bluuebunny/crossref_metadata_2025_split huggingface dataset:
The removal of retained gallstones from the common bile duct: Experience with sodium cholate infusion and the Burhenne catheter
Authors: Britton D C , Gill B S , Taylor R M R , James Oliver 
Published: March 2007

Abstract
The use of cholic acid T tube infusion and of the Burhenne catheter has been investigated in the management of gallstones retained in the common bile duct following biliary surgery in 9 patients. Four of 7 patients treated with cholic acid infusion showed disappearance of the stones during treatment. The stones in a fifth subject were removed by a combination of cholic acid infusion (1 stone disappeared) and instrumentation with a Burhenne catheter (a second stone removed). Use of a Burhenne catheter was unsuccessful in 3 of 4 patients. Details of the technique of cholic acid infusion are given, and possible complications of the treatment are discussed. The use of cholic acid infusion for the dissolution of stones in the common bile duct is recommended.
Aorto-iliac reconstruction with special reference to the extraperitoneal approach
Authors: Helsby Raymond , Moossa A R 
Published: March 2007

Abstract
We have used the extraperitoneal approach for aortoiliac reconstruction for lower limb ischaemia in over 130 patients. The operative exposure is excellent. Operating time is shortened and the upset to the patient much less than in the transperitoneal approach. We now believe that the method is suitable for use in the majority of aorto-iliac reconstructions. Patency rate 4 years after surgery for claudication is 89 per cent.
Prognosis after portocaval anastomosis: A 15-year follow-up
Authors: Windle R , Peacock J H 
Published: March 2007

Abstract
A 15-year follow-up of 57 patients who underwent portocaval anastomosis is reported. Twenty-seven patients were still alive and the progress of these and of those who died is followed.
The young cryptogenic cirrhotic with no encephalopathy, normal liver function tests and absence of portal vein mural thrombus at the time of operation is best benefited.
The only factor from the series to suggest a poor prognosis is deterioration in liver function in the postjaundice cirrhotic, and the development of encephalopathy in cryptogenic cirrhotics suggests a poor long term prognosis, but its onset is not related to the time before death.
Acute segmental ischaemic enteritis in Thailand
Authors: Welch Theodore P , Sumitswan Somsak 
Published: March 2007

Abstract
A disease characterized by segments of ischaemic small intestine has been recognized in northern Thailand over the past decade. The clinical features and appearance of the diseased intestine are described. Most of the patients were treated by surgical resection of the affected bowel. The overall mortality was 14 per cent. Recently, some patients have been successfully treated by non-surgical means. The aetiology of the disease is still unknown.
Prediction of kidney viability before transplantation
Authors: Baxby K , Johnson R W G 
Published: March 2007

Abstract
A patient who receives a kidney transplant which fails suffers a physical and psychological disaster.
Almost one-third of the kidneys transplanted in the United Kingdom are primary failures; many others function only after a delay, and the long term prognosis for these kidneys is poor. There is a need to identify kidneys which will function immediately after transplantation, those which will function after a delay and those which will never function. Such identification is seldom possible from the history. By continuous hypothermic perfusion we can identify a group of kidneys which will probably never function. The perfusate lactate level predicts which of the remaining kidneys will function immediately and which will not. Kidneys which function immediately after transplantation have a very much better long term prognosis after transplantation than those with delayed onset of function.
Intrabiliary rupture of hydatid cyst of the liver
Authors: Kattan Y B 
Published: March 2007

Abstract
In a series of 136 cases of hydatid disease affecting various tissues and organs admitted to one surgical unit in the Medical City Hospital, Baghdad, and personally studied and treated by the author, the liver was involved in 94 cases (69.1 per cent) and intrabiliary rupture occurred in 15.
Pain in the right upper abdominal quadrant associated with tenderness and rigidity, radiating to the back and right shoulder, was the presenting feature in almost all the patients. Hectic fever was present in 14. Obstructive jaundice developed in all the patients at some stage of the illness, but was complete with clay-coloured stools in only half. Chills and rigors were present in 67 per cent, eosinophilia in 40 per cent, a positive Casoni's test in 87 per cent, itching with urticaria and weal formation in 20 per cent and a palpable mass in the liver in 67 per cent of cases.
Operative treatment is mandatory in order to clean the mother cyst of hydatid membranes, debris and daughter cysts, to explore and clear the common bile duct and to ensure free biliary passage to the duodenum. Sphincterotomy is neither necessary nor advisable, and when the gallbladder is not invaded by the cyst it should be preserved.
Pullthrough operation with delayed anastomosis for rectal cancer
Authors: Kirwan William O , Turnbull Rupert B , Fazio Victor W , Weakley Frank L 
Published: March 2007

Abstract
The technique of pullthrough resection with delayed anastomosis for carcinoma of the rectum as performed at the Cleveland Clinic is described. A series of 84 cases of rectal cancer treated in this way is reported.
The average tumour diameter was 4·5 cm, the average margin of resection was 4·1 cm and the average distance of the tumour from the anus was 7·6 cm, The incidence of necrosis of the pullthrough was 1·2 per cent. The overall 5-year survival was 63 per cent with 100 per cent, 57 per cent and 53 per cent for Dukes' A, B and C tumours respectively. The quality of bowel function following surgery is described in detail. It is felt that this procedure has an important place in sphincter conservation in carcinoma of the middle third of the rectum.
Anterior highly selective vagotomy with posterior truncal vagotomy: A simple technique for denervating the parietal cell mass
Authors: Hill G L , Barker M C J 
Published: March 2007

Abstract
Anterior highly selective vagotomy with posterior truncal vagotomy was performed in a consecutive series of 20 patients with uncomplicated chronic duodenal ulcer.
After identification of the vagal trunks the anterior leaf of the lesser omentum was separated from the lesser curve of the stomach, carefully preserving the anterior nerve of Latarjet. The distal extent of the dissection was from a point approximately 7–8 cm from the pylorus. After ensuring that all branches of the anterior nerve passing to the lesser curve had been severed, the trunk of the posterior nerve was divided and a segment removed. The lower 6–7 cm of oesophagus were cleared of nerve fibres.
All the patients recovered well from the operation and none suffered from prolonged gastric stasis in the postoperative period. Fourteen patients are well and free of symptoms (follow-up 3–15 months). Four patients have a sense of epigastric fullness and one of these vomits occasionally. Three patients have been troubled periodically by diarrhoea and one has ulcer-type pain although no recurrence has been seen on endoscopy or on barium meal examination.
One week after surgery the mean percentage reduction was 73 per cent in basal acid output and 65 per cent in peak acid output after stimulation with pentagastrin. Five of the patients had late positive insulin tests; 3 of these were the first 3 patients in the series. The other patients were insulin negative. In 10 patients the pattern of gastric emptying of a radionuclide-labelled meal 6 months after surgery was compared with that of 23 controls. The mean half-emptying time was similar in the two groups (71·7 ± 10·1 min v. 71·3 ± 3·8 min).
It is concluded that this new and simpler operation is technically feasible and it may be worth a cautious trial in centres with a special interest in this type of surgery.
Immediate resection in the treatment of large bowel emergencies
Authors: Valerio David , Jones Peter F 
Published: March 2007

Abstract
In a consecutive series of 122 patients who required an emergency operation for disease or injury of the colon or rectum, 80 (65 per cent) had an immediate resection of the diseased segment of bowel, with an operative mortality of 15 per cent. The free use of immediate resection is of benefit to patients, but good results depend on the experience of the surgeon and the use of a number of special techniques.
Evaluation of intended radical surgery in carcinoma of the gallbladder
Authors: Evander A , Ihse I 
Published: March 2007

Abstract
The records of 44 consecutive patients with carcinoma of the gallbladder from 1968 to 1977 were reviewed. All patients were investigated with a view to resection of the tumour and this was carried out in 10 patients, all macroscopic tumour being excised in 6. The basic operation was cholecystectomy, but liver resection (4 patients), liver resection and colectomy (3 patients) and pancreaticoduodenectomy (1 patient) were also carried out. Of these 10 patients, 3 died in hospital, while of the 34 patients in whom a palliative procedure was possible, 15 died during their hospital treatment. The median survival times were 4 months and 3 months respectively. Only one patient in this series is alive and symptom-ree at 36 months.
It is concluded that radical surgery, of itself, does not confer any advantage to the group of patients with carcinoma of the gallbladder. Alternative strategies for diagnosis and treatment of this condition are discussed.
Accuracy of oesophageal brush cytology: Results of a prospective study and multicentre slide exchange
Authors: Mortensen N J Mcc , Mackenzie Elizabeth F D 
Published: March 2007

Summary
The value of brush cytology has been assessed in the diagnosis of 101 oesophageal strictures in a department with no previous experience of oesophageal cytology. Cytological specimens obtained using a brush gave a correct diagnosis in 86 per cent of 36 malignant strictures with only 2 false negatives; when combined with biopsy, accuracy rose to 92 per cent. Of 65 benign strictures examined there were 3 false positives. In a series of test slides sent to 11 other hospitals the average false negative diagnosis was 4 per cent and false positive 3 per cent. Four of the centres had little previous experience and only two had extensive experience in oesophageal cytology. Therefore, brush cytology as a proved aid to the accurate diagnosis of oesophageal malignancy is within the capability of most pathology departments and should be used more widely.
The incidence and course of perianal complications and arthralgia after intestinal resection with restoration of continuity for Crohn's disease
Authors: Heuman R , Bolin T , Sjödahl R , Tagesson C 
Published: March 2007

Summary
The influence of bowel resection for Crohn's disease on the frequency of arthralgia and perianal manifestations was evaluated in a follow-up study of 82 patients. Arthralgia and perianal manifestations were analysed according to two separate periods: the preoperative duration of disease (4·2±3·2 years) and the postoperative duration (4·3±2·6 years). In patients operated on more than once, the time before the first and after the latest operation was included in the study. At the time of the follow-up, 19 patients suffered from recurrent disease. The frequency of arthralgia did not change after resection irrespective of whether or not there was recurrence. In patients without recurrence, however, perianal manifestations diminished after resection (P &lt; 0·05). In the postoperative period only 10 per cent of those without recurrence suffered from perianal lesions compared with 47 per cent of those with recurrence (P &lt; 0·001). If perianal lesions were in existence preoperatively, they healed spontaneously in 80 per cent of the patients without recurrence, but were still active among those with recurrence (P &lt; 0·001).
Our results indicate that the perianal manifestations are closely connected to the inflammatory process in the intestine. On the other hand, the arthralgia seems to be independent of the inflammatory process of the bowel and may be related to a general defect of the gastrointestinal mucosa in Crohn's disease.
Single dose doxycycline prophylaxis and peroperative bacteriological culture in elective colorectal surgery
Authors: Törnqvist A , Ekelund G , Forsgren A , Leandoer L , Olson S , Ursing J 
Published: March 2007

Summary
A prospective study was performed on 196 consecutive patients undergoing elective colonic surgery to evaluate the prophylactic effect of a single dose of doxycycline. The patients were randomized into four groups: group I 200 mg i.v. preoperatively, group II 600 mg i.v. pre-operatively, group III 600 mg i.v. postoperatively, and group IV 200 mg i.v. preoperatively and 200 mg i.v. daily 3 days postoperatively. The rate of septic complications for the different groups were: 113 per cent, 117 per cent, III 20 per cent, and IV 19 per cent. There was no statistically significant difference in occurrence of septic complications between the groups.
The degree of bacterial contamination during operation was estimated by culture from wound irrigation fluid and from cotton swabs. Bacteria were recovered from the irrigation fluid in 97 per cent, while culture from cotton swabs proved to be much less sensitive. A high number of bacteria in the irrigation fluid was significantly correlated to a high complication rate. It is suggested that direct plating from irrigation fluid can be used for defining a high risk group of patients in colonic surgery.
Gastric hypermotility and antropyloric dysfunction in gastric ulcer patients
Authors: Liebermann-Meffert D , Müller C , Allgöwer M 
Published: March 2007

Abstract
Impaired gastric emptying in gastric ulcer patients has generally been explained by gastric hypomotility.
The gastric motor response to an electrical vagal stimulus was measured intraoperatively in patients with gastric ulcers (GU, n = 21), duodenal ulcers (DU, n = 25) and combined ulcers (GDU, n = 6).
Amplitude and duration of the contraction and integrated motor response were found to be significantly greater in GU patients than in patients with duodenal and combined ulcers.
Thus, hypermotility of the gastric muscle exists in GU patients and the delayed gastric emptying in GU disease may be the result of antropyloric motor dysfunction rather than of gastric hypotony. Abnormal motility associated with duodenogastric reflux appears to be a key feature in the pathogenesis of gastric ulcer.
A comparison of circular stapling devices in colorectal anastomoses
Authors: Blamey S L , Lee P W R 
Published: March 2007

Abstract
The short term results of colorectal anastomosis using the Russian SPTU and American EEA circular staplers are compared. Anastomoses with these stapling devices were attempted in 61 patients between October 1978 and December 1980. In 1 patient the stapling method failed at operation, so that 60 patients had a stapled anastomosis as their definitive form of anastomosis. Of these, 31 were stapled using the Russian SPTU device and 29 using the American EEA device. Parameters of age, indication for operation, surgical assessment of curability, tumour stage and distance from the anal verge are compared to demonstrate similarity of the groups. Practical aspects of the use of the staplers are discussed. Local complications of dehiscence, anastomotic haemorrhage, stenosis and fistula formation occurred in 17 patients. Complications related specifically to the stapling procedure occurred with similar frequency in both groups: 8 patients treated with the SPTU stapler and 9 patients treated with the EEA stapler. No significant advantage was demonstrated for either stapler with respect to overall local complications; however, the authors have found the EEA stapler both easier to use and easier to maintain.
Carotid artery occlusion following endarterectomy: Evaluation by spectral analysis of Doppler ultrasound signals
Authors: Aukland A , Hurlow R A , Hamer J D 
Published: March 2007

Abstract
The clinical results of carotid endarterectomy are well documented, but there is little objective information on the incidence of postoperative occlusion. We have studied the postoperative patency of the internal and external carotid arteries using continuous wave Doppler ultrasound with spectral analysis (Spectrascribe BOC – Medishield). Seventy-nine patients who had had 89 endarterectomies during the past 5 years entered the study. The mean follow-up was 21 months.
Fourteen patients had an occluded internal carotid artery of whom 4 had suffered an immediate postoperative stroke and 1 a delayed stroke: transient ischaemic attacks occurred in another 4 patients. Of the 60 patients with a patent internal carotid artery one suffered an immediate postoperative stroke and 2 a delayed stroke; 6 patients had recurrent transient ischaemic attacks. None of the 5 patients who had an external carotid endarterectomy developed postoperative symptoms, although there was occlusion in 2. The carotid artery was occluded in 4 of 43 completely asymptomatic patients.
Thus, 18 per cent of all carotid endarterectomies and 9 per cent of asymptomatic patients in this series had postoperative occlusion of the carotid artery.
Intrathoracic gastric bypass for carcinoma of oesophagus found unresectable at exploration
Authors: Lam K H , Wong John , Lim S T K , Ong G B 
Published: March 2007

Abstract
Assessment 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.
The surgical management of primary intrahepatic stones
Authors: Choi T K , Wong J , Ong G B 
Published: March 2007

Abstract
Primary 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 stones.
Results and prognostic factors in salvage surgery for squamous carcinomas of the tongue
Authors: Pittam M R , Thornton Helen , Palmer B V , Chapman P , Shaw H J 
Published: March 2007

Abstract
Fifty-six patients who had undergone salvage surgery for residual or recurrent squamous carcinomas of the tongue between 1967 and 1977 were reviewed. Failure to obtain operative clearance led to certain local recurrence. The tongue or cervical lymph nodes were involved in 27 of the 28 patients who died with recurrent tumour. The overall age-corrected actuarial postoperative survival was 45.1 per cent at 2 years and 35.3 per cent at 5 years. Survival was reduced in women and patients aged over 60 years at operation, and in patients whose tumours were at first biopsy moderately or poorly differentiated, classified as stage III or IV at initial presentation or preoperatively, or recurred within 6 months of completing primary treatment.
Precision in measuring shunt length in jejunoileostomy for morbid obesity
Authors: Miskowiak Jerzy , Andersen Bjørn 
Published: March 2007

Abstract
We performed a prospective assessment of intraoperative precision in determination of shunt length in 138 patients. The variations were slight and of the same order of magnitude in the jejunum and ileum. Precision in per cent of measured length was independent of the actual length and of the surgeons who performed the operations. The results indicate that factors other than errors in the measurements are responsible for variations in weight loss after jejunoileostomy.
Ovulation in a cytogenetically proved phenotypically male fertile hermaphrodite
Authors: Parvin Simon D 
Published: March 2007

Abstract
An unusual case of true hermaphroditism is reported. The patient was a 32-year-old phenotypically male true hermaphrodite. Histology of his removed ovary suggested that ovulation had, at some time, occurred. He had also fathered a child and this is believed to be the first case of a cytogenetically proved true hermaphrodite who is fertile as a male.
Experiences with cadaver renal allograft contamination before transplantation
Authors: Spees E K , Light J A , Oakes D D , Reinmuth B 
Published: March 2007

Abstract
Microbial contamination occurred in 23 (13 per cent) of 177 cadaver donor kidneys prior to renal transplantation. In 16 cases there were no complications directly attributable to the organisms recovered from the preservation media. Three patients developed perinephric infections associated with renal artery anastomotic disruption and required emergency transplant nephrectomy. A fourth patient developed renal artery stenosis and a hypogastric artery aneurysm that required correction 6 months later with preservation of renal allograft function. In 3 cases no follow-up information was available. None of the 154 uncontaminated kidneys developed arterial disruption or aneurysm. Candida albicans and Pseudomonas aeruginosa infections were responsible for the nearly disastrous arterial disruptions and possibly the hypogastric arterial aneurysm. These findings demonstrate the importance of bacteriological surveillance of perfusion media to detect nosocomial infection, to guide antibiotic chemotherapy and to direct surgical management of septic complications. In our experience contamination was not necessarily incompatible with long term satisfactory results; however, when complications did occur they were serious. It is likely that the size of the microbial inoculum, the patient's immune competence and the protective effect of antibiotic therapy administered to the donor and recipient affected the eventual outcome.
Duodenoscopic placement of biliary prostheses to relieve malignant obstructive jaundice
Authors: Cotton P B 
Published: March 2007

Abstract
We have been able to place prosthetic tubes in the bile duct at duodenoscopy in 17 of 23 patients with malignant obstructive jaundice. Initial problems with sepsis and tube migration appear to have been overcome by using tubes with double pigtails, and by inserting two tubes simultaneously. Effective palliation of jaundice has been achieved in 10 of the last 12 patients. The technique has potential advantages over the percutaneous transhepatic route, and is now ready for wider evaluation.
Parastomal haemorrhage from an ileal conduit secondary to portal hypertension
Authors: Hollands M J 
Published: March 2007

Abstract
A case of parastomal haemorrhage around an ileal conduit is presented and the literature reviewed. Simple methods of treatment, such as good stoma care, vitamin K, direct pressure and ligation of individual bleeding points, are effective in the short term, and persistence with these methods is advocated rather than major surgery.