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Biomedical subjects

G Leman

Publications and source records attributed to G Leman.

15 recordsLinked to original sources

Symptomatic adenomyomatosis of the gallbladder--report of a case.

Adenomyomatosis of the gallbladder is a benign and degenerative condition of the gallbladder, characterized by proliferation of the mucosa of the gallbladder wall, forming invaginations and diverticula, penetrating a thickened muscular layer: the so-called Rokitansky-Aschoff sinuses (RAS). Most of the patients with adenomyomatosis remain asymptomatic. Hence adenomyomatosis is usually an incidental finding, either on ultrasonography performed for the detection of stones or by histologic examination of surgical gallbladder specimens. Only occasionally does adenomyomatosis not associated with cholelithiasis cause right upper quadrant pain. We report a case of symptomatic adenomyomatosis of the gallbladder. Clinical findings, etiology, diagnosis and therapy are discussed.

Adenomyoma↗

Laparoscopic pyloric exclusion after endoscopic retrograde cholangiopancreatography perforation.

We describe a laparoscopic technique of pyloric exclusion with gastroenterostomy and common bile duct T tube insertion for obvious perforation at endoscopic retrograde cholangiopancreatography with papillotomy. The patient was operated on immediately after diagnosis of the lesion. The postoperative sequellae were very comparable to those of elective laparoscopic common bile duct exploration. We believe this approach is interesting, especially in the current era of frequent litigation.

Cholangiopancreatography, Endoscopic Retrograde↗

Evaluation of telesurgical (robotic) NISSEN fundoplication.

BACKGROUND: The laparoscopic surgical approach has proven its benefit for the patient. There are however several shortcomings, which have triggered considerable research for improvement. One improvement may be the introduction of telesurgery by the interposition of a computer interface between surgeon and patient. MATERIAL AND METHODS: A prospective randomized study was conducted in an advanced laparoscopic procedure, Nissen fundoplication. The control group underwent the conventional laparoscopic approach, while the investigational group underwent the telesurgical approach. RESULTS: Feasibility was 100%. The procedure was more time consuming in the Telesurgical group, at all stages of the operation. Mortality was nil and morbidity was comparable in both groups. CONCLUSION: The telesurgical approach is feasible in advanced laparoscopic procedures like Nissen fundoplication. At the present time there is however no obvious added benefit from this new technique.

Adolescent↗

Laparoscopic inflatable band with Roux-en-Y gastric bypass.

BACKGROUND: Roux-en-Y gastric bypass (RYGBP) leaves a large blind gastric segment, which is inaccessible for conventional endoscopy. METHOD: A case is reported, describing a variation of laparoscopic RYGBP by partitioning the stomach by an inflatable band rather than by stapling or division. RESULTS: The stomach was partitioned into a proximal 15 cc pouch and a distal part by an adjustable gastric band. A RYGBP was fashioned from the proximal pouch. 9 patients were treated with this technique: 7 as an initial procedure and 2 after previous gastric banding which had been followed by insufficient weight loss. 1 of these latter patients developed erosion of the band through the gastrojejunostomy 7 months postoperatively. CONCLUSION: Laparoscopic proximal RYGBP with inflatable-band gastric partitioning is feasible. Erosion of the band though the gastrojejunostomy, however, might be a serious side-effect of this technique.

Adult↗

Causes of dissatisfaction in some patients after adjustable gastric banding.

BACKGROUND: The laparoscopic application of the adjustable gastric band has gained widespread acceptance as a gastric restrictive procedure. The weight loss been well documented. This paper evaluates the patients' satisfaction. METHODS: Between April 1995 and July 1999, 82 consecutive patients underwent the Lap-Band procedure. RESULTS: Follow-up is 100%. The satisfaction index is high. 80% of all patients are extremely pleased or pleased. 15% of patients are displeased or extremely displeased. 5% have no opinion. The reason for low satisfaction differ, but 3 groups can be distinguished: 1) patients who suffered surgical complications; 2) patients who did not benefit from the procedure; 3) most importantly, patients who suffered psychological complications. CONCLUSION: Gastric Banding is a safe, standardized and effective operation, with good acceptance by the patients. More efforts have to be made to improve patient selection and to avoid surgical complications. Most importantly, more focus is needed on the psychological aspect of the procedure and its consequences.

Adolescent↗

An unusual low-abdominal tumor: cystadenoma of the seminal vesicle.

Cystadenoma of the seminal vesicle is an extremely rare benign tumor, which to our findings has only been mentioned earlier in seven previous reports. It is a benign and mostly multilocular tumor, thought to originate from embryologic remnants. Preoperative diagnosis is rarely made. Complete extirpation is the correct treatment. We present this first Belgian case with a discussion of imaging techniques, symptomatology, pathology, diagnosis, and treatment.

Cystadenoma↗

Somatostatin induces ectopic activity fronts of the migrating motor complex via a local intestinal mechanism.

To study the peripheral effect of somatostatin in dogs a tiny Silastic catheter was implanted in an almost terminal branch of the mesenteric artery, providing blood supply to a jejunal segment of 5-10 cm. In 4 dogs one catheter was implanted, perfusing a small bowel segment about 60 cm below the angle of Treitz; in 3 dogs two catheters were implanted, perfusing two small bowel segments about 30 and 60 cm below the angle of Treitz. The catheter was kept open by continuous perfusion with a diluted heparin solution by means of a portable insulin infusion pump fixed to the animal's protection jacket. Small bowel motility was recorded electromyographically. Experiments were started 2 wk after surgery and were performed in conscious fasted animals. Control experiments using intraarterial saline perfusion showed normal migrating motor complexes in the perfused segment. Intraarterial perfusion of somatostatin (50-200 ng/kg X h) induced ectopic activity fronts, which always started just distal to the perfused segment and progressed down the small bowel at a normal propagation velocity. During the occurrence of ectopic fronts no activity fronts were observed in the small bowel proximal to the perfusion site. Apart from ectopic fronts, normal activity fronts, starting in the duodenum and passing the perfused segment, were also observed. The most proximal part of the jejunum was more sensitive to intraarterial somatostatin than the more distal jejunum. Intravenous infusion of the same doses of somatostatin had no effect. Somatostatin, therefore, seems to induce ectopic fronts via a local mechanism. We propose that somatostatin is able to relieve the intestine locally from an inhibitory mechanism that prevents the development of activity fronts.

Action Potentials↗

[The treatment of chronic osteitis using genta-PMMA chains].

Disulphine blue vital staining, cancellous bone grafts to Papineau and local implantation of genta-PMMA-chains are new procedures in treatment of chronic osteitis. Between May 1978 and December 1984 a total of 24 patients underwent surgery for osteitis. The mean follow up was 25 months (range 17 m. and 35 m.). Good results were obtained in 70.8% (17/24).

Adolescent↗

An unusual case of small bowel obstruction.

A patient with small bowel obstruction due to a fruit pith (peach) is presented. The diagnostic work up, the treatment and a review of the literature in the matter of obstructions due to swallowed goods are presented. Intestinal obstruction due to ingested organic material is a clinical entity on its own, and careful history taking can give a clue for diagnosis.

Aged↗