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Biomedical subjects

D Civalleri

Publications and source records attributed to D Civalleri.

At least 73 records · Page 4Linked to original sources
PubMed1980

[Behavior of plasma pancreatic polypeptides and motilin in obese patients subjected to biliopancreatic bypass].

Biliopancreatic bypass for obesity entails a 2/3 distal gastrectomy with Roux-en-y reconstruction, being the small bowel transected at its midpoint and the enteroenteroanastomosis placed 50 cm proximal to the ileocecal value. Pancreatic polypeptide (PP) and motilin fasting and meal-stimulated plasma concentrations were determined in 13 nonobese healthy volunteers, in 13 nonoperated obese patients, in 9 subjects within two months, in 12 subjects four to twelve months, and in 7 subjects fifteen to twenty months after operation. There were no significant differences in PP fasting levels between either the obese and control groups or between the postoperative groups and the preoperative group. Both meal-stimulated peak and integrated response values were similar in the obese and control groups, and were strikingly and progressively reduced postoperatively, with statistically significant difference between all postoperative groups and preoperative group. Mean plasma motilin fasting and peak values were higher in the obese group than in the control group, and significantly reduced in the 4-12 and 15-20 month group. Despite the huge variability among data, the integrated response in the 0-2 month group was significantly decreased in comparison with the preoperative group, while a subsequent progressive increase was shown by the 4-12 and 15-20 month groups.

Fasting↗
PubMed1980

[Behavior of plasma gastrin in obese subjects subjected to biliopancreatic bypass].

Biliopancreatic bypass for obesity entails a 2/3 distal gastrectomy with Roux-en-Y reconstruction, small bowel being transected at its midpoint and the enteroenterostomy placed 50 cm proximal to the ileocecal valve. Plasma fasting and meal-stimulated gastrin concentrations were measured by radioimmunoassay in 13 nonobese healthy volunteers, 13 pre-surgery obese patients, 11 patients within two months, 12 patients between four and twelve months and 7 patients between fifteen and twenty months after operation. There were no significant differences in fasting and meal-stimulated peak plasma gastrin levels between obese group and the control group and between any of the postoperative groups and the preoperative group. The 15-20 month post-surgery group mean fasting value was lower than in the other groups, whilst the mean peak value was unchanged. Integrated gastrin response was significantly higher in this group than in the preoperative group.

Biliary Tract Surgical Procedures↗
PubMed1979

Bilio-pancreatic bypass for obesity: 1. An experimental study in dogs.

Bilio-pancreatic bypass is a new procedure that tries to obtain a maldigestion syndrome with selective malabsorption of the main high calorie foods. The operation consists of a gastric resection and division of the proximal jejunum just distal to the ligament of Treitz. A gastroentero-anastomosis is then constructed using the distal end of the transected jejunum, while the proximal jejunum is anastomosed to the side of the distal ileum. An experimental study carried out on 12 dogs confirmed that the operation causes a selective malabsorption with loss of weight and no complications. On the basis of this study it is suggested that this procedure has the following advantages over jejuno-ileal bypass: (a) normal absorption of bile salts, water and electrolytes; (b) slow recovery of absorption; (c) absence of a blind loop.

Animals↗
PubMed1979

Bilio-pancreatic bypass for obesity: II. Initial experience in man.

After a successful trial of bilio-pancreatic bypass in dogs, a clinical study has been completed in 18 patients followed for more than 1 year. The operation has been modified to achieve the best weight reduction, and forming the bilio-pancreatic tract of equal length to the alimentary tract with a short common ileal tract, the average weight loss as a percentage of the preoperative body weight was 24.1 +/- 5.4 per cent (mean +/- s.d.) at 6 months and 33.7 +/- 4.1 per cent at 12 months. The only immediate complication was a wound dehiscence, and there were no late complications. Liver function studies showed the absence of hepatic deterioration and liver biopsies showed improvement of liver morphology 1 year after the operation. It is suggested that this procedure may be an alternative to jejuno-ileal bypass in the management of obesity.

Adolescent↗
PubMed1978

[Behavior of the serum electrolytes after jejuno-ileal bypass for obesity].

Serum electrolytes, diarrhoea and absorption of bile salts were examined before and for one year after jejuno-ileal by-pass in 5 obese subjects. Marked decrease in blood potassium, calcium and magnesium was noted post-operatively, with potassium and calcium levels still well below the preoperative levels after 1 yr. Faecal volume increased considerably soon after operation, then fell to about 1 1/day in the first few months and changed little thereafter. Absorption of bile salts was seriously and lastingly compromised. In the light of the relevant literature, these results show that electrolyte imbalance, being closely linked to diarrhoea induced by bile salts, is an inevitable consequence of this operation and cannot be controlled by changing the surgical procedure.

Adult↗
PubMed1976

[Experience with the treatment of acute hepatic coma using extracorporeal perfusion of heterologous liver and exchange transfusion].

Extracorporeal pig liver perfusion was adopted in 2 patients with acute hepatic coma due to fulminant hepatitis. Exchange transfusion was used in a third patient, while a fourth was subjected to both procedures. A marked haematological improvement was noted in all cases. Yet, three patients died without showing any clinical benefit. In the fourth case, coma regressed and gradual improvement to the point of complete recovery was achieved. Liver perfusion and exchange transfusion in the same patient were attended by very different clinical effects, though each procedure produced a comparable improvement at the blood chemistry data. Careful analysis of the data suggests that the difference was attributable to discrepancies between the degree of tissue purification achieved.

Acute Disease↗
PubMed1976

[Results with arteriovenous fistulae in periodic haemodialysis].

Personal experience regarding 92 arteriovenous fistuale carried for the application of the artificial kidney in 70 patients is described. The technical technique is explained and haemodynamic considerations in support of a preference for end-to-end anastomosis are illustrated. A critical assessment is made of the reasons for failure and their prognostic significance as far as subsequent operation is concerned.

Arteriovenous Shunt, Surgical↗
PubMed1975

[Success in a case of fulminant hepatitis treated with extracorporeal liver perfusion and exchange transfusion].

Extracorporeal perfusion of pig liver lasting 4 hr, followed by isovolaemic exchange (6 litres in 1 hr) were employed in the management of coma in a case of acute virus hepatitis. Liver perfusion led to temporary regression of coma, whereas transfusion was followed by gradual improvement in the clinical picture; this was apparently not a direct consequence of the procedure adopted. Assessment of the degree of purification obtained with these two methods offers an explanation for the difference in their clinical effectiveness.

Adult↗
PubMedDate not supplied

[Surgical resection of gastrointestinal stromal tumor after treatment with imatinib: clinical case].

The stromal tumor is the most common mesenchymal tumor of the gastrointestinal tract. Surgical resection is the first-line therapy for operable lesions, however for inoperable imatinib is an effective therapy. In this setting a patient has been operated after a remarkable response to imatinib, used as both neoadjuvant and adjuvant. This approach led to a disease-free condition without toxicity and complications.

Adult↗