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B Vladimirov

Publications and source records attributed to B Vladimirov.

At least 19 recordsLinked to original sources
PubMed2004

[Polyposis of the colon and cancer].

Polyposis of the colon is a colon cancer predisposition syndrome. Familial adenomatous polyposis (FAP) accounts for 1% of the cases of inherited colorectal cancer (CRC). The National Register of inherited CRC and polyposis of the intestines keeps track of 18 patients from 14 families with FAP. Eight of them have been operated of CRC, on 6 patients preventive colectomy with ileorectal anastomosis has been done and four patients refused surgery. Colectomy has been done due to the malignant development also on a female patient with difused juvenile polyposis with adenomatosis. Of three patients under surveillance with the Peutz-Jeghers syndrome, surgery has been done on one female patient with ileus and bleeding large polyps.

Adenomatous Polyposis Coli↗
PubMed1996

Comparison of three urease tests for detection of Helicobacter pylori in gastric biopsy specimens.

OBJECTIVE: To propose two modified urease tests for the detection of Helicobacter pylori in gastric biopsy specimens. PATIENTS AND METHODS: The presence of H. pylori infection was determined in 237 patients undergoing upper gastrointestinal endoscopy. Three media were used for the urease tests: Christensen's 2% urea broth and two urea agar media, modified by increasing the concentration of urea (to 4% and 10%) and phenol red and omitting the nutrients. RESULTS: The modified tests had good sensitivity (> 78%), specificity (96%) and accuracy (> or = 86%) at 2 h using small amounts (15%) of biopsy homogenates. They were statistically more sensitive and accurate than Christensen's broth. CONCLUSION: Both the modified 4% and 10% urea agar tests are simple, sensitive and specific and can be performed with small amounts of sample.

Bacteriological Techniques↗
PubMed1996

[Endoscopic sphincterotomy in choledocholithiasis and an intact gallbladder].

Endoscopic sphincterotomy (ES) with extraction of calculi is a basic method of treating choledocholithiasis in post-cholecystectomy patients (8, 9). Endoscopic treatment contributes to a considerable reduction of the indications for reoperation. The existing views concerning ES done in patients with preserved gallbladder, especially in the era of laparoscopic surgery, are still conflicting (3, 6). There are several options: cholecystectomy with removal of calculi in the common bile duct by ES in a subsequent stage, or vice versa-primary ES with ensuring cholecystectomy. The undertaking of independent surgical or endoscopic treatment is likewise practicable (2, 6).

Aged↗
PubMed1996

[The surgical and alternative treatment potentials in biliary tract cancer. II. Alternative potentials].

The modern diagnosis of biliary tract cancer is still unsatisfactory regardless of the introduction of updated instrumental diagnostic methods. The latter may undergo development and transformation into therapeutic procedures. Patients with increased operative risk, and those presenting locally intractable neoplasm or metastases are indicated for this kind of alternative therapeutic approach. Experience had with endoscopic treatment of 89 patients with cancer of the biliary apparatus is shared. In forty of them (45 per cent) treatment with endoscopic papillotomy, prosthetic replacement or pernasal drainage proves successful. The procedure runs the hazards of early and late complications. Survivorship is prolonged by six months average, maximum 23 months. In eight cases permanent percutaneous (external) biliary drainage is undertaken as a final palliative measure, contributing to survival ranging from 1 to 3 months. In conclusion, the alternative methods have an actual place in the armamentarium of treatment procedures for this contingent of oncological patients.

Adult↗
PubMed1996

[The place of endoscopic transpapillary (peroral) cholangioscopy in the diagnosis and treatment of biliary tract diseases].

The introduction of intraoperative, and later postoperative cholangiography, results in the reduction of residual concrements in the bile ducts, but by no means in their total removal. Cholangioscopy was used as an alternative to this method (1, 5, 10). In 1923, J. Bakes employed a rigid choledoscope, and in 1970 J. M. Shore-a flexible one. Nowadays, technical improvement of the procedure makes possible to use cholangioscopy by one of two basic routes--transhepatic and peroral transpapillary (4, 6, 7, 9, 11). The former is recommended in the event of impossible or failing examination through papilla Vateri, or in the presence of stones and strictures within the intrahepatic bile ducts which cannot be reached by transpapillary route (4, 6, 9, 11). Peroral choledoscopy is used in clinical practice for a short time, and the early experience is still insufficient for definitive evaluation (2, 3, 7, 8, 9, 11).

Aged↗
PubMed1996

[The surgical and alternative treatment potentials in biliary tract cancer. I. Surgical treatment].

Biliary apparatus cancer is a rare condition characterized by low operability percentage. This is a comparative study of two series of patients, operated during the periods 1952-1979 and 1980-1994. In the first observation period (28 years) 119 patients are operated, and in the second 13-year period a total of 206 patients are subjected to operative and endoscopic treatment. One-hundred five patients present gallbladder carcinoma. The age, gender and clinical patterns characterizing the contingent being examined do not show noteworthy changes with time. Over the past few years, a variety of palliative operations are used, with the proportion of cases subjected to radical operation showing no increase. Carcinoma of bile ducts is diagnosed in 98 patients. During the second observation period, the number of women and patients in advanced and senile age augment. The diagnosis is delayed; thanks to puncture biopsy with cytological study, histological verification shows a three-fold increase. The number of radical operations is slightly increased while the percentage of explorative laparotomies is noticeably diminished. Carcinoma of papilla Vateri has optimal outlooks for surgical treatment. In the latter case too the number of women and patients above 60 years of age shows an increase. Radical intervention is resorted to in fourteen out of 33 patients.

Adult↗
PubMed1994

[The treatment of acute cholecystitis complicated by mechanical jaundice].

After analyzing the summed up treatment results in 368 patients with acute cholecystitis, complicated by obstructive jaundice, the inference is reached that it is a matter of a complication, unfavourable in terms of prognosis, with a definite impact on both immediate and long-term therapeutic results. Early operative intervention following intensive preoperative preparation (including ERHPG with endoscopic papillosphincterotomy and ensuing biliary decompression, or echographic percutaneous cholecystectomy) contribute to control the acute inflammatory process in the gallbladder, and preclude the development of liver (or hepato-renal) failure against the background of obstructive jaundice. Proceeding from the severe, irreversible changes in liver and kidney, hardly responding to treatment, and persisting deterioration of the general condition, acute cholecystitis complicated by obstructive jaundice is defined as an emergency life-endangering condition, requiring a priority operative approach.

Acute Disease↗
PubMed1994

[Pancreatoduodenal resection for carcinoid of Vater's papilla].

Papilla Vateri carcinoid is among the very rarely occurring locations of the lesion. The small lumen of the papilla is the underlying cause of becoming clinically manifest with icterus rather early. Accessibility of the process for endoscopic biopsy facilitates the diagnosis. Even histologically it is very difficult to differentiate benign from malignantly altered carcinoids. Only the existence of metastases confirm with certainty their malignant nature. An observation on papilla Vateri carcinoid in a 60-year-old woman, proved preoperatively through cytological study, is reported. Intraoperative--no metastases are discovered. Sparing pancreatoduodenal resection is performed with a good functional outcome, recorded at the checkup examination after two years.

Ampulla of Vater↗
PubMed1991

[Villous adenomas of the major duodenal papilla: apropos a case].

Proceeding from a review of the literature and the personal observation of a case of tubulovillous adenoma of the large duodenal papilla, which had undergone malignant degeneration, the authors outline the diagnostic problems in this pathology. Since its clinical manifestations are not specific enough, it comes into consideration only after the possible more common diseases in the region of the right subcostal space have been ruled out. Preoperative diagnosis can be established mainly with fiber duodenoscopy. The demand from the pathologist is not only to give a histologic diagnosis, but to define the biologic nature of the tumor formation, since this predetermines the operative approach. It is sometimes difficult to give answer to the latter requirement even through and intraoperative express biopsy specimen examination.

Adenoma↗
PubMed1991

[Atypical anatomical variants and anomalies of the biliary tract in patients with biliary tract and pancreatic diseases. II. Endoscopic treatment].

Results are reported of endoscopic treatment of 79 patients with atypical anatomical variants and anomalies of the bile ducts: common bile duct calculosis (54), stenosing papillo-odditis (8), indurative pancreatitis (2) and bile duct cancer (15). The following endoscopic manipulations have been performed: endoscopic sphincterotomy (72); hydrostatic balloon extraction of calculi (27); hydrostatic balloon dilatation of constricted segments (29); mechanical lithotripsy (15); nasolabial drainage (17) and endoprosthesis (15). Much more difficult was the extraction of calculi from the common bile in the event of atypical anatomical variants and anomalies of the distal portion of the common bile duct (chi 2 = 14.55; p less than 0.001). Treatment resulted in significant reduction of the bilirubin levels (t = 4.13; p less than 0.001), of AP (t = 4.47; p less than 0.001), GGTP (t = 4.07; p less than 0.001); AcAT (t = 5.75; p less than 0.001) and AlAT (t = 5.63; p less than 0.001). Complications occurred in 6 per cent of the patients (acute pancreatitis, cholangitis, hemorrhage). Mortality from endoscopic treatment was 1.3 per cent. Endoscopic methods for treatment are advised as alternative to operative treatment for patients in advanced age and high operative risk.

Adult↗
PubMed1990

[The endoscopic treatment of large calculi in the choledochus. The preliminary results with intracorporeal electrohydraulic shock-wave lithotripsy].

Results are reported of endoscopic treatment of: 236 patients with common bile duct calculi treated by endoscopic sphincterotomy with or without hydrostatic balloon extraction and extraction of the calculi, mechanical lithotripsy and endoprosthesis; preliminary results in 12 patients treated by intracorporeal electrohydraulic lithotripsy. Complete removal of calculi from the common bile duct was achieved in 171 of 236 sphincterotomized patients (72 per cent). Complications were observed in 11 per cent of the patients. Mechanical cracking of common bile duct calculi was realized in 60 of 65 patients (92 per cent) with complications observed in 3 per cent. Thus, with the use of mechanical lithotripsy the success of endoscopic treatment rose to 98 per cent, without increase in the incidence of complications. Seven patients had endoprostheses placed because of failure to extract the calculi. Intracorporeal electrohydraulic lithotripsy was performed in 12 patients with common bile duct lithiasis (4 with single and 8 with numerous stones with diameter 20-40 mm. In one patient transient acute pancreatitis was observed. A rise in serum amylase content was recorded in 9 patients. The stones in the common bile duct were effectively broken to pieces and removed in 8 patients. Lithotripsy was unsuccessful in 4 patients, two of whom had solid calcium depositions. In the common bile duct of the other two MTBE gas applied. The patients were subjected to repeated lithotripsy with positive effect. It is pointed out in conclusion that crushing stones in the common bile duct allows real improvement of the results of endoscopic sphincterotomy in common bile duct calculosis. Endoscopic treatment of larger calculi became also feasible which until a few years ago were contraindication for endoscopic treatment.

Aged↗
PubMed1990

[Atypical anatomical variants and anomalies of the biliary tract in patients with biliary tract and pancreatic diseases. I. The incidence according to ERCP].

Of 570 patients with clinical manifestations of bile duct and pancreas diseases, examined by ERCP, 122 had different atypical anatomical variants (142 in 114 patients) and anomalies of the biliary passages (8 patients). The incidence of the individual atypical anatomical variants of the bile ducts was, as follows: 1. variants in the entry of the common bile duct in the duodenum--3.3 per cent (19 of 570 patients); 2. variants in the entry of ductus cysticus in the common bile duct--11.1 per cent (63 of 570 patients); 3. variants of the ramifications of the hepatic canals--10.5 per cent (60 of 570 patients). Of the bile duct anomalies, choledochocele was the most common--in 5 of the 8 patients in this group. In addition, there was a double gall bladder, gall bladder atresia and cysts of the intrahepatic bile ducts in one case each. High was the incidence of choledocholithiasis (63 per cent) and especially of primarily formed calculi in the common bile duct (20 per cent), as well as bile duct cancer (11 per cent). Cancer of the biliary passages was significantly commoner in atypical anatomical variants of ductus hepaticus (18 per cent) vs. 8 per cent in atypical variants of ductus cysticus and none in the common bile duct variants (chi 2 = 4.06; p less than 0.05). Cancer of the common bile duct was found also in 1 of the eight patients with anomalies of the biliary passages.

Age Factors↗
PubMed1990

[The relationship between duodenal diverticula, biliary tract and pancreatic diseases and their endoscopic treatment].

Of 570 ERHP performed in patients with biliary tract and pancreas diseases, duodenal diverticuli were found in 67 (11.8 per cent). Diverticuli were more frequently diagnosed in patients beyond 60 years of age (67.2 per cent). In 83.6 per cent the diverticuli were single, mostly measuring 15-30 mm and localized in the peripapillary area (70 per cent). ERHP was successful in 85 per cent. Diverticuli were most frequently accompanied by stenosing papillo-odditis (82 per cent), cholecystitis (67 per cent), common bile duct calculosis (58 per cent), followed by pancreatitis (37 per cent) and cancer of the bile ducts (4.5 per cent). Endoscopic treatment was conducted in 46 cases: endoscopic sphincterotomy, hydrostatic balloon dilation of narrowed segments, hydrostatic balloon extraction of calculi, mechanical lithotripsy, nasolabial drainage and endoprosthesis. Significantly lower was the technical success of endoscopic sphincterotomy (78 per cent) when compared with its performance in patients without diverticuli (99 per cent). In spite of this, complex endoscopic treatment resulted in significant fall of bilirubin level (t = 6.58; p less than 0.0001), of AP (t = 8.15; p less than 0.001), of GGJP (t = 6.99; p less than 0.0001), of AcAT (t = 7.14; p less than 0.01). The incidence of complications (6.5 per cent) was not higher than the one observed in patients without diverticuli. In conclusion, endoscopic treatment of bile duct diseases is recommended to be performed also in patients with diverticuli, especially in adult patients and in those exposed to increased operative risk.

Aged↗