ISSN:0007-1323    

DOI:10.1002/bjs.1800740402

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740403

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740404

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractFrank intrabiliary rupture is an important complication of liver hydatid cysts and its incidence is between 5 and 25 per cent. The main principles of management are the surgical treatment of the cyst with removal of all cystic elements and drainage of the biliary tree. Accurate pre‐ and intra‐operative diagnosis and permanent drainage of the biliary tree by a wide choledochoduodenostomy are important to reduce morbidity and mortality. In this report 28 cases of frank intrabiliary rupture of hydatid cysts treated by choledochoduodenostomy are presen

ISSN:0007-1323    

DOI:10.1002/bjs.1800740405

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe effect of a short course of anti‐platelet agents, started pre‐operatively, on the patency of femorodistal bypass grafts is unknown. One hundred and forty‐eight such grafts were randomized to act as controls or to receive dipyridamole 200 mg b.d. for 48 h pre‐operatively and dipyridamole 200 mg b.d. with aspirin 300 mg daily for 6 weeks after surgery. Patients were well‐matched and the mean pre‐operative pressure index of 0·37 rose to 0·78 during the first postoperative week. No deaths were attributable to the treatment. Ninety‐three grafts were autogenous vein and the remainder were prosthetic (GORE‐TEXTrademark of W. L. Gore and Associates Inc.(PTFE), human umbilical vein or externally supported Dacron). At 1 year autogeneous vein cumulative patency was 75 per cent. Overall results showed higher patency in the treated group (P = 0·012) which was entirely accounted for by the difference between prosthetic dipyridamole and aspirin group (85 per cent patency) and prosthetic control groups (53 per cent patency, P = 0·005) and arose during the first postoperative month. There were 11 deaths and 8 amputations in the dipyridamole and aspirin group and 8 deaths and 12 amputations in the control group. It is concluded that a six week perioperative course of dipyridamole and aspirin allows the patency of prosthetic femorodistal bypass to approach that of autogenous vein, and the regimen therefore is recommended for patients who may require

ISSN:0007-1323    

DOI:10.1002/bjs.1800740406

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe use of non‐autogenous prostheses for femorodistal grafting has been attended by relatively poor patency rates. We have attempted to improve on these disappointing results by fashioning a composite graft using expanded PTFE (GORE‐TEX) and transposed non‐reversed saphenous vein, placed between the femoral artery and anterior tibial artery. We report the early results using this technique in 25 critically ischaemic limbs. At 12 months, the cumulative graft patency for this group of patients was 65 per cent (mean follow‐up of 19 months). Eighteen of the twenty‐five limbs were saved and there was no mortality. This technique offers a useful alternative to other forms of distal grafting and appears superior to the results obtained using non‐autogenous femorodist

ISSN:0007-1323    

DOI:10.1002/bjs.1800740407

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740408

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractTwo hundred and fifteen femoropopliteal bypass procedures using autologous saphenous vein grafts were randomly allocated to either the reversed or in situ technique. Eleven veins (5 per cent) were rejected at operation on the basis of their small size, nine in the reversed group and two in the in situ group, and there were two (2 per cent) perioperative deaths in each group, leaving 102 reversed and 98 in situ grafts for further study. The cumulative patency at 3 years of the reversed grafts was 77 per cent and that of the in situ grafts was 68 per cent (n.s.). The patency of all grafts was affected adversely by small veins (P<0·005), long grafts (P<0·05), low volume of blood flow in the grafts (P<0·001) and poor run‐off (P<0·05). These factors influenced the outcome of the in situ and reversed operations to a similar degree and there was no statistically significant difference between them within any subgroup. The mean compliance of the in situ grafts measured 3 months or more after operation with an ultrasonic echo‐tracking system was 0·024 ± 0·01 per cent/mmHg (± s.d.) compared with 0·017 ± 0·01 per cent/mmHg for the reversed grafts (t = 2·43, P<0·02). The incidence of fibrous stricture formation as shown by intravenous digital subtraction angiography was 29 per cent in both the reversed and the in situ grafts. The results of the study to date indicate that reversed and in situ vein grafts are equally effective for femoro

ISSN:0007-1323    

DOI:10.1002/bjs.1800740409

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740410

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractTen cases of secondary arterio‐enteric fistulae are described. There were nine graft enteric fistulae and one fistula involving the aortic suture line following elective resection of an infected graft. Only four of the patients initially received prophylactic antibiotics (single dose) at the original aortic reconstruction, and the vascular suture line had only been protected in two. Eight patients presented with bleeding and two with groin abscesses. One patient died before operation. Graft resection was undertaken in all patients and organisms were grown from six of eight grafts cultured. No patient died during operation but one died after 3 days. Axillofemoral bypass grafts were constructed in seven patients (four immediately after resection of prosthetic grafts and three within 4 days of operation). Only three of the eight patients who survived operation are still alive; two died of a ruptured aorta and one from a recurrent fistula. Two patients died of other causes. Four of five axillofemoral grafts in surviving patients subsequently occlude

ISSN:0007-1323    

DOI:10.1002/bjs.1800740411

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY