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Biomedical subjects

D L Bouwman

Publications and source records attributed to D L Bouwman.

43 records · Page 3Linked to original sources
PubMed1979

Cholelithiasis following subtotal gastric resection with truncal vagotomy.

Subtotal gastrectomy with bilateral truncal vagotomy is a good operation for peptic ulcer disease. Recurrence rates are low, and diarrhea and dumping are usually tolerable. The development of gallstones following this procedure, however, has become more problematic in that further opeation becomes a real necessity. In two groups of patients having undergone a standardized subtotal gastrectomy, with and without truncal vagotomy, only 6 per cent of the patients with resection alone had biliary calculi develop. This is consistent with the incidence of gallstone formation in the normal population. However, in the group undergoing resection with bilateral vagotomy, 21 per cent had gallstones develop which were detected by ultrasonography or oral cholecystography and confirmed at operation. This suggests that cholelithiasis following truncal vagotomy is a long term complication which must be recognized and, unless otherwise indicated, requires an additional surgical procedure. Only when results of long term follow-up studies verify the therapeutic effectiveness of such operations as highly selective or parietal cell vagotomy without drainage will a more physiologically sound operation be within our grasp.

Cholecystectomy↗
PubMed1978

Pulmonary effects of albumin resuscitation for severe hypovolemic shock.

The effect of albumin when added to the resuscitation regimen of patients in hypovolemic shock was studied in a randomized prospective manner in 52 injured patients who received an average of 15.3 transfusions, 9.6 liters of balanced electrolyte solution, and 980 ml of fresh frozen plasma. Before and during operation, 27 patients received an average of 25 gm of albumin and 150 gm/day for three to five days. Patients who received albumin had greater dependence on respiratory support, averaging eight days while receiving ventilatory support with volume ventilator compared with three days in patients not receiving albumin. Furthermore, patients receiving albumin had forced inspiratory oxygen/Pao2 ratios that were statistically and significantly higher than those of patients not receiving albumin during all phases of their hospital course. These effects were associated with increased plasma volumes caused by the oncotic effects of albumin and by its interference with saline diuresis. On the basis of this preliminary report, albumin seems to have a detrimental effect on respiratory function.

Adult↗