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D Reggio

Publications and source records attributed to D Reggio.

15 recordsLinked to original sources
PubMed1996

Benign biliary strictures: a review of 21 years of experience.

BACKGROUND: The treatment of patients with benign biliary strictures remains a challenge for even the most skilled biliary surgeons. Within the wide range of causes of benign biliary strictures, iatrogenic lesions represent one of the major ones. Biliary reconstruction with Roux-en-Y anastomosis remains the treatment of choice for most cases of benign biliary strictures despite recent reports about endoscopic or percutaneous management that have been quite encouraging. STUDY DESIGN: We retrospectively evaluated 194 patients who underwent surgery for benign biliary strictures over a 21-year period. The biliary strictures were classified into eight different types according to their level. The surgical procedures had been tailored mainly to the site and the extent of the structure as well as the overall status of the patient. RESULTS: Postoperative mortality and morbidity rates were 2.6 percent and 20.1 percent, respectively. The results we obtained were 79.6 percent good, 8.9 percent moderate, and 11.5 percent unsatisfactory. The mean follow-up was 9.3 years. In particular, hepati-cojejunostomy performed in low- and mid-level strictures had the best prognosis (good, 85.5 percent), while high and diffuse strictures had worse results (good, 70 percent), although with only hepaticojejunostomy according to Hepp-Couinaud, this percentage increases to 81 percent. CONCLUSIONS: Correct preoperative assessment of the site and extent of the biliary stricture is important in the choice of the gold-standard surgical procedure. Hepaticojejunostomy and hepaticojejunostomy according to Hepp-Couinaud are the treatments of choice in most instances of benign biliary strictures. Cholangiojejunostomy and hepatic resections are rarely indicated and are performed mostly for highly complicated and intrahepatic strictures. Endoscopic or percutaneous balloon dilation should be reserved for high-risk patients.

Anastomosis, Roux-en-Y↗
PubMed1991

[Acute biliary pancreatitis. Therapeutic approach].

Those forms of acute pancreatitis with a biliary etiology necessitate the choice of surgical techniques whose main objective is to obviate the cause of lithiasis and remove the necrotic and hemorrhagic areas of the gland. While probably overestimated from an epidemiological point of view, acute biliary pancreatitis still causes an overall mortality rate of 10% and has hardly been affected by the development of intensive care units and the routine use of somatostatin. By comparing the various approaches reported in the literature the Authors attempt to match the surgical concept of "timing" and the type of operation to be performed with the anatomopathological stage of disease. The paper reports the preliminary results of a treatment protocol in use since 1988 in group of 35 patients in whom the preoperative diagnosis of acute biliary pancreatitis was confirmed by computerised tomography.

Acute Disease↗
PubMed1990

The value of endoluminal ultrasonography and computed tomography in the staging of rectal cancer: a preliminary study.

A prospective study was carried out in 14 patients with rectal cancer. Tumors were staged preoperatively by endoluminal ultrasonography (EU) and computed tomography (CT). Patients were followed postoperatively for 2 years by the same modalities. Extramural spread was 100% (9/9), accurately assessed by EU and 77.8% (7/9) with CT. Lymph node sensitivity was 87.5% for EU and 37.5 for CT (P less than 0.05). Overall accuracy of lymph node metastases was 85.7% for EU and 57.1% for CT (P less than 0.1). In conclusion, the study shows EU to be statistically more accurate for nodal metastases than CT; therefore, its routine use can be recommended in the preoperative staging of rectal carcinoma in those patients for whom a sphincter-saving procedure is considered.

Female↗
PubMed1988

In vitro enhancement of human platelet aggregation by somatostatin.

Very low concentrations of somatostatin (S-14) strongly potentiate the in vitro aggregation induced by collagen, ristocetin and arachidonic acid, but not that induced by ADP or epinephrine, in both human platelet rich plasmas and gel-filtered platelet preparations. Desensitization phenomena may be induced either by repeated addition of S-14 or long lasting contact between S-14 and platelets.

Adenosine Diphosphate↗
PubMed1988

Secondary sclerosing cholangitis: an experimental study.

An experimental study on rabbit sclerosing cholangitis (SC) secondary to direct injection into the biliary tract of the chemical substances commonly employed for intraoperative sterilization of the hydatid cyst content is reported. Among the various substances utilized, 10% formalin and 30% hypertonic solution caused gross and microscopic lesions compatible with less advanced forms of sclerosing cholangitis. The authors present their hypothesis on the development of SC in operated hydatid cysts of the liver.

Alanine Transaminase↗
PubMed1988

[Somatostatinoma].

Explore the source record for details and available documents.

Duodenal Neoplasms↗
PubMed1987

Combined medical and surgical therapy: a new approach to abdominal hydatidosis.

The experience with 28 patients affected by hepatic and abdominal hydatidosis and treated by combined medical and surgical therapy is reported. All the patients were subject to preoperative and postoperative medical therapy with mebendazole (50 mg/kg/daily). The percentage of living scolices in hydatid fluid obtained during surgery, evaluated microscopically and by mice inoculation, was lower in patients treated medically than in patients operated on without pre and postoperative medical therapy. These data support the efficacy of the preoperative medical therapy in order to decrease the biological activity of the parasite and, consequently the risk of secondary localization due to intraoperative dissemination. Two ultrasound proved recurrences (7.1%) were observed only in patients with multiple or diffuse hydatidosis. In these cases it is uncertain whether it was a relapsing or residual disease. No toxic or collateral effects, following the schedule of dosage and timing of the drugs used, were observed in these patients. It is concluded that, at the present time the combined medical and surgical therapy, is considered the most effective therapeutical approach to abdominal hydatidosis.

Abdomen↗
PubMed1987

Lingual thyroid. A case report.

Lingual thyroid is a rare example of ectopic thyroid involving major problems in diagnosis, surgical approach and operative procedure. A case is presented with wide review of the literature. The personal operative procedure performed through the oral route is described.

Adult↗
PubMed1986

[Use of pirenzepine in prevention of stress ulcers in high-risk surgical patients].

In an endoscopic controlled trial the effectiveness of pirenzepine in preventing stress ulcer in high risk patients for surgical operation was studied. 40 patients of both sexes aged between 19-72 were at random distributed to pirenzepine treatment (10 mg e.v./8 hours, starting the day before surgery to 10th day after it), or to "void" period (without specific therapy). Endoscopic findings was performed before and after treatment and every patient was daily monitored for: dyspepsia, defecation, residual intragastric volume, intestinal peristalsis, beginning oral food intake, haemodynamic and metabolic parameters. The results obtained showed the gastric and duodenal cyto-protective effect and the better post-operative clinical course, when pirenzepine was administered by parenteral infusion.

Adult↗
PubMed1986

Surgical indications and techniques in the treatment of chronic pancreatitis.

Forty-six patients operated on for chronic pancreatitis are reported. 3 (6.4%) underwent splanchnicectomy, 29 (59.2%) Roux-en-Y side-to-side pancreaticojejunostomy, 17 (34.6%) resective procedures (8 left hemipancreatectomy, 5 subtotal pancreatectomy, 3 pancreaticoduodenectomy, 1 total pancreatectomy). Overall postoperative morbidity was 13%: 29.4% after excisional surgery and 3.4% after drainage procedures. One patient treated by subtotal pancreatectomy died because of a hepatorenal syndrome. All the 3 patients treated by splanchnicectomy required resection within two years. The best results were obtained by pancreaticojejunostomy. Drainage procedures represent the operations of choice for chronic pancreatitis as long as correct indications exist. Splanchnicectomy has been discarded as a mean of pain relief because of pain recurrence with time.

Adolescent↗