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Biomedical subjects

G LaFerla

Publications and source records attributed to G LaFerla.

5 recordsLinked to original sources
PubMed1988

Choledocholithiasis--in vivo stone dissolution using methyl tertiary butyl ether (MTBE).

We report a series of 10 elderly patients with large bile duct calculi refractory to standard endoscopic extraction techniques who were treated by gall stone dissolution using methyl tertiary butyl ether (MTBE) instilled through a nasobiliary catheter. In eight patients complete bile duct clearance was achieved after an average of eight hours MTBE instillation. In two patients gall stone size did not change. Both underwent operative gall stone removal and subsequent stone analysis showed low cholesterol content, which is unlikely to respond to MTBE. Apart from occasional transient nausea and drowsiness, no adverse reactions were noted. Methyl tertiary butyl ether appears to be a powerful in vivo gall stone dissolution agent which, from preliminary studies, is not associated with serious toxicity.

Aged↗
PubMed1987

In-vivo chemical choledocholitholysis using MTBE.

Following endoscopic sphincterotomy, it is possible to clear a large proportion of stones from the bile ducts. In a few cases, however, the stones are too large to retrieve. Mechanical lithotripsy is unpredictable and carries a substantial risk of impaction. We report a patient who had multiple large stones in the bile ducts which were successfully dissolved using MTBE. No adverse effects were noted.

Aged↗
PubMed1986

The role of prostaglandins E2 and F2 alpha in infantile hypertrophic pyloric stenosis.

Endogenous prostaglandins (PGs) have been isolated in large amounts from the gastrointestinal tract of man. These substances are intimately related to muscle contraction and cytoprotection. The gastric juice and serum levels of PGE2 and F2 alpha have been assayed in nine infants with infantile hypertrophic pyloric stenosis (IHPS) and seven age-matched controls. The gastric juice levels were significantly raised in the IHPS group for both PGE2 (P = 0.001) and PGF2 alpha (P = 0.02) as compared to controls. The possible role of PGs in the etiology of IHPS is discussed.

Dinoprost↗
PubMed1986

Hyperamylasaemia and acute pancreatitis following endoscopic retrograde cholangiopancreatography.

Hyperamylasaemia and acute pancreatitis are the more common complications of endoscopic retrograde cholangiopancreatography (ERCP). Ninety patients who underwent ERCP +/- endoscopic papillotomy were monitored for rises in the serum amylase and the development of acute pancreatitis. The incidence of hyperamylasaemia (greater than 300 IU/L) was significantly greater (p = 0.01) when the pancreatic duct was imaged (75%) than with bile duct imaging alone (33%). The incidence of acute pancreatitis following imaging of the pancreatic duct +/- bile duct was 11.3% and was found to be significantly increased in those patients (n = 9) who also underwent endoscopic papillotomy. Imaging of the biliary tree only +/- endoscopic papillotomy carried no significant risk of acute pancreatitis. In those patients who developed pancreatitis, the rise in serum amylase occurred early and was significantly higher at 2 h following ERCP. These findings may help to identify patients who are at risk of developing this complication.

Acute Disease↗