bluuebunny/crossref_metadata_2025_split huggingface dataset:
Esophageal carcinoma: Patient selection for transhiatal esophagectomy. A prospective analysis of 50 consecutive cases
Authors: Barbier Peter A. , Becker Christoph D. , Wagner Hans E. 
Published: May 2005

AbstractFifty patients underwent transhiatal esophagectomy (THE) without thoracotomy with gastric interposition for esophageal carcinoma. Resection was considered curative in 15 patients with stage I or II, and palliative in 35 patients classified as stage III or IV. Postoperative morbidity was 42%. The frequency of complications was significantly higher following palliative surgery than after curative surgery. The mortality rate was 2%. On the basis of the clinical, diagnostic, surgical, and histologic data for all patients, criteria for patient selection are defined. Patients with tumors of the pretreatment T3 category and those with systemic metastases were excluded from the study. Differentiation between the pretreatment T1 and T2 categories was without importance in determining the suitability for THE.In advanced tumors of the upper thoracic esophagus, involvement of the tracheobronchial system may preclude complete removal of the tumor. Sharp dissection, which is often required in these cases, increases the risk of THE. Because such involvement can be recognized accurately on computed tomographic (CT) examination of the mediastinum, tumors of the upper thoracic esophagus should only be treated by THE if there are no signs of involvement of the tracheobronchial system on preoperative CT.Respiratory impairment rarely constitutes a contraindication, and THE is well tolerated even by geriatric patients. THE is a safe procedure for both curative and palliative resection of esophageal carcinoma provided that candidates for this operation are selected properly.
Increased ulcer relapse rate after PCV in smokers
Authors: Graffner Hans , Lindell Gert 
Published: May 2005

AbstractThere is epidemiological evidence of an association between cigarette smoking and peptic ulcer disease. Patients who are smokers and treated with H2‐receptor antagonists have a higher recurrence rate than equally treated nonsmokers. To study whether this is also a fact among surgically treated patients, we investigated 306 patients operated on with parietal cell vagotomy (PCV) from 1971 to 1980. Sixty‐two percent were cigarette smokers and among these, 16% were female compared to 33% in the nonsmoking group (p<0.01). An ulcer recurrence rate of 24% was found among smokers with a primarily duodenal ulcer disease compared to 7% in nonsmokers (p<0.01). In the group of patients with pyloric/prepyloric ulcer disease, a 34% ulcer recurrence rate was reported in the smoking group compared to a 5% ulcer recurrence rate among nonsmokers (p<0.01). Before surgery, basal and pentagastrin‐stimulated acid output were significantly higher in the smoking group, but, postoperatively, no significant differences were seen. This implies that factors other than gastric acid secretion must be the cause of the higher ulcer recurrence rate in smokers.
Hepatic hemobilia of traumatic or iatrogenic origin: Recent advances in diagnosis and therapy, review of the literature from 1976 to 1981
Authors: Curet Philippe , Baumer Richard , Roche Alain , Grellet Jacques , Mercadier Maurice 
Published: May 2005

AbstractA rare lesion, macroscopic hemobilia involving the liver, is usually of traumatic or iatrogenic origin. A review of the international literature published between 1976 and 1981 demonstrated 73 such cases, including 50 of an iatrogenic nature. Among the diagnostic investigations employed, duodenal fibroscopy gave negative results in 50% of cases. Ultrasonography and computed tomography are now replacing scintigraphy with99mtechnetium as a diagnostic procedure for intrahepatic fluid collections. The most reliable method is arteriography, this alone providing both diagnostic and topographic data. The fact that treatment by endovascular route was successful in 24 of the 28 patients suggests that the need for surgery requires reconsideration, particularly in cases of iatrogenic origin.
Hepatolithiasis: Present status
Authors: Nakayama Fumio , Koga Akitoshi 
Published: May 2005

AbstractIn contrast to ordinary cholesterol cholelithiasis, hepatolithiasis or intrahepatic calculi pose serious health problems not only in Japan but also in China, Taiwan, Korea, the Philippines, Malaya, Singapore, and Indonesia. Soft brown calcium bilirubinate stones are present in the grossly dilated intrahepatic bile duct distal to a stricture. Liver lobes involved become fibrous and contain large cysts filled with stones. The classification of hepatolithiasis based on prevailing pathological findings is presented. Two main factors, bile stasis and bacterial infection, are thought to be responsible for the formation of intrahepatic calculi (calcium bilirubinate stones). Β‐glucuronidase from bacteria such asEscherichia colipresent in intrahepatic ducts hydrolyzes bilirubin diglucuronide to bilirubin. The bilirubin combines with the calcium in bile to form calcium bilirubinate which leads to the formation of intrahepatic calculi. The presence of bile stasis, due to bile stricture, aids growth of intrahepatic calculi and aggravates bacterial infection in situ. The clinical picture and the diagnosis and treatment of hepatolithiasis are discussed with emphasis on the recently introduced diagnostic imaging techniques of the hepatobiliary system. Also the principle and practice of operative procedures employed by hepatolithiasis are presented.
Strictures of the intrahepatic bile ducts
Authors: Mercadier M. , Fingerhut A. 
Published: May 2005

AbstractStrictures of the intrahepatic bile ducts are rare. Frequently, the condition passes unrecognized by both the internist and the surgeon, and is too often discovered only at autopsy. The strictures are related either to an inflammatory process, which is rare, or to a tumor which is more common. Benign or malignant stenosis may involve an intraparenchymatous hepatic duct or one of its segmental afferents. It results in proximal stasis, infection, lithiasis, and biliary cirrhosis. In fact, the prognosis and treatment of the lesion are dominated by the inflammatory or malignant origin of the stricture.
Papillomatosis of the intrahepatic bile ducts
Authors: Mercadier M. , Bodard M. , Fingerhut A. , Chigot J. P. 
Published: May 2005

AbstractIntrahepatic biliary papillomatosis is most often the initial stage of diffuse biliary papillomatosis. Without any specific clinical expression, the disease may mimic the symptomatology of biliary lithiasis. It is usually discovered either during surgery or postoperatively by the presence of mucus discharge via the drainage system of the biliary tract. Its course is unfavorable because of its tendency to extend to the entire biliary tree and even to the pancreatic ductal system. Papillomatosis may degenerate, as recent publications have shown. Numerous therapeutic approaches have been proposed, including transcanalicular extraction, drainage, and hepatic excision. Most often, these measures are only palliative because of the unrelenting extensive character of the disease. Prognosis is bleak. Perhaps some hope may be provided by hepatic transplantation.
Hepatic hemobilia: Hemorrhage from the intrahepatic biliary tract, a review
Authors: Sandblom Philip , Saegesser Frédéric , Mirkovitch Velimir 
Published: May 2005

AbstractHepatic hemobilia is defined as hemorrhage arising from pathological changes in the intrahepatic biliary tract. The main causes are iatrogenic trauma, cholangitis, tumors, and coagulopathy. The salient features of the hemobilia syndrome are described and their causes explained. The treatment, when necessitated by hemorrhage or clot formation, is either resection of the liver or occlusion of the responsible artery by ligature or embolization. The iatrogenic trauma may be operative, resulting from instrumental lesion of the bile ducts, needle biopsy, transhepatic cholangiography, biliary tract prosthesis, or inlaying hepatic artery catheters. Among the inflammatory etiologies, special attention is given to nematodes in the ducts, “the tropical hemobilia.” Spontaneous hemobilia may, just as nose bleeds or hematuria, result from treatment with anticoagulants.
Liver transplantation for biliary atresia
Authors: Iwatsuki Shunzaburo , Shaw Byers W. , Starzl Thomas E. 
Published: May 2005

AbstractOrthotopic liver transplantation was performed 15 months to 20 years ago in 126 recipients, all of whom were under 18 years of age. Eighty‐six of these pediatric recipients were treated before 1980 with azathioprine (or eyclophosphamide) and prednisone, to which antilymphocyte globulin (ALG) usually was added. One‐year patient survival was 40%. In the last 40 cases, the new drug cyclosporine has been given with low doses of steroids. The one‐year patient survival increased to 65%. Both in the pre‐cyclosporine era and more recently, the survival of patients with biliary atresia has been lower than in the next largest category of patients, namely, those with liver‐based inborn metabolic errors. The difficulty of operation in patients with biliary atresia has been greater than in recipients with other diagnoses, partly because of previous operations such as portoenterostomy (Kasai procedure). Hepatic portoenterostomy, worthwhile as it is, has posed technical difficulties for eventual liver transplantation, particularly when complicated Roux limb techniques or venting procedures have been applied. In our total experience the longest survival after liver replacement in a child whose original diagnosis was biliary atresia is 132/3 years.
Hepatic transplantation and biliary atresia: Early experience in eight patients
Authors: Ascher Nancy L. , Najarian John S. 
Published: May 2005

AbstractRecent improved results have raised interest in hepatic transplantation. Transplantation experience in patients with biliary atresia at the University of Minnesota is reported. These patients are frequently first seen when very small; rigorous metabolic support is used to optimize hepatic function and enhance weight gain while a donor is found. Preoperative exchange transfusion is performed as dictated by coagulation parameters; this minimizes operative blood loss. The operative procedure is performed as described by Starzl using a cholecystojejunostomy and aorto‐aortic anastomosis. Immunosuppression is achieved with cyclosporine and low‐dose prednisone. Weekly percutaneous biopsies provide an early indication of rejection which occurs frequently in these patients. Rejection is treated with bolus steroids and/or antilymphoblast globulin. Five of eight children with biliary atresia have returned to health after liver transplantation. Two deaths were related to difficulties with the donor hepatectomy and the last child died after erosion of a central venous catheter with cardiac tamponade. In this small series, early success after liver transplantation (>24 hours), predicted longterm survival.
Arterial surgery in Scandinavia
Authors: Bergqvist David , Myhre Hans O. 
Published: May 2005

AbstractWith help of a questionnaire with a 96% response rate, the exact number of arterial operations in Scandinavia has been established. In Sweden in 1980 it was 470 per million inhabitants and in Norway in 1981 it was 553 per million inhabitants, but regional differences within the countries were great. In only 14% of the hospitals were more than 100 arterial operations performed per year. The development of arterial surgery during a 10‐year period in the cities of Malmö and Oslo, with active vascular centers, is also given. The increase in the two cities is similar and above 300%. Percutaneous transluminal angioplasty comprised 11% of the total number of arterial interventions in 1981.
Repair of bile duct injuries
Authors: Saber Khairy , El‐Manialawi M. 
Published: May 2005

AbstractTwenty‐two patients with surgical injury to the common hepatic duct or common bile duct were evaluated. In 20 patients the injury occurred during cholecystectomy and resulted from mistaken identification of the common duct for the cystic duct. Roux‐en‐Y hepaticojejunostomy was performed in 21 patients. Three of the anastomoses were end‐to‐side, while 18 were side‐to‐side. Choledochoduodenostomy was performed in 1 patient.There were no operative deaths in the 22 patients. Four (18%) patients developed wound infections and in 2 (9%) patients there was a transient bile leak. Two patients died of liver failure due to irreversible biliary cirrhosis 2 and 3 years after the initial injury. All patients in whom side‐to‐side Roux‐en‐Y hepaticojejunostomy was performed as a first procedure (14 cases) had a successful long‐term result with no signs of cholangitis or anastomotic stenosis. The 3 patients with end‐to‐side hepaticojejunostomy developed anastomotic stricture with repeated attacks of cholangitis and required secondary operations. The patient treated by choledochoduodenostomy had a satisfactory result. Patients with iatrogenic bile duct injury can be managed with a high degree of success if referred early and treated appropriately.
Quality of life with the continent ileostomy
Authors: McLeod Robin S. , Fazio Victor W. 
Published: May 2005

AbstractA survey of 71 patients with continent ileostomies was undertaken to determine their life‐style. Comparison of life‐style in patients with a conventional ileostomy compared to those with a continent ileostomy was possible because 40 of the 71 patients previously had conventional ileostomies. Approximately 50% of them had been restricted in work, hobbies, and travel, and 90% were restricted in clothing selection and athletic activities. About 10% of the patients with continent ileostomies experienced limitations in one of these parameters. With either ileostomy, dietary restrictions were encountered by 54%. The mean cost of supplies was $200 with the continent ileostomy compared with $475 with the conventional ileostomy. Following conversion from a conventional to a continent ileostomy, 68% of the patients noted an improved sex life and 80% noted an improved body image. All would choose retrospectively to have a continent ileostomy and 96% found the result to be as good as or better than their preoperative expectations. If complications were to arise, 97% of patients would undergo revisional surgery rather than have removal of the continent ileostomy. We conclude that patient satisfaction with the continent ileostomy is high. Fewer limitations are encountered with the continent ileostomy than with the conventional ileostomy.
A clinical evaluation of radiation‐induced hyperparathyroidism based on 148 surgically treated patients
Authors: Hedman Ingmar , Hansson Göran , Lundberg Len‐Marie , Tisell Lars‐Erik 
Published: May 2005

AbstractDuring a 29‐year period ending in 1981, there were 839 patients treated surgically for hyperparathyroidism (HPT). One hundred and forty‐eight (17.6%) of these patients had a history of previous radiation to the neck region. Latency time between irradiation and diagnosis was inversely correlated to age at irradiation and showed a mean of 35 years. Hyperparathyroidism (HPT) following neck radiotherapy (r‐HPT) had the same clinical presentation as spontaneous primary HPT (p‐HPT); however, the r‐HPT patients traced by follow‐up had milder disease. In patients with r‐HPT or p‐HPT, kidney stones were more common in men, while mental and skeletal changes were more common in women. The percentage distribution of adenoma and chief‐cell hyperplasia did not differ between the two groups. There were no cases of water clear‐cell hyperplasia or parathyroid carcinoma among r‐HPT patients. Location of a parathyroid adenoma in an upper gland was significantly more common (p<0.001) in patients with r‐HPT compared to patients with p‐HPT. This distribution of adenomas could be correlated with the radiation treatment field. Concomitant thyroid abnormalities were diagnosed in 84% of patients with r‐HPT and in 49% of patients with p‐HPT. Thyroid carcinoma occurred 9 times more often in r‐HPT patients strengthening the indication for surgery in irradiated subjects.
The Dardik biograft in reconstructive arterial surgery: Report on a five‐year experience in 94 cases
Authors: Raithel Dieter , Schweiger Hans 
Published: May 2005

AbstractSince March 1977, there have been 94 peripheral vascular reconstructions performed using the Dardik biograft, i.e., the glutaraldehyde‐tanned human umbilical vein. The indication for operation was limb salvage in 88.3%. In 74.5% only one or no crural vessels was patent. In 50 patients previous bypass grafting had failed. The distal anastomosis was placed below the knee in 91.5%, and in 53.2% a tibial or peroneal revascularization was performed. The accumulated graft patency rate at 5 years was 47.4%. Poor results were obtained when the umbilical vein was combined with other graft materials. It is concluded that the human umbilical vein cord is the graft of choice in below‐knee reconstructions when the autogenous saphenous vein is not available.
What is new in Sweden? Changing pattern of general surgery
Authors: Bergentz Sven‐Erik 
Published: May 2005

AbstractThe results of recent studies on the development of general and vascular surgery in Sweden have been analyzed. Among the findings were the following:
There was a marked decrease in the number of cholecystectomies performed. Related findings seem to indicate a decline in the incidence of gallstone disease.
A slight but continuous decrease in the number of appendectomies performed has occurred over the last decade.
There was a decrease in the number of gastric resections performed for gastroduodenal ulcer since 1970 and a considerable total decrease in the number of surgical interventions for this disease since 1977.
Arterial reconstructive surgery has increased considerably during the last decade.
The decline in the number of surgical procedures being performed concomitant with an increase in the number of surgeons may have significant impact on departments of surgery throughout Sweden in the near future.
Malignant jaundice: Results of diagnostic and therapeutic endoscopy
Authors: Soehendra N. , Grimm H. , Berger B. , Nam V. C. 
Published: May 2005

AbstractDirect cholangiography plays an important role in the diagnosis of malignant obstructive jaundice. Endoscopic retrograde cholangiopancreatography is gradually gaining ground over percutaneous transhepatic cholangiography. Endoscopy can determine the exact location and extent of the obstruction. Typical changes of the ducts are often helpful in interpreting the causes of obstructive jaundice. Representation of the bile and pancreatic duct systems is successful in 95% of cases in the hands of an expert. Acute pancreatitis is a complication occurring in about 1% of cases. Immediate drainage can usually prevent septic complications. Endoscopic drainage is a palliative measure for inoperable patients. Compared to biliodigestive anastomoses, catheters are subject to clogging in the lessrisky, nonsurgical method. Blockage causes late cholangitis which can only be recognized and remedied by regular aftercare of the patient. Endoscopic placement of the prosthesis has an 85% rate of success. The rate of complications related to the procedure is 2%. The mortality rate is 1%.
Biliary concrements: The endoscopic approach
Authors: Rosseland Arne R. , Osnes Magne 
Published: May 2005

AbstractSince 1970, endoscopic retrograde cholangiopancreaticography (ERCP) has received much attention as a diagnostic method in pancreaticobiliary disease. The information given by ERCP is of great value in the management of patients with symptoms after biliary tract surgery and especially in patients with suspected obstructive jaundice. In patients with symptoms highly suggestive of cholelithiasis, ERCP examination should be considered for definitive diagnosis despite a negative oral cholecystogram and ultrasound finding.Endoscopic papillotomy is a major advance in the treatment of many elderly and high‐risk patients with common bile duct stones. It should replace surgery in most of these patients with retained or recurrent stones and appears justified in many patients who have not yet undergone cholecystectomy, either in the hope of avoiding biliary surgery altogether or to defuse an acute clinical situation. The rule of endoscopic treatment in the young and fit has yet to be established.
Emergency colonoscopy
Authors: Rossini Francesco Paolo , Ferrari Arnaldo , Spandre Mauro , Cavallero Mariella , Gemme Carlo , Loverci Carlo , Bertone Alberto , Pintor Marco Pinna 
Published: May 2005

AbstractDifferent diagnostic techniques for massive active lower gastrointestinal hemorrhage are reviewed. According to data in the literature and personal experience in 409 emergency endoscopic examinations of the large bowel, emergency colonoscopy is a valuable diagnostic tool in cases of massive colorectal bleeding.
Teaching surgical endoscopy of the gastrointestinal tract
Authors: Dent Thomas L. , Kukora John S. , Leibrandt Thomas J. 
Published: May 2005

AbstractSurgical endoscopy, or the utilization of endoscopic techniques in the diagnosis and treatment of surgical disease, is an integral part of the practice of modern gastrointestinal surgery and the training of surgical residents. In addition to information crucial to preoperative evaluation and postoperative surveillance, endoscopy offers alternative therapeutic and complementary intraoperative options.Surgical endoscopy can be taught as part of an integrated residency experience, a separate endoscopy rotation, a postresidency fellowship, or an individually‐arranged preceptorship. Each method of teaching has relative advantages and disadvantages. The 3 surgical endoscopy training programs with which the authors have been associated include an integrated experience, a separate endoscopy rotation followed by an integrated experience, and a preceptorship followed by an integrated experience.
A clinicopathological study of gastric cancer with special reference to age of the patients: An analysis of 1,630 cases
Authors: Mitsudomi Tetsuya , Matsusaka Toshimitsu , Wakasugi Kenzo , Takenaka Masaharu , Kume Kazuhiro , Fujinaga Yutaka , Teraoka Hiroaki , Iwashita Akinori 
Published: May 2005

AbstractA series of 1,630 patients with gastric cancer was reviewed with special reference to their ages. The overall resectability rate was 84.6%. With increasing age, there was also an increase in: the male‐to‐female ratio, the frequency of tumors located in the distal third of the stomach, and the degree of differentiation of the carcinoma (p<0.01). There was no age‐related association to: tumor size, early gastric cancer of 30–40%, macroscopic classification, histological staging, or symptomatology. The 5‐year survival rates did not differ significantly among the various age groups. From 1980 to 1984, clinical characteristics were evaluated in 58 patients under 40 years of age and in 39 patients 80 years of age and older. Preexisting medical illnesses and postoperative complications were more frequent in the aged group; however, there were no operative deaths in either group. In conclusion, although there are several distinct properties depending on the age of the patients, very elderly as well as young patients can be successfully treated.