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Biomedical subjects

E Gianetta

Publications and source records attributed to E Gianetta.

At least 55 records · Page 3Linked to original sources

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↗

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↗

[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↗

[A case of severe obesity treated jejunoileal bypass. 1-year clinical course].

A 40 + 5 cm jejunoileal bypass was created as a means of treating a case of morbid obesity. Clinical, functional and morphological examinations were carried out prior to surgery and at various times for the following year. An initially rapid loss of weight was followed by an early halt around the 7th month and a subsequently steady state. While metabolic and cardiorespiratory benefits were obtained, considerable and progressive hyperchlorhydria and lithiasic cholecystitis were noted, along with minor, reversible complications.

Adult↗

[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↗

[New method for preparation of the totally hepatectomized dog. Critical review of the literature and surgical technics].

A critical review of the relevant literature is followed by the presentation of a new method for total hepatectomy in the dog. This is carried out in a single stage. Its main advantage is there is no temporary interruption of the portal or portocaval flow. A synthetic prosthesis is anastomosed end-to-end with the subhepatic vena cava and end-to-side with the supradiaphragmatic cava. Next, the portal vein is anastomosed side-to-side with the prosthesis and ligated upstream. Hepatectomy is then performed.

Animals↗

[Definitive breast cancer surgery as an outpatient: rationale and our experience].

INTRODUCTION: The objective of this study was to evaluate the feasibility of outpatient breast definitive surgery. CASE AND METHODS: Between January 2001 and September 2003 181 definitive breast cancer surgical approaches were performed at Surgical Department of Genoa University on 173 patients. Mean age was 60 years (28-92). All the patients were discharged the day of surgery or the day after in the morning. RESULTS: There were no major complications or deaths. The specific complication rate was similar to inpatient setting and there was no readmission. The patients' quality of life and satisfaction were satisfactory or good. DISCUSSION: In conclusion, holding in due consideration some philosophical and technical changes, breast cancer surgery can be safely and comfortably performed on an outpatient basis.

Adult↗

[Surgical treatment of Crohn's disease complications. Our experience].

Thirty-five patients with Crohn's Disease (CD) were observed: 18 have been treated with medical therapy and 17 (48.6%) underwent to surgical treatment : 1) intolerance to the medical treatment in 5.9% (1 case); 2) local complications in 94.1% (16 cases: 6 stenosis, 2 occlusions, 3 abscesses, 3 fistulas, 1 perforation with peritonitis, 1 case toxic megacolon). The operations have been 19: resective interventions 14 (bowel and/or colon resections), conservative interventions 5. The mortality was 0, the morbidity 35,29%. The incidence of the recurrences in a follow up of 5 year was 42,9%. The Authors conclude that the surgery, indicated for the treatment of complications, can be resective surgery (perforating Crohn disease: fistulas, abscess) or conservative surgery (stenosing Crohn disease: stenosis). Recently the conservative intervention are proposed in the treatment of fistulas and abscesses too, but when the inflammation is mild and in patients that underwent to extensive intestinal resection with risk of short bowel syndrome.

Abdominal Abscess↗

[Excision of a schwannoma of the neck: surgical technique].

We present a case of schwannoma of the neck in 49 year old man, symptomatic (paresthesia, cervical mass and dysphagia). After ultrasonography and magnetic resonance of the neck, the patient was operated and excision of the lesion was completely performed. The operation was performed through a cervical approach: the nerves and the vascular and muscular structures were carefully isolated and preserved. The tumour arised from the cervical sympathetic chain. The diagnosis of schwannoma was possible only by histopathologic examen. After 48 months no local recurrence or postoperative complication related to intervention were found. These lesions are uncommon. The identification of the nerve is often difficult until the operation, which is the treatment of choice for the schwannoma.

Head and Neck Neoplasms↗