundred and twenty‐five hepatic resections were done in the University Surgical Unit at the Queen Mary Hospital, Hong Kong, from 1964 to 1974 for conditions varying from primary hepatoma and recurrent pyogenic cholangitis to spontaneous rupture of the liver due to a bleeding haemangioma.The overall mortality was 17.6 per cent. A case was classed as an operative death unless the patient was discharged from hospital. There has been long term survival after resection for primary carcinoma of the liver and no mortality when resection was carried out for benign condition

ISSN:0007-1323    

DOI:10.1002/bjs.1800620602

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractPartial hepatectomy was performed in dogs either as the only procedure or following a period of ischaemia to the liver remnant produced by inflow occlusion for periods of 30–60 minutes before partial hepatectomy. Temporary portal decompression was maintained through the portion of liver subsequently excised.1. Survival in dogs subjected to partial hepatectomy and ischaemia to the liver remnant was similar to that in animals after partial hepatectomy alone.2. Metabolic changes were similar in both groups but dogs submitted to partial hepatectomy and ischaemia to the remnant had higher serum alkaline phosphatase and alanine amino‐transferase levels with increased bromsulphthalein retention in the fourth to sixth postoperative weeks.3. Replacement of liver mass proceeded rapidly in all groups of animals.It is concluded that ischaemia of the liver remnant for up to 60 minutes preceding partial hepatectomy in the dog is consistent with survival and produces little change in postoperative liver function or in the rate of restoration of liver m

ISSN:0007-1323    

DOI:10.1002/bjs.1800620603

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractA technique of orthotopic liver transplantation in the pig is described in which the main feature is the accomplishment of four of the five anastomoses by the use of the Vogelfanger NRC vascular suturing instrument. The advantage of this instrument is the rapid accomplishment of safe leak‐proof anastomose

ISSN:0007-1323    

DOI:10.1002/bjs.1800620604

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractThe response of plasma cortisol and cyclic AMP concentrations to surgical trauma was examined in 7 general surgical patients. Five patients made uncomplicated recoveries and showed peak cortisol levels at 6 hours postoperatively, returning to normal by 24 hours. One patient developed postoperative pneumonia and the plasma cortisol remained elevated up to 48 hours, and the final patient showed no cortisol response at all. The plasma cyclic AMP concentrations showed a consistent rise during the operation itself, which was statistically significant when compared with preoperative levels (P<0.0125). Concentrations had fallen to normal by 6 hours in all the cases, except in the patient who developed pneumonia, where the plasma cyclic AMP also showed a prolonged elevation. The significance of these findings requires further elucidation, but the temporal relationship of the cyclic AMP and cortisol peaks would support the hypothesis that cyclic AMP may play a part in the mediation of ACTH release following surgical trauma.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620605

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractOne hundred and sixteen patients with early corrosive burns of the oesophagus treated by the author are reviewed. It is emphasized that the all important aspect of management of these patients is prophylactic treatment to avoid stricture of the oesophagus. Early treatment consists of intravenous fluid therapy, broad spectrum antibiotics, sedation, parenteral hydrocortisone and more importantly maintaining the patency of the oesophagus followed by dilatation. The importance of early barium meal studies and oesophagoscopy is stressed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620606

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractEighty‐three adult patients with peptic oesophageal stricture are reviewed with regard to diagnosis and treatment. Sliding hiatus hernia was present in 94 percent of cases. The strictures were graded according to the degree of stenosis encountered at initial oesophagoscopy, but several other factors influenced the management of each case. Bouginage should always be attempted before proceeding to surgery. Thirty‐eight patients were treated by bouginage alone, with 21 (55 per cent) good results and 3 deaths. Forty‐five patients came to surgery, with 32 (71 per cent) good results and 3 deaths. Six patients sustained instrumental perforation of the oesophagus with 1 fatality. There was in addition 1 case of silent perforation following selfbouginage, which is believed to be unique. Hiatal herniorrhaphy combined with simple bouginage is recommended where reflux oesophagitis dominates the clinical picture. Local plastic repair (oesophagoplasty) has proved a simple and effective method of treating low annular strictures. Oesophagogastrostomy was carried out in 12 patients without operative loss and with good results in 8 cases; the addition of a pyloroplasty is believed to lessen postoperative r

ISSN:0007-1323    

DOI:10.1002/bjs.1800620607

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractThe rates of transport of potassium, sodium and water across the intestinal mucosa of Thiry‐Vella fistulas of colon and ileum, were studied in dogs in two experimental situations; (1) following intravenous infusion of potassium (15 mEq) over 30 minutes and (2) during variations in the intraluminal concentration of potassium in the range 0.8–16.0 mEq/l.Following intravenous infusion of potassium the rates of potassium secretion into the colon were usually increased; the rates of sodium and water absorption were either unchanged or decreased. The unidirectional rate of movement of potassium into the lumen increased as the concentration difference across the mucosa increased; the movement of potassium in the opposite direction remained relatively constant. The unidirectional movement of sodium and water into the lumen of the colon also increased but to a lesser extent. The effect on potassium transport in the ileum was not so marked.With increase in the intraluminal concentration of potassium there was a decrease in the rate of net potassium secretion in both colon and ileum. The rates of net absorption of sodium and water were not significantly altered. Unidirectional potassium movement into the body increased in all the ileal fistu

ISSN:0007-1323    

DOI:10.1002/bjs.1800620608

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractCriticisms have been levelled against linear air flow operating enclosures because of their alleged physical and biological conditions and the effects of these, both on the surgical team and on the patient's tissues.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620609

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractDetails of 2 patients with idiopathic bilateral parotid duct strictures are presented. The possible aetiology and treatment are discussed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620610

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractGeneral anaesthesia in the early stages of pregnancy may carry an increased risk of embryotoxicity. One hundred and six women scheduled for non‐emergency surgery were interviewed preoperatively and their menstrual history taken. Forty‐three (41 per cent) were considered to be using adequate contraceptive therapy. Thirty‐one (29 per cent) of the patients could have been in the early stages of pregnancy, and of these women, 19 (61 per cent) were undergoing surgery of a minor nature. Simple history taking identified the women “at risk” and it is suggested that surgery could have been delayed without detriment in m

ISSN:0007-1323    

DOI:10.1002/bjs.1800620611

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY