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Biomedical subjects

J P Richieri

Publications and source records attributed to J P Richieri.

18 recordsLinked to original sources
PubMed1994

[Endoscopic retrograde cholangiopancreatography in children and adolescents].

Nineteen children and adolescents, mean age 9.6 +/- 1.2 years, underwent endoscopic retrograde cholangiopancreatography (ERCP). Indications for ERCP were cholestasis in 11 cases, suspected pancreatic disease or trauma in 8 cases. Equipment and technique used for papilla catheterisation were similar to those routinely used in adults. Bile duct or pancreatic opacification were successfully obtained in all cases. Transient acute pancreatitis following the procedure was observed in one patient, and resolved spontaneously. ERCP confirmed diagnosis suspected after ultrasound study and abdominal CT scan in 9 patients. In the remaining 10 cases, diagnosis was only made by ERCP. Twelve patients were operated based on ERCP results. We conclude that ERCP is rarely performed in children, but remains as useful as in adults in biliary and pancreatic examination.

Adolescent↗
PubMed1989

[Treatment of achalasia by pneumatic dilatation].

Between 1979 and 1988, 60 patients with achalasia were treated by pneumatic dilatation under general anaesthesia, using the Rider-Moeller apparatus. The diagnosis rested on clinical, radiological, manometric and endoscopic criteria. These 60 patients underwent a total of 99 dilatations: 63.3 per cent were dilated once and 37.7 per cent were dilated several times. Forty seven of the 60 patients were followed up for more than 12 months (mean: 44 months): 2 of them (4.2 per cent) had to be operated upon, while 45 (95.7 per cent) are asymptomatic. Immediate complications were perforation in one case and cardial fissure in another; both were treated medically and cured. There was no oesophagitis or peptic stenosis, and no patient died. These results are compared with those found in the literature. The authors underline the simplicity, safety and effectiveness of pneumatic dilatation and suggest that it should be used as first-line treatment of achalasia, surgery being performed only when dilatation fails.

Adolescent↗
PubMed1984

[Retrograde endoscopic cholangiography after biliary surgery].

Retrograde cholangiography was conducted in 310 patients early or late after biliary system surgery. Principal indications for the investigation were angiocholitis (37% of cases), isolated jaundice (30%) or acute hepatic colic (17%). Biliary tract lesions were excluded in 7% of patients while in the remaining 93% it was possible to determine the precise cause of the disorder. In 30% of cases the disorder was unrelated to the previous operation or the lithiasic disease, whereas in 63% it was related to the latter (remaining or reformed stone, odditis) or to the surgical procedure (stenosis, common bile duct ligature or injury to main bile duct). These results, and those reported in the ligature, suggest that retrograde cholangiography can provide a precise diagnosis and ensure adapted therapy after biliary surgery.

Adult↗
PubMed1982

[Prevention of gastroduodenal complications in coronary surgery. Usefulness of preoperative fiberoscopy].

Fiberoscopic examination of the oesophagus, stomach and duodenum was carried out in 60 coronary disease patients prior to aorto-coronary bypass. Lesions of the upper digestive tract were detected in one-third of the patients; half of them were asymptomatic. The management of these cases depended upon the urgency of the cardiovascular operation. In 17 cases, a 1-month treatment of the digestive lesions with antacids and cimetidine was instituted immediately after fiberoscopy, and revascularization was performed 8 days later. In 3 cases, the cardiovascular operation was postponed; after 1 month of treatment only one patient had active lesions on control fiberoscopy and had to undergo digestive surgery prior to aorto-coronary bypass. No gastroduodenal complications of cardiovascular surgery was observed in this series.

Antacids↗
PubMed1980

[Peptic esophageal strictures. Dilatation with the Eder-Puestow's olives system (author's transl)].

Esophageal dilatations under topical pharyngeal anesthesia with the Eder-Puestow's metallic olives system were performed 101 times on 30 patients presenting peptic strictures. This method uses first a metallic wire introduced into the esophagus and the stomach under endoscopic control. Then, the wire allows to guide dilatating olives through very tight strictures. Functional results were excellent 28 times out of 30; two patients only required repeated dilatations because of uncomplete treatment (stenosis on esojejunal anastomosis). Finally, surgical procedure was never indicated. The use of Eder-Puestow's material together with fiberoptic esophagoscope reduces the hazard of peroral bougienage: no complication occured in our series.

Aged↗
PubMedDate not supplied

Treatment of external gastrointestinal fistulas by a combination of total parenteral nutrition and somatostatin.

Thirty-seven patients with external gastrointestinal fistulas were treated with a combination of total parenteral nutrition (TPN) and somatostatin (ST). There was a significant fall in fistula output within the first day of treatment (p less than 0.001). On the first day of combined therapy, the reduction of fistula output was 70%, and in 68% of the cases, the fistula output fell to less than 50% of the initial level. Spontaneous closure was observed in 82% of the cases, and the time taken to close the fistula ranged between 1 and 14 days of starting therapy [5.4 +/- 0.7 days (mean +/- SEM)]. The response to TPN-ST treatment occurred, irrespective of age and sex of patients, duration and daily output of the fistulas before ST use, and their location in the gastrointestinal tract. Infection of fistula output was a factor of adverse prognosis. In all cases, and in the absence of mechanical obstacles, treatment that combines TPN and ST could be tried and continued up to 14 days in cases in which the fistula output falls more than 50% on the first day of treatment.

Adult↗
PubMedDate not supplied

Pneumatic dilatation in the treatment of achalasia.

The results of a European survey on pneumatic dilatation in the treatment of achalasia have been compiled from a questionnaire completed by 18 different surgical teams. The total number of patients investigated was 2,161. Surgical treatment was prescribed by 94% of teams, whereas pneumatic dilatation was only prescribed by 56%. The indications for pneumatic dilatation were: inoperability (28%), drug failure (17%), surgical failure (11%). Nine surgeons believe pneumatic dilatation is indicated in all cases (50%), four consider it ineffective and useless (22%), and one expressed no opinion (6%). The arguments in favour of pneumatic dilatation are the fact that the procedure is minor and cost efficient and that it is relatively safe and effective with good long-term results in 75% of cases. Pneumatic dilatation should be used as the initial treatment in achalasia; surgery is only indicated in cases of failure.

Dilatation↗