ISSN:0007-1323    

DOI:10.1002/bjs.1800601202

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractA hypothesis is advanced in which it is argued that variations in the extrinsic autonomic innervation of short small‐bowel segments are responsible for the unpredictable behaviour of such segments. Experimental evidence is offered to substantiate the hypothesi

ISSN:0007-1323    

DOI:10.1002/bjs.1800601203

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractThirteen patients are described in whom strangulated external hernia was associated with generalized peritonitis. The causes of this combination are discussed.Although the features of peritonitis are usually quite distinguishable from those of an uncomplicated strangulated hernia, in virtually all the cases previously reported in the literature the presence of peritonitis was not recognized until operation for the hernia was undertaken. Increased awareness of this complication and a conscious effort to exclude it resulted in the correct preoperative diagnosis in 4 of our patients.When the peritonitis is recognized preoperatively it is suggested that a laparotomy should be performed to deal with the intraperitoneal lesion, and that the associated groin hernia should be repaired by a preperitoneal approach through the laparotomy incision.

ISSN:0007-1323    

DOI:10.1002/bjs.1800601204

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractReflux of dye into the pancreatic duct was studied during operative choledochography performed in 211 conservative cases undergoing elective cholecystectomy. Reflux occurred with the same frequency whether the dye was injected by hand or by a constantflow electrically driven pump. The outlined pancreatic duct was abnormal in 27 per cent of cases where a pancreatogram was obtained. No association was found between ductal stones and reflux of dye into the common bile‐duct. Pancreatic reflux was associated with a low biliary pressure and segmental duodenal activit

ISSN:0007-1323    

DOI:10.1002/bjs.1800601205

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractIn a review of 157 patients admitted to hospital as emergencies with acute gall‐stone disease it was found that 52 cases (33.1 per cent) had undergone definitive operation for gall‐stones during the emergency admission in spite of an overall conservative policy in relation to operation. The results of these early operations are compared with those of operations delayed to a second admission in other patients of this series. There was no significant difference in mortality or morbidity, but there was a saving on average of 5 days in hospital for those patients who were operated on at the first admiss

ISSN:0007-1323    

DOI:10.1002/bjs.1800601206

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractPrevious reports, concerning the operation of choledochoduodenostomy have stressed the importance of an ‘adequate’ stoma. However, there does not appear to have been an attempt to measure the stoma size by some objective method.The results with a new technique for the assessment of the stoma and duct system postoperatively are reported. The method involves the use of a transnasal guided catheter system with selective catheterization of the common bile‐duct via the stoma. Accurate delineation of the stoma and ducts is then possible.The stoma was successfully catheterized in 13 out of 16 attempts, and satisfactory radiographs were obtained in 1 other patient by a modification of the technique. The measurements of the maximum diameter of the stoma were considerably less than those reported previously; despite this the clinical result in the short term was good in all except the 2 patients in whom the stoma could not be demonst

ISSN:0007-1323    

DOI:10.1002/bjs.1800601207

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractThe 5‐year results of a double‐blind, randomized, controlled trial of selective versus truncal vagotomy, each with pyloroplasty, are reported. of 100 patients entering the trial, 95 are available for study. There were 4 suspected or proven recurrent ulcers in the truncal group and 1 suspected but no proven recurrence in the selective group. The incidence of episodic diarrhoea was significantly less in the selective group; 4 mild and no severe cases compared with 11 mild and 2 severe cases among the truncal vagotomies. There was no severe dumping; mild symptoms were more common in the selective group but not significantly so. Miscellaneous dyspeptic symptoms were a little more common in the truncal group. Taking all these symptoms into consideration, the Visick clinical status of the selective group was superior. Weight changes, haemoglobin levels, and calcium levels were similar and satisfactory in each group. Selective vagotomy is superior to truncal vagotomy when each is combined with pyloropla

ISSN:0007-1323    

DOI:10.1002/bjs.1800601208

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractA double‐blind, randomized, controlled trial of Finney pyloroplasty and gastrojejunostomy, each with selective vagotomy, is reported. There were no operative deaths but 5 patients have subsequently died or have been lost to follow‐up, leaving 94 patients, with a mean follow‐up time of 3 1/2 years. There has been 1 proven recurrence after gastrojejunostomy and 2 after pyloroplasty, with 1 further suspected recurrence in each group. The clinical grading marginally favoured gastrojejunostomy. There was no significant difference in the incidence of bilious vomiting, dumping, diarrhoea, or other disturbances, but there was a significantly greater increase in bowel frequency after pyloroplasty. Weight changes were similar, and there was no gross anaemia or calcium deficiency in either group. Gastrojejunostomy is reversible and pyloroplasty is not, and therefore we recommend gastrojejunostomy as the drainage procedure of choice when drainage is necessary after vag

ISSN:0007-1323    

DOI:10.1002/bjs.1800601209

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractIn a study of drill biopsy carried out in 106 patients with breast lesions, comparing the accuracy of diagnosis with that of clinical examination and excision biopsy, reliability declined as stromal reaction in the tumour increased. Accordingly, a negative result is meaningless. Tumour size did not appear to be an important factor. The significance of these results is briefly discussed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800601210

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractFollow‐up of patients after local excision of carcinoma of the breast indicated that there was a high incidence of local recurrence and that this could be a difficult problem to manage. A retrospective study was performed comparing 50 patients who had undergone local excision and radiotherapy with 50 patients following simple mastectomy and radiotherapy. Local recurrence occurred in 16 per cent of the local excision group compared with 2 per cent in the simple mastectomy grou

ISSN:0007-1323    

DOI:10.1002/bjs.1800601211

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY