Biomedical subjects

B Stimec

Publications and source records attributed to B Stimec.

24 records · Page 2Linked to original sources

PubMedDate not supplied

[Overview of the surgical importance of variations in the hepatic artery].

Hepatobiliary and gastric surgery greatly depend upon knowledge and recognition of origin, relations and course of the hepatic artery. This paper presents the main variants of the arterial vessels in the hepatoduodenal ligament, with a concise review on their clinical relevance. Special attention was drawn to the aberrant hepatic arteries, which are found in nearly half of the cases, and to the macro- and microvasculature of the common bile duct.

Digestive System Surgical Procedures↗

PubMedDate not supplied

[Laparoscopy in gynecologic oncology].

Using technological progress, laparoscopic lymphadenectomy is becoming a standard for staging of pelvic cancer. In the same way more extensive procedures such as para-aortic lymph nodes dissection and radical hysterectomy have been demonstrated to be feasible by laparoscopy. In the future, because of its well known advantages, laparoscopic surgery may appear as a way to decrease the consequences of oncologic treatments in patients with low risk tumors and to propose more aggressive treatments of patients with bad prognosis tumors.

Female↗

PubMedDate not supplied

[Anatomic and surgical aspects of intrahepatic segmentation].

This article presents anatomical and surgical patterns of hepatovenous and portal segmentation in the human liver. Special attention was drawn to the significance of portal fissures, their projections and surgical approach to large blood vessels. The anatomical variations of hepatic veins and the constituents of the portal triad (with particular surgical importance) were also included. Finally, the study gives a brief description of the perivascular fibrous capsule morphology and its relations to the portal bifurcation.

Bile Ducts, Intrahepatic↗

PubMedDate not supplied

Endoscopic manometry of the sphincter of Oddi in sphincterotomized patients.

BACKGROUND/AIM: Endoscopic sphincterotomy (ES) of the sphincter of Oddi (SO) has been accepted as an effective method in extraction of common bile duct stones in postcholecystectomy patients. The purpose of this study was to examine the completeness of the performed ES and observe the post sphincterotomy pancreatic duct sphincter (PDS) activity using endoscopic manometry. MATERIALS AND METHODS: Activity of the sphincter of Oddi was examined in 15 sphincterotomized patients using endoscopic manometry one to 2.5 years after endoscopic sphincterotomy for choledocholithiasis. RESULTS: In eight patients absence of choledochoduodenal gradient, baseline pressure and the sphincter of Oddi phasic activity up to 2.5 years after endoscopic sphincterotomy indicated a complete sphincterotomy. In seven patients with incomplete endoscopic sphincterotomy, manometry exhibited either a lower choledochoduodenal gradient and baseline pressure without phasic activity of the sphincter of Oddi (three patients), a sphincter of Oddi activity without choledochoduodenal gradient (one patient), or a complete restitution of the sphincter of Oddi activity 1 to 2 years after endoscopic sphincterotomy (three patients). In five patients, with complete endoscopic sphincterotomy, measurements of pancreatic sphincter activity showed lower values of the pancreatic ductal pressure and baseline pressure, while the pancreatic sphincter phasic activity was equal to that found in the control group. CONCLUSIONS: Endoscopic manometry is method which enables us to test the completeness of endoscopic sphincterotomy and to follow the restitution of the phasic contractile function of the sphincter. Manometric findings reveal pancreatic sphincter in most patients as a separate sphincteric entity, the function of which is reduced but not eliminated by a complete endoscopic sphincterotomy.

Adult↗

PubMedDate not supplied

Ductal morphometry of ventral pancreas in pancreas divisum. Comparison between clinical and anatomical results.

Aim of the investigation is to precisely study the morphological features of ventral pancreas ductography in pancreas divisum, in order to improve the radiological interpretation and differential diagnosis of this frequent pancreatic anomaly. The clinical part of the study was based on 610 endoscopic retrograde pancreatograms, with pancreas divisum diagnosed in 14 (2.3%) cases; while the anatomical part consisted of 203 postmortem pancreatograms of human pancreas obtained at autopsy, where pancreas divisum was found in 12 (5.9%) cases. The following ductal features of the ventral pancreas were studied: length and calibre of the main duct, number of side branches, calibre of the common bile duct and the biliopancreatic junction angle. No significant differences were detected between the results from the 2 groups, with the exception of side branches, which were more numerous in the anatomical series, probably because of higher injection pressure and consequent better opacification. These results underline the potential of the anatomical pancreatography serving as a model for studying the ductal system of pancreas divisum.

Cholangiopancreatography, Endoscopic Retrograde↗

PubMedDate not supplied

Endoscopic biliary manometry in cholecystectomized patients with and without choledocholithiasis.

BACKGROUND/AIMS: Direct study of the function of the sphincter of Oddi became possible recently with the advent of endoscopic manometry. A dysfunction of the bilio-pancreatic sphincter apparatus has been implicated in some bilio-pancreatic disorders. The purpose of this study was to examine the relation between dysfunction of the sphincter of Oddi and the formation of common bile duct stones. METHODOLOGY: Endoscopic biliary manometry was performed on 45 cholecystectomized patients. Endoscopic retrograde cholangiography showed choledocholithiasis in 26 patients while 19 patients were free of common bile duct stones. Nine healthy subjects served as controls. RESULTS: Manometric investigation showed a significant increase in the percentage of retrograde phasic contractions of the sphincter of Oddi (SO) in patients with choledocholithiasis compared to the control group (p < 0.05). Also, a significantly higher frequency of SO phasic contractions was found in the group of patients with choledocholithiasis when compared to the cholecystectomized group without common bile duct stones (p < 0.05), but there was no difference when compared with the control group. Markedly increased SO basal pressure was found in 5 patients with choledocholithiasis as well as in one cholecystectomized patient without choledocholithiasis (greater than x + 3SD). However, the SO basal pressure, phasic SO pressure, amplitude and duration of the phasic contractions as well as the choledochal pressure did not differ significantly between the groups. CONCLUSIONS: This study demonstrates manometric abnormalities in the SO of patients with choledocholithiasis which suggests that SO dysfunction and pathophysiological mechanisms are related to the formation of common bile duct stones.

Biliary Tract↗