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Biomedical subjects

A Csendes

Publications and source records attributed to A Csendes.

At least 109 records · Page 6Linked to original sources
PubMed1989

Late subjective and objective evaluations of antireflux surgery in patients with reflux esophagitis: analysis of 215 patients.

The results of late subjective and objective evaluations of antireflux surgery in 215 patients with reflux esophagitis who were included in a prospective, controlled study are reported. A special protocol--including analysis of reflux symptoms, radiology, endoscopy, esophageal manometry, and standard acid reflux test--was designed. The surgical technique used was as follows: (1) highly selective vagotomy, (2) closure of the hiatus, (3) calibration of the cardia, (4) posterior gastropexy, and (5) fixation of the gastric fundus to the diaphragm. The operative mortality rate was 0.4%, and postoperative complications occurred in 5% of the patients. Only 5% of the patients were lost from the late follow-up. A total of 150 patients with more than 5 years since operation were completely evaluated. Reflux symptoms greatly decreased after surgery. Radiologic studies were normal in 93% of the patients, and endoscopy showed a long-standing healing of macroscopic esophagitis in 83% of the cases. Manometric features were analyzed in 159 patients before and in 115 patients 1 year after surgery. A significant increase in lower esophageal sphincter pressure was demonstrated, as well as an increase in the total length and abdominal length of this sphincter (p less than 0.0001). The increase in gastroesophageal sphincter was evaluated in 46 patients 1 year and 5 years after surgery, and this showed a maintenance of sphincter competence. Esophageal clearance markedly improved after surgery, and the standard acid reflux test, which was positive in 100% of cases before surgery, persisted positive in 16% (p less than 0.001). Final clinical evaluation 5 years after surgery demonstrated excellent and good results in 85% of the patients and failure or reoperation in 8% of the patients.

Adolescent↗
PubMed1989

Late results of immediate primary end to end repair in accidental section of the common bile duct.

The late results of 43 patients with accidental section of the common bile duct are presented. Injuries located high at the hepatic duct were three times more frequent than those located more distally. A complete section occurred in 36 while incomplete section was observed in seven patients. The final results of end to end repair revealed good late results in eight while 29 had a benign stricture four years postoperatively.

Adolescent↗
PubMed1988

Common bile duct pressure in patients with common bile duct stones with or without acute suppurative cholangitis.

Resting common bile duct pressure was measured in three groups of patients: group 1, 53 patients with gallstones but without common duct stones; group 2, 35 patients with common bile duct stones unaccompanied by cholangitis; and group 3, 36 patients with common duct stones and acute suppurative cholangitis. A significantly higher pressure in the common bile duct was documented in patients with cholangitis when compared with the other two groups. Twenty-four patients with cholangitis had common duct pressure values above 20 cm H2O, the maximal values of normal. Additionally, patients with cholangitis with pressure values over 30 cm H2O (nine patients) showed absence of green bile in the extrahepatic biliary tract, suggesting cessation of bile excretion into biliary duct. In all these cases, an impacted stone at the distal end of the common bile duct was documented.

Acute Disease↗
PubMed1988

A prospective, randomized study comparing highly selective vagotomy and extended highly selective vagotomy in patients with duodenal ulcer.

The recurrence rate of duodenal ulcer after highly selective vagotomy is nearly 10 percent. To diminish this percentage, extended highly selective vagotomy with sectioning the gastroepiploic nerves has been proposed in order to reduce postoperative gastric acid secretion. We have prospectively compared the decrease in gastric acid secretion through measurement of basal acid output, maximal acid output, and peak acid output in patients who underwent highly selective vagotomy or extended highly selective vagotomy. No significant differences in postoperative gastric acid secretion were found and, therefore, no changes in the probability of postoperative recurrence of duodenal ulcer were seen.

Adolescent↗
PubMed1988

Triglyceride and cholesterol content in bile, blood, and gallbladder wall.

Cholesterol gallstone disease is frequent in Chile compared with other countries, as is cholesterolosis of the gallbladder. The purpose of this study was to determine any differences in bile composition and cholesterol content in the gallbladder wall and serum of patients compared with findings in patients with gallstones and control subjects. In control subjects, cholesterol content of the gallbladder wall was determined in autopsy material. Patients with cholesterolosis had bile composition similar to that of patients with gallstones, with supersaturation of cholesterol in the bile. Also, these patients had increased levels of cholesterol in the gallbladder wall but normal serum cholesterol levels. These findings suggest that altered bile composition occurs in patients with cholesterolosis and gallstones.

Adult↗
PubMed1988

Anomalies of extrahepatic biliary duct and gallbladder associated with intestinal malrotation: a case report.

Knowledge of congenital anomalies in abdominal viscera is important for surgeons, if they are to treat such patients and solve their problems adequately. This article presents an unusual case of reversed rotation of the intestine associated with anomalies in the biliary tract and gallbladder. This patient underwent surgery because of a bleeding duodenal ulcer. During surgery the following viscera positions were detected: the gallbladder was located to the left of the round ligament, the choledochus was in front of the first portion of the duodenum, the small intestine was in the left portion of the abdomen, and the colon was exclusively at the right side of the abdomen. This reversed rotation is a rare condition, only occasionally reported in the literature. However, the simultaneous association with anomalies in the gallbladder position (in the left lobe) and the biliary tract (the choledochus located in front of the duodenum) makes this a case unlike any other described in the medical literature.

Adult↗
PubMed1988

Late subjective and objective evaluation of the results of esophagomyotomy in 100 patients with achalasia of the esophagus.

One hundred patients with achalasia of the esophagus were analyzed at a late follow-up by means of subjective and objective parameters. The surgical technique consisted of an anterior esophagomyotomy (6 cm long, not extending into the stomach more than 5 to 10 mm) with the addition of an anterior hemi-Nissen or Dor procedure, similar to the Thal serosal patch. No operative deaths occurred. The mean follow-up was 6.8 years, and only 1 patient was lost from this follow-up. Preoperative dysphagia, which was present in 100% of the patients, persisted only occasionally in 8%, and a significant gain in weight was recorded in 90% of the patients. In three patients epidermoid carcinoma developed 5 to 9 years after surgery. In one patient a severe gastroesophageal reflux with an esophageal ulcer developed. Radiologic studies demonstrated a significant increase in the diameter at the gastroesophageal junction and a decrease at the middle third of the esophagus (p less than 0.0001). The resting pressure of the lower esophageal sphincter showed a significant decrease, from 37 mm Hg to 10 mm Hg, after surgery (p less than 0.0001), when we analyzed 84 patients before and 68 patients after operation. The total length of this sphincter also decreased. The manometric evaluation of the lower esophageal sphincter pressure in the same 42 patients before, 2 months after, and 5 to 7 years after surgery demonstrated persistence of the low sphincter pressure. There was a significant increase in the amplitude of the esophageal waves, and the standard acid-reflux test demonstrated reflux into the esophagus in 19% of the patients. Final clinical evaluation showed excellent and good results in 92 of the 94 controlled patients.

Adult↗
PubMed1987

A prospective study of intraoperative histologic antrum and corpus boundary in patients undergoing highly selective vagotomy for duodenal ulcer.

The results of the present study demonstrate that, at the level of the proximal branch of Crow's foot of Latarjet, parietal cells are found, and therefore, it must be sectioned when performing highly selective vagotomy. At the level of the distal branch, antral mucosa is found. At the level of the middle branch, in almost one-half of the instances, parietal cells are found, and its section must be evaluated with gastric emptying studies.

Adult↗
PubMed1987

Type IV gastric ulcer: a new hypothesis.

In 1965 Johnson proposed his classification for gastric ulcer, which was subsequently adopted by the majority of surgeons. However, for many years we have observed the high frequency of subcardial or juxtacardial ulcers near the esophagogastric junction, which has not been reported elsewhere. In this article we describe the characteristics of this type of gastric ulcer and propose to designate it as a type IV gastric ulcer. This nomenclature is based on its clinical and pathophysiologic features. The anatomically "high" gastric ulcer has an incidence of 27.4%; its main features include a frequent association with the type O blood group; a low basal and stimulated acid output, a high incidence of upper gastrointestinal bleeding, a slower emptying of fluids, and a high percentage of deep penetrating ulcer.

Blood Group Antigens↗