摘要:

This article briefly reveals the author's experience of 95 major hepatic resections performed for various conditions during a seven‐year period. The necessity for better understanding of intrahepatic anatomy of the liver, especially of the hepatic venous anomalies, and the use of more recent diagnostic aids, is stressed. The author's indications and the types of resection performed are described in detail. Some of the views expressed are in direct opposition to the traditional methods of treatment of some hepatic lesions. The low mortality of 12.6% in this series has been attributed to proper selection of patients for resection, and advancement in anæsthesia and surgical technique, including better preoperative and postoperative ca

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1972.tb06728.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

The intrahepatic anatomy of the right, middle and left hepatic veins and the additional hepatic tributaries of the inferior vena cava are described.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1972.tb06729.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

Operative cholangiography was introduced with the major objectives of demonstrating previously unsuspected bile duct calculi, avoiding fruitless choledocholithotomy, and reducing the incidence of residual duct calculi. This report describes the effects on patient management of a policy of routine operative cholangiography in the surgery of gallstones in the Professorial Surgical Unit at the Royal Brisbane Hospital. All three objectives were realized, but for full achievement of the potential of the technique, skill, experience, and persistence are required by the surgeon, both to obtain satisfactory pxeexploratory and completion cholangiograms, and to remove all demonstrated calculi at the primary procedure.SummaryA review has been carried out of the effect on patient management of the use of routine operative cholangiography in a series of 327 patients undergoing surgery for gallstones in the Professorial Surgical Unit at the Royal Brisbane Hospital. Operative cholangiography was carried out in 82% of cases, and the technique failed in 16% of these. The reasons for failure are analysed. Operative cholangiography is a reliable and accurate method of predicting the presence of choledocholithiasis. It can dispense with the necessity for choledochotomy in a significant number of cases where clinical indications for duct exploration exist, and occasionally reveals a previously unsuspected stone. With cholangiography, the incidence of retained stone after cholecystectomy should approximate to zero. Completion cholangiography reduces the incidence of retained ductal stone after choledocholithotomy, but in order to reduce the incidence still further, skill, experience and persistence are required by the surgeon in obtaining an adequate cholangiogram, in the interpretation of the cholangiogram, and finally in the removal of the duct stones. It is recommended that operative cholangiography should be performed as a routine during biliary surgery.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1972.tb06730.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

In this paper the case report of a patient with a benign tumour of the common bile duct is presented, and a review of the literature relating to the subject is made. Reference is also made to the value of percutaneous cholangiograms in the diagnosis and management of cases of obstructive jaundice of obscure origin.SummaryA report of a benign papillary cystadenoma of the common bile duct is presented. The literature on this subject is reviewed, and 76 cases were found. The different histological types are listed. Although there are no cardinal diagnostic features in the clinical picture, it should be remembered that benign tumours are a rare cause of jaundice. This condition is surgically correctable and has a good prognosis. Percutaneous transhepatic cholangiography is discussed in relation to this case.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1972.tb06731.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

Six patients with distal ulcerative colitis and a relatively normal proximal colon have been treated by colectomy followed by a caecal pull‐through type of anastomosis and preservation of the anal sphincters. The early results in five patients have been quite encouraging and suggest that this procedure may earn a place in the management of selected patients with this diseas

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1972.tb06732.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

A condition of posterior tibial syndrome is postulated, and its pathology is related to that of the anterior tibial syndrome. A case is reported in which cure was achieved by operation to split the deep fascia.SummaryA patient with posterior tibial syndrome and relief of symptoms by operation to split the deep fascia is described.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1972.tb06733.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

When marked loss of the lower eyelid occurs, a useful reconstructive surgical technique is the tarsoconjunctival slide operation. Here the tarsus is supplied from the upper lid, and the full thickness is completed by skin graft or an advancement flap.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1972.tb06734.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

An analysis is made of 125 intravenous pyelograms performed before open prostatectomy upon cases of benign prostatomegaly. It is noted that the incidence of associated pathology was low, and that the decision to operate was adhered to in all cases. The tenet that prcopcrative intravenous pyelography is mandatory is therefore held questionable.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1972.tb06735.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

A classification of acromio‐clavicular joint injuries is presented, and the treatment of each type is discussed. Twenty‐three patients with complete acromio‐clavicular joint dislocation treated by surgery are rev

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1972.tb06736.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

The significance of an adequate sensory mechanism in the maintenance of continence is stressed and a number of important considerations are reviewed. It appears likely that several factors play a part, perhaps in varying degrees under different circumstances. The muscles of the pelvic floor and the lining of the anal canal are both capable of assisting in the fincr degrees of localization and discrimination.SummaryIn summary, I believe that at present we can say that the sensory component of continence is subserved by the sequential recognition of the contents by the colon, rectum, pelvic floor and anal canal. The colon and rectum provide vague and diffuse sensation, with poor localization and poor discrimination. The pelvic floor provides the first means by which the acute urge to defæcate is appreciated, and also the first and perhaps most important means of discriminating accurately between various contents of the rectum. Similar sensory appreciation is mediated by the lining of the anal canal, and although the powers of discrimination are excellent and the sensitivity acute, this should be regarded as a rather late means of achieving recognition. Patients in whom one or more of the latter two mechanisms are disturbed might reasonably be expected to develop significant postoperative defects in continence. In most young patients with congenital deformities of the ano‐rectum, and in whom the anal canal has never been present, the pelvic floor is still able to act as an accurate sensory receptor. Furthermore, its capacity in this regard can be developed to such an extent that high‐quality function can usually be achieved. On the other hand, adult patients who suddenly lose the sensory capacity of the anal canal to which they have always been accustomed frequently develop functional defects of varying seve

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1972.tb06737.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY