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C J Schein

Publications and source records attributed to C J Schein.

13 recordsLinked to original sources
PubMed1979

Surgical significance of the histopathology of the common bile duct.

Silver biopsies of the common bile duct were obtained from 15 patients with clinical and surgical evidence of cholangitis. The most pronounced histologic changes were edema, congestion, and marked mucous gland hypertrophy and hyperplasia. No ulceration, intramural abscess, or areas of necrosis were found. Clinical cholangitis is not associated with necrotizing changes in the duct wall. This fact is the histologic basis for satisfactory healing of choledochal enteric anastomoses performed in the presence of cholangitis.

Adult↗
PubMed1979

Gallstone-linked tubular stenosis of the common bile duct.

The transpancreatic segment of the distal common bile duct can be extrinsically stenosed by a pure gallstone-linked pancreatic disorder. It has a specific roentgen configuration--long, tubular and smooth. In two instances it was associated with severe suppurative complications. Precholedochotomy cholangiography is required to identify such long segment benign tubular stenosis of the distal common bile duct as an indication for management alternatives and as a guide to judicious common bile duct exploration.

Aged↗
PubMed1978

The web factor in cholangitis.

Choledochoscopy demonstrates that stone-related suppurative cholangitis has the pathologic characteristics of a multiloculated intraductal abscess. The fibrin web compartmentalizes the duct, traps calculi, and limits spontaneous extrusion. The stones act as foreign bodies and stasis maintains the bacterobilia. This is the anatomic basis and rationale for early direct surgical drainage as the definite effective treatment.

Cholangitis↗
PubMed1978

Choledochoduodenostomy as an adjunct to choledocholithotomy.

Choledochoduodenostomy was performed in 100 patients for calculus related disease of the common bile duct. There were no significant early or late complications of the anastomotic procedure. The 3 per cent mortality was related to antecedent advanced liver disease in two instances and, in one instance, to intra-abdominal sepsis. The surgical bypass has the advantage of circumventing the retained stone problem or the sequelae of benign obstructive disease in the distal part of the choledochus. It permits postoperative roentgenographic and endoscopic evaluation of the anastomotic site. Cholangitis, blind segment disability and malfunction have not been seen with these indications and this technique. When the common bile duct is at least 1.4 centimeters wide, primary or secondary choledochoduodenostomy with a wide anastomosis has significant advantages over T-tube intubation in the therapeutic and prophylactic management of choledocholithiasis.

Adult↗
PubMed1978

Vagotogenic cholecystitis.

Truncal vagotomy provokes acute cholecystitis in the stone-containing gallbladder of dogs. An apparently similar sequence has been fortuitously observed in three patients. These circumstances suggest that where cholelithiasis is encountered in a clinical situation in which truncal vagotomy is performed, cholecystectomy or stone removal and cholecystostomy be done as a synchronous adjunctive procedure.

Aged↗
PubMed1977

Varices of the common bile duct as a surgical hazard.

In the case of a 78-year-old woman with three common duct stones is reported. The most striking finding at operation, was extensive varices of the common duct. There was no evidence of varices elsewhere nor of an arteriovenous fistula. The varices are assumed to be idiopathic or a unique manifestation of a chronic cholangitic venous disorder. The situation, although unique, is readily recognized. Methods of management directed at avoiding intraoperative bleeding are suggested.

Aged↗
PubMed1976

The Morison pouch.

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Biliary Tract Surgical Procedures↗