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D J Moote

Publications and source records attributed to D J Moote.

6 recordsLinked to original sources
PubMed1992

Post-laparoscopic cholecystectomy bilomas--preliminary experience.

The incidence of biloma formation after laparoscopic cholecystectomy (LC) is, in the early experience of many centres, significantly higher than after open cholecystectomy. We describe four cases representative of the possible spectrum of post-LC bile leaks and review the literature regarding the radiologic investigation and management of this complication. We suggest that post-LC bilomas should initially be drained percutaneously. Endoscopic cholangiography (ERC) should then be used to identify the source of the leak, but sphincterotomy and/or stent placement may be best reserved for those whose leaks do not resolve after 10 days of free drainage. Surgery is recommended only for major biliary injury and for leaks that remain unresolved after sphincterotomy and/or stenting. An algorithmic summary of this approach is presented.

Adult↗
PubMed1992

Sonographic changes during hepatic interstitial laser photocoagulation. An investigation of three optical fiber tips.

RATIONALE AND OBJECTIVES: Interstitial laser photocoagulation (ILP) destroys tumors thermally, using laser energy delivered from implanted optical fibers. The objectives of the study are to identify a fiber tip/delivered energy combination which produces lesions of useful size, visible on ultrasound (US) during ILP, and to compare ILP lesions and their US images. METHODS: Hepatic ILP was performed at laparotomy in six pigs, using three different fiber tips (cylindrical diffusing, spherical diffusing, plane-cut). US images were obtained during ILP, immediately after ("early" images), and before the animals were killed (2-2.5 hours, "late" images). Actual lesions were assessed histopathologically. RESULTS: Few US changes were seen around cylindrical diffusing and spherical diffusing tips until tip destruction. Plane-cut tips, at 1.5 to 2.0 W, produced prominent US images of the 1- to 2-cm thermal lesions. Early images tended to overestimate necrosis. Late images approximated necrosis. CONCLUSION: For US-controlled ILP, plane-cut tips are better than currently available cylindrical diffusing or spherical diffusing tips. Lesion image growth periods might enable control of lesion size. Further studies are needed to determine the consistency of the described relationship between lesion images and actual lesions.

Animals↗
PubMed1991

Fluoroscopically guided percutaneous gastrostomy: is gastric fixation necessary?

In this animal study the authors evaluated the safety of inserting gastrostomy catheters percutaneously without the aid of gastric fixation. In a laboratory model (excised dog stomachs) there was not leakage around gastrostomy tubes of different sizes (nos. 8 to 18 French), despite maximum gastric distension and intragastric pressures of up to 100 mm Hg. When the tubes were removed, the risk of leakage from the gastrostomy increased in proportion to the size of the gastric defect. Percutaneous gastrostomy catheters (no. 14 French) were then placed in five live dogs without gastric fixation and were immediately withdrawn. All animals remained well. Autopsies performed 7 days later showed no evidence of leakage. The authors conclude that there is no leakage around correctly placed gastrostomy tubes. Although gastric defects larger than no. 10 French leak easily in vitro, a defect of no. 14 French is well tolerated in vivo. The authors suggest that percutaneous gastrostomy may be performed safely without gastric fixation devices in patients as long as the size of the initial cathether used is no. 14 French or smaller.

Animals↗
PubMed1990

Complete foregut duplication.

Alimentary tract duplications are rare congenital anomalies with the majority identified in the pediatric age group. However, duplications may be seen in the adult population and require operative excision. A 53-year-old man was seen with vague, nonspecific symptoms and was found to have a complete esophageal and gastric duplication with communication to the normal alimentary tract. Appropriate-for-structure epithelium was noted throughout the length of the duplication.

Barium Sulfate↗
PubMed1989

Pneumatosis coli: is there a relationship with sigmoid colon redundancy?

Pneumatosis coli (PC) is a process characterized by gas-filled cysts in the wall of the large intestine. The barium enema examinations of 14 patients with idiopathic PC were assessed: 93% involved the sigmoid colon, and 84% of patients with sigmoid pneumatosis had sigmoid colon redundancy in comparison to 14% of the control population (p less than 0.001). It is proposed that the sigmoid cysts result in redundancy by affecting the mesentery and colon length. This redundancy may account for the increased risk of sigmoid volvulus in this condition.

Barium Sulfate↗