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Biomedical subjects

D Hopton

Publications and source records attributed to D Hopton.

11 recordsLinked to original sources
PubMed1980

The diagnosis of acute gallbladder disease by technetium-99m-labelled HIDA hepatobiliary scanning.

A series of 105 patients with upper abdominal pain suggestive of biliary colic who had hepatobiliary scans within 48 h of admission to hospital is presented. Fifty of the 65 patients with abnormal scans had operative treatment and gallbladder pathology was found in every case. Fourteen of these patients had hepatobiliary scans which also showed delayed excretion of tracer into the duodenum, and of these, 12 were found to have common bile duct stones and one a stricture of the distal end of the common bile duct. Of the 40 patients who had normal scans, 7 were found to have gallstones on further investigation. In these patients abnormal hepatobiliary scans have shown a 100 per cent correlation with gallbladder disease. We suggest that this is the investigation of choice for the surgeon contemplating early cholecystectomy on patients with suspected acute gallbladder disease.

Acute Disease↗
PubMed1979

Several standard elective operations for duodenal ulcer: ten to 16 year clinical results.

A survey was undertaken of 558 men with duodenal ulcer who had been treated ten to 16 years previously by truncal vagotomy and drainage, truncal vagotomy and antrectomy and subtotal gastrectomy. Of the 558, 65 had died and 111, presumed living, could not be traced, leaving 382 available for assessment. Between 75 and 85% of the traced patients were considered to have an excellent or very good result, which is a slight improvement on the previously published results in this same group of patients at five to eight years follow-up. Some of the side effects of operation had diminished slightly in frequency and there had been no significant increase in the incidence of recurrent ulceration since the previous survey. Anemia was an uncommon finding. As between the various forms of operation, truncal vagotomy and antrectomy and subtotal gastrectomy demonstrated significantly better protection against proven recurrent ulcer than did truncal vagotomy and pyloroplasty (p less than 0.05). Compared with truncal vagotomy and gastroenterostomy, however, the results of both resection operations, though better, did not achieve statistical significance at p - 0.5 level (p less than 0.1). In regard to Visick gradings the resection procedures had better scores, but the differences were not significant at the p - 0.05 level, except for vagotomy and antractomy as compared with vagotomy and pyloroplasty. But it is stressed that in formulating a policy of surgical therapy for duodenal ulcer the greater inherent immediate risks of resection operations need to be borne in mind.

Drainage↗
PubMed1978

Common bile duct perfusion combined with operative cholangiography.

A series of 223 patients undergoing cholecystectomy has been studied. In 204 patients the common bile duct was perfused with saline at a pressure of 30 cm. The rate of flow has been analysed as a means of determining the presence of common bile duct stones, this being confirmed on the evidence of operative cholangiography or exploration of the duct. The results suggest that flow studies can be more consistently obtained than cholangiograms, which were not available for technical reasons in 8.0 per cent of patients in this series. The results of flow studies are comparable with those of cholangiography in confirming the normality of the common bile duct but are less reliable in detecting stones. The reliability is such that if radiological facilities are not available, flow studies are an acceptable alternative. In none of these patients was stenosis of the sphincter of Oddi detected. If this clinical entity does exist, it is rare and of little significance.

Cholangiography↗
PubMed1971

Double-blind clinical trial of the analgesic effects of phenazocine hydrobromide (Narphen) compared with morphine sulphate in patients with acute abdominal pain.

No significant difference could be detected either by clinical impression or statistical analysis in the relief of pain afforded by 2.5 mg phenazocine hydrobromide (Narphen) and 10 mg morphine sulphate when given by intramuscular injection to patients with acute abdominal pain. Phenazocine does not cause spasm of the sphincter of Oddi and so is recommended for treating biliary or pancreatic pain.

Abdomen↗