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Biomedical subjects

A Basoli

Publications and source records attributed to A Basoli.

At least 37 records · Page 2Linked to original sources
PubMed1979

Intrahepatic lithiasis. Study of thirty-six cases and review of the literature.

In 2,700 operations for biliary tract stones, intrahepatic lithiasis (stones located proximal to the confluence of the main hepatic ducts) was discovered in 36 patients (1.3 per cent). The diagnosis of intrahepatic lithiasis was determined only via intraoperative chalangiography in thirty-two cases (88.9 er cent); in 23 per cent of our cases of intrahepatic lithiasis, jaundice was never observed. This confirms that intraoperative cholangiography should be performed routinely in every case of biliary lithiasis. The removal of stones was generally performed by an indirect approach (papillostomy and/or choledochotomy). In 16.7 per cent of our cases, a direct approach was indicated. It is extremely important, after removal of calculi, to assure ample bilioenteric flow. Our surgical approach was therefore based mostly on the caliber of the biliary tract. When the tract was dilated less that 2 cm (in 20 cases), choledochohepaticotomy with papillostomy was most often performed (12 cases, 60 per cent). When the dilatation was more that 2 cm (12 cases), Roux-en-Y hepaticojejunostomy was performed in all. There was no operative mortality, although the long-term follow-up results were poor in 9.6 per cent of the cases.

Adolescent↗
PubMed1975

Roux-en-Y hepaticojejunostomy: a reappraisal of its indications and results.

A critical evaluation is made of 131 patients submitted to choledocho or hepaticojejunostomy. The main indications for hepaticojejunostomy were iatrogenic strictures of CBD (60 patients), and choledocholithiasis with markedly dilated duct (41 patients). The overall mortality rate was 4% representing principally renal hepatic failure, bile peritonitis and bleeding. The complications following hepaticojejunostomy included only in one case biliary fistula which required reoperation. The long-term results of 80 patients available for a followup study were as follows: 63 patients (78.7%) were symptom-free at 2-13 years followup; 8 patients had brief episodes of cholangitis which responded to antibiotic and corticosteroid treatment; 9 patients required reoperation for stricture of anastomosis. These overall results are a strong argument for hepaticojejunostomy which, compared with choledochoduodenostomy, avoids the hazards of the so-called sump syndrome and of the reflux of enteric contents in the CBD. An increased incidence of peptic ulcer disease in the patients submitted to hepaticojejunostomy was not observed. In very high strictures and in reinterventions anastomosis between left hepatic duct and Roux-en-Y jejunal limb was carried out. The results achieved with this technique, which was performed in 26 patients, were about the same following hepaticojejunostomy.

Adult↗
PubMed1975

Spontaneous internal biliary fistulas.

Etiology, diagnostic investigations and surgical procedures on 58 patients with spontaneous internal biliary fistulas are reported. Cholelithiasis and peptic ulcer were found to be the presumptive cause of fistula respectively in 53 and five patients. Preoperative diagnosis was established on 31 patients while in the remaining 27 fistula was found incidentally at surgery. Surgical treatment included a wide variety of operations which were performed on the basis of the pathologic features of fistula. Over all mortality rate was 5 percent and morbidity 13 percent. The unsatisfactory results of the surgical treatment of internal biliary fistulas are another strong argument for performing early cholecystectomy in all the patients with cholelithiasis.

Adult↗
PubMed1974

Hypoglycemia and insular hyperplasia: review of 148 cases.

On the bases of personal experience and the series of 148 cases from an international inquiry and a review of the literature, the relation between insular hyperplasia and hypoglycemia was examined. The fundamental points in this investigation included: age, diagnostic investigations, histological findings and postoperative results. The data on the patients with insular hyperplasia indicates that 83% were of adult age. Insular hyperplasia was the only abnormal factor determined to be present. Through treatment a high percentage of cases (71%) was cured. From a practical surgical point of view, differentiation between occult insulomas and insular hyperplasia is not critical. Consequently, good results can be achieved in botlh diseases by practicing a progressive blind resection guided by examination of the operated specimen and by intra-operative blood sugar levels.

Adenoma, Islet Cell↗
PubMedDate not supplied

Primary sclerosing cholangitis: an analysis of 37 retrospective cases.

The clinical and laboratory findings of 37 patients with primary sclerosing cholangitis (PSC) were reviewed. Mean age was 43.8 years, sex ratio between males and females was 3:1; IBD was present in 91% of patients with 51% having ulcerative colitis, 23% unclassified colitis and 17% Crohn's disease. Twenty-seven patients (73%) were symptomatic presenting most commonly with fatigue, pruritus and hepato-splenomegaly. Cholangiography revealed abnormalities affecting both extrahepatic and intrahepatic biliary ductal systems in 51.8% of cases, and only the intrahepatic or extrahepatic biliary tree, respectively in 11.1% and in 37% of cases. The last prevalence was very high compared with that previously known. Clinical and biochemical data, when compared between asymptomatics and symptomatics, demonstrated a significant difference only for alkaline phosphatase which increased in the symptomatic group and for prothrombin activity which decreased among symptomatic patients. Nevertheless, predictive value of sALP for the presence of PSC was high when pts were pooled together with a randomly selected group of 36 non-affected persons that underwent ERCP for suspected primary sclerosing cholangitis: sensitivity was 94% and specificity 78%.

Adult↗
PubMedDate not supplied

[Intrahepatic lithiasis. Apropos of 36 cases of "regional" intraheptic lithiasis].

Out of 2,700 operations for cholelithiasis and its sequelae (1960-1976), 36 cases (1.3%) of intrahepatic lithiasis (i.l.), namely proximal to the origin of the common hepatic, were observed. The prime objective of treatment namely removal of calculi, was achieved indirectly (hepatocholedochus and/or papilla) in 84% of cases, directly (hilar) in 16%. The second objective, that of ensuring optimal bilio-enteric drainage, was achieved by papillostomy or hepaticojejunostomy depending on the lumen of the bile way (respectively less or more than 2 cm.). Operative mortality was nil, while long-term results have proved poor in 9.6% of cases. The i.l. problematic is dealt with in detail on the basis of this series.

Adolescent↗