摘要:

AbstractThe designation and comparative effects of the various types of vagotomy in current use for the treatment of duodenal ulcer are discussed and the surgical anatomy of the form known as 'proximal gastric' vagotomy, 'parietal cell' vagotomy or 'highly selective' vagotomy is examined. A detailed and fully illustrated description is given of a well‐tried technique for the performance of this latter operationW.It is emphasized that really long‐term results of proximal gastric vagotomy without drainage for duodenal ulcer are still lacking, but the possible legitimate uses of this procedure at the present time are considered as well as its potential place in the future if its achievements live up to their early prom

ISSN:0007-1323    

DOI:10.1002/bjs.1800610502

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractA prospective study was made of 225 patients with gallbladder disease treated by cholecystectomy. Of these, 77 (34 per cent) complained of oesophageal symptoms; after cholecystectomy 44 continued to hace these symptoms, 33 having been cured. Patients in the 40–59‐year age group had a higher incidence of oesophageal symptoms and significantly fewer were cured by choiecystectomy than in the other age groups. In patients with refru× on barium studies andlor an enlarged hiatus at operation the incidence of oesophageal symptoms was higher (60 per cent), and less than 20 per cent of these were improved by cholecystec

ISSN:0007-1323    

DOI:10.1002/bjs.1800610503

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractAnalysis of the clinical course in 85 patients with histologically proved primary hepatocellular carcinoma showed that 73 followed the classic pattern of the disease with a rapid onset and a quick demise. Howeoer, in I2 patients the course was longer in that the duration of illness was over 2 years. This was largely accounted for by the duration of symptoms prior to diagnosis. No clinical differences could be discerned between these 12 patients and the other 73, and survival once diagnosis had been made was no different. The frequency of an underlying cirrhosis in the whole series was 58 per cent. The course of these patients differed in no way from those without cirrhosis except that the age hepatocellular carcinoma presented was older. One patient who received no specific therapy lived for 4 years from the time of diagnosis, and in each of the treatment groups there were occasional patients surviving for several years.

ISSN:0007-1323    

DOI:10.1002/bjs.1800610504

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractThere appears to be no constant relationship between the modes of clinical presentation and the varying pathological processes in patients with amoebic liver abscesses who present with or develop the abdominal manifestations suggestive of peritonitis. In a proportion of the patients (37 per cent)there is no evidence of a leakage from or rupture of the abscess. In spite of the abdominal manifestations there is no pus, either localized or generalized, in the peritoneal cavity. These patients constitute the group with the syndrome of 'pre‐rupture'. The cases with 'pre‐rupture' invariably have superficial abscesses situated in the right lobe of the liver, together with fibrinous adhesions between the visceral and parietal peritoneum over the abscess site. It appears that the hepatic lesion responsible for the syndrome is at a stage just prior to leakage or frank rupture of the abscess. The pathogenesis of the syndrome is discussed and valuable physical signs in the diagnosis of the syndrome are described. By recognizing the existence of this syndrome a laparotomy could be avoided, as closed aspiration of the liver abscess and amoebicidal therapy are the only measures necessary in the management of these patie

ISSN:0007-1323    

DOI:10.1002/bjs.1800610505

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractTwo cases of papilloma of the gallbladder are described. The literature of this rare condition is reviewed, with particular reference to the possibility that the condition may be premalignant, its capacity to cause symptoms and its treatment.

ISSN:0007-1323    

DOI:10.1002/bjs.1800610506

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractDirect non‐operative injection of radio‐opaque material through a cannula introduced at the duodenal papilla by means of a fibre‐optic duodenoscope achieved opacification of the bile ducts, the pancreatic duct or the entire biliary pancreatic ductal system in 392 (89 per cent) of 439 patients in whom it was attempted. The desired ducts were opacified in 75 per cent of cases; the bile ducts in 206 out of 278 and the pancreatic duct in 120 out of 161 cases. The anatomical conditions found were: long common biliary pancreatic channel, 30 per cent; short common biliary pancreatic channel, 28per cent; two orifices in the hepatopancreatic ampulla, 24 per cent; two orifices on the duodenal papilla, 18 per cent; two orifices on the duodenum, there being no papilla, less than I per cent. Morbidity resulting from the procedure consisted of infectious reactions in 20 out of 295 patients in whom the bile ducts were opacified and hyperamylasaemia and abdominal pain in 28 out of 300 patients in whom the pancreatic duct was opacified. The method is of value in diagnosing the cause of cholestatic jaundice. In non‐jaundiced subjects it may complement or clarify inconclusive cholangiograms or cholecystograms obtained by other techniques. If it shows dilated bile ducts operation should not be delayed, otherwise there is a risk of cholangitis. Pancreatic carcinoma may be revealed by stenosis, partial or total, of the pancreatic duct or by filling defects in the pancreatic parenchyma. Both chronic pancreatitis and pancreatic carcinoma may cause partial stenosis of the pancreatic duct. A filiform appearance of the pancreatic duct suggests chronic pancr

ISSN:0007-1323    

DOI:10.1002/bjs.1800610507

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractIntravenous infusion of methylene blue stained an insulin‐secreting islet cell adenoma a reddish‐blue colour. It appears that certain vital dyes localize in pancreatic islet ce

ISSN:0007-1323    

DOI:10.1002/bjs.1800610508

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractThe condition of parathyroid cyst is discussed and 4 cases are reported. It is believed that one of these patients suffered from primary hyperparathyroidism resulting from a parathyroid cyst.

ISSN:0007-1323    

DOI:10.1002/bjs.1800610509

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractSeventy‐three cases of solitary thyroid nodule have been analysed in detail, including their clinical presentation and operative and histological features. Females were more frequently affected than males in a ratio of 6:1. A considerable number of solitary nodules diagnosed clinically turned out to be multinodular at operation (164 per cent).The incidence of malignancy in the present series was 6.8 per cent while that of toxicity was 6 per cent.Drill biopsy was found to be a useful diagnostic aid with a high accuracy rate. Thyroid lymphography has not been found to be of much help.In view of the low incidence of malignancy a plea for excision of the solitary thyroid nodule is mad

ISSN:0007-1323    

DOI:10.1002/bjs.1800610510

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractA case of antesternal pendulant goitre is reported, and its pathogenesis and an unconventional surgical approach are discussed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800610511

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY