Biomedical subjects

C Pera Madrazo

Publications and source records attributed to C Pera Madrazo.

At least 19 recordsLinked to original sources

PubMed1995

[Prognostic factors in severe acute pancreatitis. Univariate and multivariate study].

OBJECTIVES: The aim of this study was to analyze the prediction of mortality in patients with severe acute pancreatitis. PATIENTS AND METHODS: In a retrospective study 43 patients with severe acute pancreatitis were included. All patients required ICU admittance and surgical treatment. We evaluated severity according to Ranson's criteria, APACHE II score, CT scan classification (Hill), intraoperative findings (Vankemmel's classification) and number of organs failure. We performed a univariant and multivariant statistic study with lineal discriminant analysis. RESULTS: The overall mortality was 46.5%. Ranson's score and APACHE II did not correlate with mortality. Hill's classification did not reach significance either. However, only the Vankemmel's classification and the number of organs failure had statistic value (p < 0.01). After lineal discriminant analysis, the association of more than 4 Ranson's criteria, APACHE II up to 9 points, grades IV and V in Hill's classification and 4 organs failure had a predictive value for mortality. CONCLUSIONS: In our limited experience the Vankemmel's classification and the number of organs failure had a predictive value for mortality in patients with acute pancreatitis. The association of more than 4 Ranson's criteria. APACHE II up to 8 points, grades IV-V in Hill's classification and 4 organs failure disclosed poor prognosis.

APACHE↗

PubMed1994

[Hepatic confluence tumors: results and quality of life according to the type of treatment].

We analyzed survival rate and quality of life according to the treatment modality in 52 patients with hilar tumors. Six of them underwent resection (11.5%); 4 without hepatectomy, one left hepatectomy and one trisegmentectomy. The remaining 46 patients were treated by: radiologic external-internal drainage (12), placement of percutaneous endoprostheses (14), surgical intubation (18), and cholangioanastomoses to segment III in 2. Prognostic factors (PITT and A.P.A.C.H.E. II), survival time and quality of life were analyzed. Survival and comfort index were significantly better (p < 0.001) in the resection group than in the palliation one. Among palliative procedures percutaneous endoprostheses and surgical intubation offered better quality of life (p < 0.001) than radiologic external-internal drainage. We conclude that resection improves survival and offers better quality of life than palliative procedures. Our results suggest that resection during laparotomy should be attempted in order to improve results in the treatment of hepatic confluence tumors.

Adult↗

PubMed1994

[Self-expanding metallic endoprostheses in the palliative treatment of biliary obstructions in nonresectable carcinoma of the head of the pancreas].

OBJECTIVE: A study of immediate and long-term results with the self-expandable metallic stent (Wallstent), in the treatment of biliary obstruction in 25 patients with non resectable carcinoma of the head of the pancreas was carried out. Stent placement was successful in all patients. RESULTS: Complication rate was 4% (n = 1); one patient had venous bleeding after percutaneous catheter placement. There was no procedure related mortality (30-day mortality); hospital stay was 6, 7 days (2-12). Average survival was 6 months (+/- 2.97). Average patency of the initial stent lasted 5 months (+/- 2.01); comfort index was 83%. Five patients required re-admission. Late complications were cholangitis in 2 and stent occlusion in 4. Disimpaction in one patient and placement of additional stent (PAL-MAZ) in the remaining 3 patients were performed. One patient required surgical treatment; hepaticojejunostomy was performed. Elapse time between prostheses placement and stent occlusion was 3.4 months (2-4.5). CONCLUSIONS: We conclude that metallic stent placement has low morbidity without mortality and provide good quality of live. The most frequent late complication was prostheses obstruction.

Cholestasis↗

PubMed1992

[The palliative treatment of pancreatic cancer: percutaneous drainage versus surgical diversion].

In a retrospective study, the outcome of 56 patients with unresectable carcinoma of the exocrine pancreas undergoing two palliative operations (bypass surgery vs percutaneous transhepatic biliary drainage with endoprosthesis) for the management of biliary obstruction was evaluated. Morbidity and mortality were similar in the two groups. Postop hospital stay was 8 days for the intubated, and 15 days for operated patients (p less than 0.01). Although the symptom-free period was similar in both groups, intubated patients had a shorter period of poor-quality life.

Biliary Tract↗

PubMed1989

[Mirizzi syndrome: apropos of 13 cases].

The authors present 13 new cases of Mirizzi's syndrome seen over a 10-year period. An analysis is made of the scant frequency of this syndrome as a cause of extrahepatic obstructive jaundice, the diagnostic difficulties, and the results of surgical treatment.

Adult↗

PubMed1989

[Cancer of the gallbladder: survival and life quality depending on the type of surgical treatment].

An analysis is made of the survival and life quality of 47 patients diagnosed by histopathology as gallbladder cancer, in relation to surgical treatment. The 47 patients, with a mean age of 70 years and a male female ratio of 1:3.7, were classified according to the Nevin stages: there were no stage I patients, 1 stage II, 8 III-IV and 38 V. The operations performed were 20 simple cholecystectomies with excision of a portion of adjacent hepatic tissue; 11 radical cholecystectomies; 10 surgical intubations; 3 percutaneous endoprosthesis; 2 gastroenteroanastomoses and 1 exploratory laparotomy. The results showed: 1) Radical cholecystectomy was the best therapeutic method, providing the longest survival (433 days) with the smallest proportion of days of poor life quality (10%). 2) In patients in stages II, III, IV, simple cholecystectomy with excision of the adjacent liver tissue yielded a survival of more than a year, even in patients of advanced age (greater than 80 years). 3) Although percutaneous and surgical intubation achieved a similar survival, the first technique produced a better quality of life. 4) In view of the diversity of the surgical techniques practiced in patients in stage V, a revaluation of this stage is necessary to individualize treatment.

Aged↗

PubMed1988