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Biomedical subjects

G Viceconte

Publications and source records attributed to G Viceconte.

At least 19 recordsLinked to original sources
PubMed1995

Endoscopic manometry of the sphincter of Oddi: its usefulness for the diagnosis and treatment of benign papillary stenosis.

BACKGROUND: Endoscopic manometry is considered useful to identify dysfunction of the sphincter of Oddi (SO) and to predict in which patients good results can be expected after endoscopic sphincterotomy, but this has not been definitively demonstrated. METHODS: Endoscopic manometry of the SO was used in a group of 30 patients with benign papillary stenosis (BPS), in comparison with 30 control subjects. During endoscopic manometry an intravenous bolus of cholecystokinin octapeptide was given to 12 patients and to 10 controls. In 24 BPS patients endoscopic sphincterotomy was performed. RESULTS: No significant differences were observed between controls and patients with regard to median values of SO basal (20 and 21.5 mmHg) and peak pressure (123 and 126 mmHg), wave amplitude (100 mmHg), frequency (4 waves/min), and propagation of the common bile duct/duodenum gradient (12.5 and 12.1 mmHg). In two BPS patients a paradoxic response to CCK-OP was observed. Endoscopic sphincterotomy, performed in 24 BPS patients (17 with SO basal pressure less than 40 mmHg and 7 with more than 40 mmHg), gave good results in 23, without any complication. No differences were observed in the results of the endoscopic sphincterotomy among patients with basal pressure more than 40 mmHg and those with less than 40 mmHg. CONCLUSIONS: On the basis of this study, manometric data do not seem helpful for diagnosis of BPS or to discriminate which patients can be treated with endoscopic sphincterotomy.

Case-Control Studies↗
PubMed1990

[Lipoma of the colon. Apropos of a case report].

Lipoma of the large intestine is a rare, benign tumor. The clinical findings and the diagnostic studies are analysed and a case of giant submucosal colonic lipoma removed by colonoscopy is reported. Colonoscopic removal of submucosal lipomas is recommended, while the necessity of a surgical treatment in presence of intussusception or subserosal lipomas is confirmed.

Aged↗
PubMed1984

Endoscopic manometry of the sphincter of Oddi in patients with and without juxtapapillary duodenal diverticula.

The motor activity of the sphincter of Oddi (SO) has been evaluated, by endoscopic manometry, in 48 subjects, 8 with and 40 without duodenal juxtapapillary diverticula. All values were expressed in mm Hg, taking duodenal pressure as zero reference. In subjects with diverticula the SO basal pressure was 14.1 +/- 4.3 mm Hg, peak pressure was 52.3 +/- 17.2 mm Hg, and wave height was 39.75 +/- 14.19 mm Hg; in subjects without diverticula these values were 31.2 +/- 8.9 mm Hg, 93.2 +/- 21.3 mm Hg, and 68.17 +/- 25.86, respectively. The difference was statistically significant (P less than 0.001 for basal and peak pressure; P less than 0.002 for wave height). Wave frequency was not significantly different in controls (4.99 +/- 1.17/min) and in subjects with diverticula (4.98 +/- 1.13/min). These findings seem to indicate that in patients with diverticula the SO is insufficient or dysfunctioning . The insufficiency of the SO and a reflux of bacteria from the duodenum into the bile duct could play a major role in the formation of stones in patients with diverticula. The same mechanism could be responsible for duodenopancreatic reflux and possible pancreatic lesion.

Adult↗
PubMed1983

Effects of ethanol on the sphincter of Oddi: an endoscopic manometric study.

The effects of ethanol, given either intragastrically or intravenously, on the sphincter of Oddi was evaluated by endoscopic manometry. In 12 subjects intragastric ethanol (150 ml of 32%) was given over 10 minutes. In five control subjects saline solution (150 ml of 0.9%) was given intragastrically instead of ethanol. In five other subjects ethanol was infused intravenously (6 ml/kg of 10%) for 36 minutes. Ethanol given intragastrically produced a significant inhibitory effect on sphincter of Oddi pressure. Peak pressure fell from a control value of 75.7 +/- 26.35 mmHg to 39 +/- 15.39 mmHg (p less than 0.001) at 35 minutes. Basal pressure fell from a control value of 30.17 +/- 19.47 mmHg to 11.83 +/- 6.35 mmHg (p less than 0.01) at 35 minutes. Wave height fell from a control value of 41.33 +/- 15.4 mmHg to 27.16 +/- 11.25 mmHg (p less than 0.02) at 35 minutes. No effects on sphincter of Oddi wave frequency were observed. No significant modifications of sphincter motor activity were observed after intragastric saline infusion. Ethanol given intravenously also produced an appreciable inhibitory effect on sphincter of Oddi pressure, without affecting its wave frequency.

Adult↗
PubMed1982

Endoscopic removal of foreign bodies in the large bowel.

Endoscopic removal of foreign bodies from the intestinal tract is an extremely useful method. In our series, foreign bodies passing down from the upper intestinal tract were removed endoscopically from the rectum and colon of 13 patients. No complications were observed. It can be concluded that endoscopy is a simple, safe and effective method which, in many cases, avoids surgical procedures.

Colon↗
PubMed1981

Endoscopic sphincterotomy: indications and results.

Endoscopic sphincterotomy (ES) is a simple, effective and remarkably safe method of treatment of choledocholithiasis and papillary stenosis. In this series, ES was technically successful in 255 (86.1 per cent) of 296 patients in whom it was attempted. Forty-nine of the successful cases had papillary stenosis complicated by pain, cholangitis and/or jaundice in patients after cholecystectomy; 205 had choledocholithiasis, of whom 164 had a cholecystectomy and 41 were poor surgical risks and did not have cholecystectomy. One patient had a tumour of the ampulla of Vater. ES has been performed as an emergency in 16 subjects because of severe septic cholangitis in 11 and acute biliary pancreatitis in 5. Of the 205 patients with choledocholithiasis, spontaneous passage of calculi after ES occurred in 151 cases (73.6 per cent), and instrumental extraction of stones was possible in 44 (21.5 per cent); 10 patients (4.9 per cent) had residual stones and required surgery. In this series the overall success rate of ES in removing common bile duct stones was 82 per cent in 238 cases; in the patients with benign papillary stenosis ES was successful in relieving symptoms and biochemical cholestasis in 72 per cent of 57 cases. Complications occurred in 18 cases (7 per cent): cholangitis in 4 (1.6 per cent) and haemorrhage in 14 (5.4 per cent). Two patients (0.8 per cent) with acute bleeding following ES died; in one of these surgery had been performed to arrest the haemorrhage, but the patient died 3 days after operation of hepatorenal failure. The other complications were treated conservatively without mortality.

Adult↗
PubMed1980

Neomycin and the combination of neomycin and bacitracin in the prevention of bacterial infection in surgery of the colon and/or rectum.

In two groups of patients submitted to surgery of the colon and/or rectum, treatment to prevent bacterial infections using a combination of 100 mg neomycin and 10,000 U bacitracin every 6 h for 48 h gave the same results as neomycin employed alone at a dosage of 500 mg every 6 h for 48 h. Results confirm the synergism of action between neomycin and bacitracin.

Adult↗
PubMed1979

[Endoscopic papillotomy. Indications and limitations].

Personal experience of 161 cases of endoscopic papillotomy (EP) is reported. Indications and contra-indications are considered in relation to the therapeutic effectiveness of the technique and to the lower percentage of morbidity and mortality connected to it with respect to that following on laparatomic surgery. On the basis of results obtained and of the data reported in the literature, it is pointed out that EP represents real progress in the treatment of calculosis of the hepatocholedochus and of stenosing papillitis.

Adult↗
PubMed1979

ERCP and EPT: Italian experience.

The use of endoscopy has had a satisfactory development in Italy and today at least 70% of Italian hospitals have a fiberscope. Most of the examinations performed are in the diagnosis of diseases of the oesophagus, stomach or duodenum, whilst only a small percentage are represented by coloscopy which is usually carried out in specialized units. One of the examinations, that is most rarely performed, is ERCP, even if some hospitals have a duodenoscope suitable for catheterization of the papilla of Vater. Regardless of the fact that the usefulness of this method has been recognized and that positive results are being reported from various centers throughout the world, ERCP in Italy is performed by very few endoscopists and only in very highly specialized centres. In Rome, for example, ERCP is performed only in our Centre of Digestive Endoscopy which furthermore has the only important experience in Italy in endoscopic papillo-sphincterotomy (EPT); this type of operation has, in fact, so far been carried out only in a very limited number of patients, in a few other endoscopy units.

Ampulla of Vater↗
PubMed1978

ERCP, endoscopic papillotomy and gallstone removal by JFB2 Olympus and PFSB 1200 Machida.

ERCP is now used as routine technique and has provided a useful tool for both diagnostic and therapeutic purposes in diseases of the biliary tract. Until now this examination has been performed throughout the world including Italy, using preferably an Olympus JF and JF B2 sideviewing duodenoscope. In addition to 727 ERCP and 55 papillotomies performed using this instrument we have also employed a convertible endoscope Machida PFSB 1200; this fiberscope, with which front and side views are possible, can be used in the study of the oesophagus, stomach, duodenum, cannulation of the papilla of Vater and papillotomy. They results obtained and advantages offered by this instrument will be discussed. Since this endoscope is not usually employed, at least in Europe, for these purposes, we considered it of interest to report on the 251 ERCP and 9 papillotomies including stone removal performed in our department with the Machida PFSB 1200.

Aged↗