摘要:

AbstractOf the 1698 cases of thyroid disease seen during the 17 years 1956–72 in the Taj Cancer Institute, Tehran, 398 were cases of carcinoma, an incidence of 23·4 per cent. The factors involved in this high incidence of malignancy are discussed and the treatment of these patients is describ

ISSN:0007-1323    

DOI:10.1002/bjs.1800640702

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractAn operation is described that combines hiatus hernia repair with the construction of an anti‐reflux valve in the stomach immediately beyond the cardia.One hundred and ten patients treated by this operation, including 28 with panmural oesophagitis, have been followed up by clinical and radiographic assessment at yearly intervals for periods from a little over 1 year to over 5 years. Three patients had return of reflux symptoms, 2 of these being the only patients in the series with X‐ray reflux at follow‐up. The return of reflux in these patients appeared to result from anatomical changes that were probably caused, at least in part, by over‐tight application of the stapling instrument used in the op

ISSN:0007-1323    

DOI:10.1002/bjs.1800640703

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe pressure profile of the gastro‐oesophageal junctional zone was studied at rest and during abdominal compression in 26 duodenal ulcer patients after subdiaphragmatic truncal vagotomy with a drainage procedure. An ‘early’ group of 9 patients was investigated 10–14 days after surgery and a ‘late’ group of 17 patients more than 1 year after operation. Comparisons were made with 25 control subjects.The resting lower oesophageal sphincter pressures after vagotomy in both the early and late groups were similar to the levels of sphincter pressure in the controls. However, the increase in sphincter pressure always observed during abdominal compression in normal subjects was significantly decreased by complete vagotomy, and the normal increase in the gastrosphincteric pressure gradient was not produced.All 26 patients were tested for completeness of vagotomy using the insulin/pentagastrin test. In 19 patients the vagotomy was complete and in 7 patients it was judged to be incomplete. A decrease in the gastro‐sphincteric pressure gradient on manometric study of the lower oesophageal sphincter was interpreted as indicating complete vagotomy. Accurate correlation between secretory response and compression response was achieved in all patients with complete vagotomy and in 5 of the 7 patients with incomp

ISSN:0007-1323    

DOI:10.1002/bjs.1800640704

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe release of gastrin by insulin hypoglycaemia was studied in man before and after vagotomy. Completeness of vagotomy was judged by the gastric acid response to the same hypoglycaemia, using several criteria including one that allows for pyloric losses and duodenogastric reflux. A total of 137 tests was performed on 10 subjects. The plasma gastrin concentration was found to rise in the preoperative studies and also in the postoperative studies no matter what type ofvagotomy had been performed or what criteria of completeness of vagotomy were used. We concluded that gastrin can be released in response to hypoglycaemia in the absence of the vagus nerve.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640705

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractDuring the period December 1970 to August 1973, 99 patients with duodenal ulcer underwent proximal gastric vagotomy without drainage, and 93 per cent of the patients were followed up for 3–6 years after the operation. A proved recurrent duodenal ulcer was noted in 4.3 per cent and a strongly suspected recurrent duodenal ulcer in 2 per cent. It is suggested that this rate of recurrence on medium term follow‐up is compatible with the continued use of proximal gastric vagotomy in the surgical treatment of duodenal ul

ISSN:0007-1323    

DOI:10.1002/bjs.1800640706

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractA review has been made of 59 patients with recurrent peptic ulceration after incomplete vagotomy. Eighteen transthoracic procedures were performed, the remainder having abdominal revagotomy. An antrectomy was also carried out in 10 of these patients. An intact posterior nerve trunk was the most common operative finding and when either an anterior trunk or nerve strands only were present there was less likely to be an early positive insulin response (P = 0·033). Following incomplete vagotomy a longer period of symptomatic relief is obtained when gastro‐enterostomy rather than pyloroplasty is used as the drainage (P<0·01). Completing the vagotomy by the abdominal route gave superior results to transthoracic revagotomy (P = 0·0015), the former procedure without antrectomy having no associated mortality in this series. Although the results of revagotomy and antrectomy are as good as those of transabdominal revagotomy alone, we recommend the latter more conservative treatment for recurrent ulceration after incomplete vago

ISSN:0007-1323    

DOI:10.1002/bjs.1800640707

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe lateral decubitus view of the barium‐filled stomach has been reassessed in a series of 42 patients with possible splenic rupture and compared with a group of 17 patients with splenomegaly. Displacement of the gastric fundus of more than 4 cm from the inner rib margin is highly suggestive of splenic rupture. Where doubt exists, the test should be repeated within a short while. Peritoneal lavage and a full blood count investigation both add to the diagnostic accurac

ISSN:0007-1323    

DOI:10.1002/bjs.1800640708

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractAlthough rare, haemobilia should be included in the differential diagnosis of obscure gastro‐intestinal bleeding, particularly when accompanied by colic and jaundice. Case histories of 2 patients with haemobilia of different origin are presented. One had traumatic haemobilia after suture of a liver rupture; in the other patient an aneurysm of a branch of the right hepatic artery ruptured into the hepatic duct. The first patient recovered spontaneously; the second required ligation of the affected blood vessel. Diagnosis and treatment of the haemobilia syndrome are discussed, with reference to the liver blood suppl

ISSN:0007-1323    

DOI:10.1002/bjs.1800640709

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractAt operation for haematemesis in bilharzial hepatic fibrosis, the gallbladder was always found to be diseased but devoid of stones. This led to a study of gallbladder bile composition in a group of bilharzial patients and comparison with a group of cholelithiasis patients. When values for biliary lipid composition were plotted on triangular coordinates, both groups fell well outside the line of maximum cholesterol solubility. The bilharzia group had significantly more cholesterol and less phospholipid than the gallstone group. The absence of stones in patients with bilharzial hepatic fibrosis was possibly due to their early demise and the suggestion is that, in this condition, it is the disease of the gallbladder itself which renders the bile lithogenic.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640710

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractIt has been shown previously that, at least in dogs, a vascularized pancreatic allograft with ligation of the pancreatic duct can maintain normal beta‐cell function for at least 5 years. In this study common organ preservation techniques, as used in human cadaveric kidney transplantation, were applied to canine pancreatic allografts to determine the influence of 24‐hour preservation on beta‐cell function, graft survival and histological appearances.Three groups of dogs were compared: group A consisted of 9 dogs with fresh grafts; group B consisted of 5 dogs who received grafts preserved for 24 hours by pulsatile hypothermic cryoprecipitated plasma perfusion; and group C was composed of 5 animals who received grafts that had been flushed with Collins' solution followed by hypothermic storage for 24 hours.It appeared that both preservation methods were equally effective and that preservation did not alter either the graft's function or its histological appearance. No significant differences after transplantation were observed in the endocrine function tests of the three groups when compared with the preoperative values; neither was there a significant difference in the mean graft survival time between the g

ISSN:0007-1323    

DOI:10.1002/bjs.1800640711

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY