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A Marni

Publications and source records attributed to A Marni.

66 records · Page 4Linked to original sources
PubMed1979

[2 cases of substitution of the portal vein with a dacron prosthesis during pancreatectomy for carcinoma of the head of the pancreas].

The Authors report their experience concerning two cases of pancreatic carcinoma in which growth involvement of retropancreatic venous peduncle required the removal of a tract 6 and 8 cm long of the mesenteric-portal axis and its replacement with knitted dacron graft. The first patient died 8 months later due to massive pulmonar and hepatic metastases. The second patient died in the early post-operative course due to septic shock and dacron graft did not show any evidence of lumen obstruction at post-mortem examination. In spite of the lack of controlled clinical trials which provide a well defined method of staging for carcinoma of the pancreas, the authors' experience shows the possibility of extending radical resections also to cases which usually are considered unresectable and in absence of politetrafluoroethylene graft also with the use of interposed knitted dacron graft good results can be achieved.

Aged↗
PubMed1979

Damage to the biliary tract during preservation.

Biliary complications following liver transplantation continue to present major difficulties. Damage to the biliary tract has been reported after preservation of the liver before transplantation. Studies in the rabbit are reported that confirm the extensive biliary autolysis during preservation. This damage is directly related to the presence of bile in the biliary tract and can be reduced by the washout of bile and biliary perfusion.

Animals↗
PubMed1979

Is it really worth re-transplanting patients?

Increasingly patients whose first renal transplant fails are being re-transplanted. A study of patients in one unit was undertaken to assess whether second kidney grafts were as successful as first allografts and whether certain factors determined the outcome of secondary transplants. Second and subsequent grafting can be performed with confidence of a successful outcome provided a careful selection of patients is made. The outcome of subsequent grafts should show no significant difference from the overall results of first renal allografts.

Graft Rejection↗
PubMed1979

Effect of portasystemic shunt on hypersplenism: clinical study in 129 patients with cirrhosis.

The effect of portasystemic shunts on hypersplenism has been evaluated in 129 patients who were operated upon. Correction of hypersplenism was obtained in 79 per cent of patients with shunting procedures without splenectomy and 90 per cent of those with splenectomy. The improvement was significant and lasting. These results confirm the beneficial effect of splenic decompression on hypersplenism after simple portasystemic shunt. On the basis of these data, we feel that a difficult splenectomy can also be avoided in patients who have cirrhosis with striking hypersplenism.

Blood Cell Count↗
PubMedDate not supplied

Alternative use of the interposition Dacron grafts in the treatment of portal hypertension. Clinical experience with 28 cases.

Twenty-eight patients suffering from esophageal bleeding due to portal hypertension were submitted to an "H" type shunt utilizing a 12 mm. wide knitted Dacron prosthesis. The series consists of 8 meso-caval, 12 porto-caval 8 spleno-renal shunts. Thrombosis of the spleno-portal axis was the main indication for the mesocaval shunt, while side-to-side porto-caval and spleno-renal "H" anastomoses were carried out in patients in whom enlarged lymphatics, edema of the porta hepatis or a too large gap between the two veins precluded the use of a direct shunt. The overall mortality rate was 7% including one operative and one late death. The long-term follow-up study included 26 patients and ranged from 6 to 34 months. In all patients patency of the shunt was evaluated by barium swallow x-ray and esophagogastroscopy. Four of them were further investigated by angiography. A good patency of the shunt was demonstrated in all cases. There was no recurrence of the variceal bleeding either in the post-operative period nor in the long-term follow-up. On the basis of our results we feel that the use of Dacron grafts as "H" type shunts is an effective alternative method in relieving portal hypertension in patients in whom it is difficult or impossible to perform a direct anastomosis and further this procedure can be extended with encouraging results to side-to-side spleno-renal shunts.

Adult↗
PubMedDate not supplied

[Arterial stenosis after renal transplantation].

Attention is drawn to the fact that renal transplants are quite commonly complicated by stenosis of the arterial pedicle. The symptomatology (hypertension, oliguria, fever and gradual loss of renal function) points to the need for angiography. In about 70% of cases, surgical management in the light of the nature of the lesion thus visualised will give good results. Stress is laid on the importance of prophylaxis with platelet anti-clumping agents. Pyramidol appears to offer encouraging results in this connection.

Humans↗
PubMedDate not supplied

[Results of autotransplantation of hepatocytes in hepatectomized rats].

With a view of clarifying the mechanism whereby the beneficial effect of hepatocyte transplantation is obtained, an autologous transplant was made of hepatocytes in the peritoneum of a surgical model of acute hepatic insufficiency in the rat, highly reproducible to the detriment of its reversibility. The cells were prepared in accordance with the non-perfusional enzymatic method proposed by Fry. The cell yield from 3 g of liver tissue was 4 X 10(6), with an index of viability of over 70%. There was no difference in survival between the treated animals and the control group, though coma appeared significantly later in the former. The conclusion is therefore drawn that transplantation offers no metabolic support to the anhepatic animal. Further investigation is required of the biochemical and metabolic aspects of the function of the hepatocyte in the light of its induction of a significant delay in the appearance of coma.

Animals↗
PubMedDate not supplied

[Advantages and disadvantages of an experimental model for the study of acute hepatic insufficiency].

At present, there is no ideal model for acute hepatic insufficiency that assists in the understanding of its numerous clinical and metabolic problems. Pharmacological models are reversible but biologically imprecise, whereas surgical models offer a homogeneous biological answer, but are irreversible and only suitable for brief experiments. An assessment is made here of a model in the rat involving complete devascularisation of the liver by portocava anastomosis and ligation of the liver peduncle, and total hepatectomy in a single stage. The following parameters were used to evaluate the experimental usefulness of the model: reproducibility of the response and death due to acute insufficiency after a period long enough to permit the efficacy of support management to be assessed. All the controls survived for indefinite periods after portocava anastomosis, whereas the mean survival of 20 animals subjected to total hepatectomy was 12.05 +/- 5.0 hr), and coma intervened 7.5 +/- 3.3 hr after resection. These results point to the usefulness of the model in studies on the treatment of hepatic insufficiency. It is open to further improvement through alteration of the post-operative glycidic control and reduction of the radicality of liver resection.

Animals↗
PubMedDate not supplied

Extrahepatic portal obstruction: Clinical experience and surgical treatment in 105 patients.

While the whole incidence of portal thrombosis is, in our experience, similar to other literature reports, there is evidence, in the last years, of an increase of idiopathic adult onset and post-cirrhotic versus childhood onset extrahepatic portal obstruction. One hundred five patients, or 24.6% of a 426 total series of patients operated upon for portal hypertension, suffered from an extra-hepatic block (52.4% pre-hepatic, and 47.6 mixed post-cirrhotic obstruction). The total series of patients were classified according to portal involvement degree: 47.6% had portal, 46.7% massive porto-radicular and 5.8% radicular obstruction. Physiopathologic differences were found among patients with acute, recanalized, or recurrent thrombosis. The clinical picture in massive or post-cirrhotic block was generally more severe, due to repeated massive and lifethreating digestive hemorrhages. The width of portal tree involvement proportionally affects the possibility of surgical management, with particular regard to shunting procedures, which, in our experience, seem to be much more effective than disconnecting operations, in avoiding bleeding recurrences and warranting a better long term survival.

Adolescent↗