摘要:

AbstractA review of the different designs for palliative oesophageal intubation tubes confirms Souttar's original suggestion that they should be flexible, incompressible, non‐traumatic, compact, have an adequate lumen and stay in place. The internal diameter should be at least 10 mm. The thickness of the wall should be about 1 mm. The length will vary according to the stricture and should be as short as possible, provided that the proximal rim prevents future longitudinal growth occluding the lumen. Various methods of achieving the ability to stay in place are described, which comprise either a large proximal rim or a roughened barrel. No details about results are given because the original patient populations vary so much. Success probably depends more on the technical expertise and experience of the surgeon than specific variations in desig

ISSN:0007-1323    

DOI:10.1002/bjs.1800690202

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractPalliative treatment by radiotherapy was attempted in 17 cases of dysphagia, due to inoperable gastric carcinoma. Thirteen experienced a useful improvement in swallowing. Radiotherapy, using a moderate dose of radiation, is suggested as an alternative to intubation in such patients.

ISSN:0007-1323    

DOI:10.1002/bjs.1800690203

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractAssessment of the resectability of carcinoma of the oesophagus or cardia may be inaccurate. At exploration, 8 patients in whom resection was contemplated were found to have unresectable lesions. An intrathoracic oesophagogastric bypass was performed without further change of position. Five patients were discharged from hospital and survived between 3 and 20 months before they finally succumbed to metastases. Each of them was able to take an ordinary diet. The aims of palliation were achieved.

ISSN:0007-1323    

DOI:10.1002/bjs.1800690204

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractOesophageal varices in 21 children with portal hypertension (intrahepatic 13, extrahepatic 8) were treated with sclerotherapy using ethanolamine oleate injected via a fibreoptic endoscope. Repeat endoscopy confirmed variceal obliteration in 18 children with a mean of 3·5 (range 1–8) injections. No patient has bled since obliteration of varices. Complications were oesophageal stricture (2 patients), oesophageal ulcer (5 patients) and haemorrhage within 30 days of injection (5 patients). The early results suggest that this is a satisfactory method for the treatment of oesophageal varices in childr

ISSN:0007-1323    

DOI:10.1002/bjs.1800690205

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractOne hundred patients with bleeding oesophageal varices were randomized into two treatment groups after resuscitation. One group was managed by tamponade only (group 1); the other group (group 2) was treated by endoscopic injection of oesophageal varices. The patients in group 2 were further subdivided into 25 patients (group 2a), who had tamponade applied immediately after sclerotherapy, and 25 patients (group 2b), who had sclerotherapy without subsequent tamponade.Injection of varices controlled the acute bleeding episode more effectively than tamponade (74 per cent in group 2 v. 42 per cent in group 1). There was no significant difference in the overall mortality rate of the two groups, but group 2 had a significantly higher proportion of Child's grade C patients (38/50 v. 29/50 = 76 v. 58 per cent). If only Child's grade C patients are considered, 16 out of 29 (55 per cent) died in group 1, whereas only 12 out of 38 (32 per cent) died in group 2 (P<0·05).Tamponade applied after sclerotherapy had no demonstrable effect on the outcome of sclerotherapy. The long term follow‐up of patients (maximum 4 years) showed that recurrence of bleeding was less in the sclerotherapy group (8·1 per cent) than in the tamponade only group (27·6 per cent; P<0

ISSN:0007-1323    

DOI:10.1002/bjs.1800690206

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractThe complications of injection sclerotherapy were retrospectively studied in 122 patients with acute variceal bleeding. Initial control of bleeding was achieved in 72·5 per cent of patients and the final success rate of sclerotherapy was 86·1 per cent. The overall morbidity rate was 30·3 per cent. Minor complications occurred in 13·9 per cent of patients and major complications were recorded in 16·4 per cent. Twenty patients developed complications directly attributable to sclerotherapy: 14 minor and 6 major. The overall mortality rate was 21·3 per cent, and 7·4 per cent of the patients died due to complications.Pulmonary complications occurred in 15 patients and resulted in 3 deaths. Retrosternal pain developed in 8 patients, but dysphagia and oesophageal ulceration were rare. No stricture was recorded. The incidence of liver failure in 17 Child's grade C cases was almost certainly a complication of the underlying disease rather than the injection therapy. It is suggested that injection sclerotherapy is an effective and relatively safe treatment for variceal bl

ISSN:0007-1323    

DOI:10.1002/bjs.1800690207

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractA Dacron patch was used to close acute defects of the stomach in rabbits. No deaths were directly attributed to the procedure. The patch was completely covered by new growth of tissue within 6 weeks. In the sixth postoperative month some evidence of rejection of the prosthetic material was present and 1 1/2 years after the operation the patch was found in granulation tissue near the stomach. From this study it was concluded that this new technique is simple, can be performed safely and offers satisfactory results. Moreover, these experiments seem to indicate that this method may have clinical applications in the treatment of gastrointestinal fistulas in carefully selected cases.

ISSN:0007-1323    

DOI:10.1002/bjs.1800690208

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractThe occurrence of achalasia in two brothers who were successfully treated by oesophagomyotomy is reported. There was no evidence of oesophageal motor dysfunction in their parents or two other siblings who were also studied. The possibility that genetic factors may be important in the aetiology of achalasia is discussed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800690209

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractPrimary intrahepatic stones are commonly found in association with recurrent pyogenic cholangitis. In 115 patients with this condition, the intrahepatic stones were removed by four different methods: common duct exploration (n = 74), transhepatic intubation (n = 10), hepatotomy (n = 5) and hepatic resection (n = 26). The choice of methods was guided by the location of stones and the condition of the bile ducts and the liver. These extraction procedures were combined with drainage procedures, i.e. sphincteroplasty and choledocho‐jejunostomy, whenever the proper indications were present. The operative mortality was 4·3 per cent. Long term follow‐up (median 7 years and 8 months) on 91 patients revealed that common duct exploration, transhepatic intubation and hepatotomy were associated with high incidences of recurrent symptoms requiring reoperation (23·6 per cent, 37·5 per cent and 75 per cent respectively). In most instances, failures were due to recurrent stone formation in the stenotic intrahepatic ducts. Hepatic resection had the lowest failure rate (4·2 per cent) and none of the patients had recurrent

ISSN:0007-1323    

DOI:10.1002/bjs.1800690210

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractA 20‐year‐old woman underwent cholecystectomy and common bile duct exploration. Seven days later, T‐tube cholangiography showed two stones retained in a developmentally anomalous cystic duct stump. She was treated with thrice‐daily flushings of large amounts of saline through the T tube, and after 7 days of treatment the biliary system was free of stones. The conditions necessary for successful non‐operative management of retained cystic duct stones are

ISSN:0007-1323    

DOI:10.1002/bjs.1800690211

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY