摘要:

AbstractHeart rates of surgeons rise when they carry out operations and this rise is abolished by β‐blockade. In an assessment of the effect of oxprenolol on surgical performance a group of surgeons took double blind either oxprenolol 40 mg or a matching placebo. Oxprenolol abolished increases in heart rate (P<0·001) but had no effect on a profile of performance tests assessing tremor, suturing accuracy and co‐ordination. Reaction time of the surgeons was significantly slowed by oxprenolol (P<0·01). Using a self‐administered visual analogue scoring system the surgeons recorded no subjective changes in mood after β‐blockade and were surprisingly unaware of whether they had taken oxprenolol

ISSN:0007-1323    

DOI:10.1002/bjs.1800670902

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractThis retrospective study compares the hospital costs of early and delayed cholecystectomy in the treatment of patients presenting with acute gallbladder disease. Of patients on the waiting list for delayed cholecystectomy, 27 per cent were readmitted as emergencies. The operating time was the same for early and delayed cholecystectomy. The overall average length of stay in the delayed group (16·1 days) was significantly greater (P<0·001) than in the early group (12·4 days). The main difference in length of stay was due to the initial medical admission in the delayed group. The hospital costs, calculated on the basis of length of stay and hospital attendances, were £156 cheaper (at 1977/78 prices) for early than for delayed cholecystectomy. Although the numbers were too small for valid statistical analysis, surgical outcome as measured by numbers of deaths, complications and readmissions was similar in the two groups. If more early cholecystectomies were performed, costs might be saved and surgical waiting lists redu

ISSN:0007-1323    

DOI:10.1002/bjs.1800670903

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractAn association between gastric surgery and gallstones has been suggested but conflicting conclusions are found in the literature. A prospective study of 118 patients with proved duodenal ulcer disease has been undertaken to determine the true incidence of gallbladder disease. Sixty‐one patients undergoing surgery and 57 patients treated medically were matched for age, sex and weight. All patients had oral cholecystography at entry into the study and at 18 months and 109 were reviewed radiologically at 3 years. Three patients in the surgical group developed asymptomatic gallstones whereas none were detected in the medical group. This gives an incidence of gallstones of 4.9 per cent 3 years after gastric surgery. These findings are discusse

ISSN:0007-1323    

DOI:10.1002/bjs.1800670904

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractBiliary ascites due to ‘spontaneous’ perforation of the extra‐hepatic bile ducts is uncommon, and should be suspected in an infant who, after a period of good health, develops jaundice and progressive abdominal distension. When the presentation is acute without jaundice the diagnosis is unlikely to be considered unless paracentesis is performed. The perforation is typically located in the common bile duct near its junction with the cystic duct and simple peritoneal drainage without suture is recommended unless the bile duct is obstructed, in which case T tube drainage or a bypass procedure is required. The prognosis is good.Four patients are presented who illustrate the spectrum of clinical presentation and the different methods of management. Two patients in whom the perforation was in the cystic duct were successfully treated by cholecystectomy.In most cases the aetiology is not apparent, but important factors may be weakening of the common bile duct wall due to ischaemia or pancreatic juice reflux, associated with a rise in choledochal pressure. In older children the onset of biliary ascites may be preceded by an acute gastrointestinal illness, which, may be a predisposing f

ISSN:0007-1323    

DOI:10.1002/bjs.1800670905

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractA model for the production of gastric mucosal haemorrhages and ulcers, similar in morphology and distribution to those seen in stress states in man, has been produced by the intraperitoneal injection of adrenaline in single, double or treble doses of 0·6 mg/kg. Lesions were produced in 2 or 3 h, without ligation of the pylorus. Severe mucosal changes were associated with a fall in gastric mucosal histamine concentration. Mucosal serotonin did not change. Rises in mucosal adrenaline were accompanied by a fall in noradrenaline, total catecholamine levels being unchanged

ISSN:0007-1323    

DOI:10.1002/bjs.1800670906

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractFaecal bile acid excretion and sigmoid myoelectrical activity were measured on three separate occasions over a 12‐month period in 21 patients with diverticular disease and the results were compared with those of 17 age‐matched normal subjects. Statistically significantly lower faecal concentrations of both deoxycholic and lithocholic acid were found in patients with diverticular disease (96·7 ± 11·3 mg/100 g, 59·6 ± 6·0 mg/100 g respectively) when compared with normal subjects (219 ± 32·0 mg/100 g and 117·6 ± 14·6 mg/100 g respectively P<0·001). These values persisted throughout the period of study. Patients with diverticular disease were found to have an abnormally rapid myoelectrical rhythm (frequency 0·2–0·3 Hz [12 – 18 c/min]) which returned towards normal after 1 year's bran treatment. Significant correlatzons were found between lithocholic acid concentrations and activity of 0·2–0·3 Hz (r = 0·67) and deoxycholic acid concentrations and activity of 0·1–0·15 Hz (6–9 c/min) (r = 0·62). It is suggested that increased colonic absorption of bile acids may occur in diverticular disease which may inf

ISSN:0007-1323    

DOI:10.1002/bjs.1800670907

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractSkin closure using continuous nylon sutures was compared with closure using interrupted nylon sutures in 105 consecutive patients undergoing laparotomy. Particular note was made of wound healing and wound infection.The incidence of wound infection was similar (3·9 per cent and 3·7 per cent respectively) and all wounds healed satisfactorily. The continuous method was quicker and cheape

ISSN:0007-1323    

DOI:10.1002/bjs.1800670908

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractIn wounds on the back of guinea‐pigs an inoculum of 6 × 105of Escherichia coli and of Bacteroides fragilis produced afrank infection rate of 27 per cent. Addition of a catgut or a braided nylon tie statistically significantly increased the rate to 56 and 48 per cent respectively. Prolene and silk produced much smaller, non‐significant rises. The rate with polyglycolic acid was 18 per cent which, though not statistically significant, suggests the possibility that this material produces conditions unfavourable to multiplication of bacteria that produce this type of infec

ISSN:0007-1323    

DOI:10.1002/bjs.1800670909

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractA 66‐year‐old man is reported who was found to have acquired von Willebrand's disease, which presented when the patient was 63 with iron deficiency anaemia and gastrointestinal bleeding. He subsequently bled from various sites in the gastrointestinal tract including an angiodysplasia of the right colon, which was successfully treated by right hemicolectomy. This is the second reported association between acquired von Willebrand's disease and angiodysplasia of the intestinal tr

ISSN:0007-1323    

DOI:10.1002/bjs.1800670910

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800670911

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY