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J S Ben-Zvi

Publications and source records attributed to J S Ben-Zvi.

8 recordsLinked to original sources
PubMed1990

Effectiveness of endoscopic drainage for pancreas divisum: endoscopic and surgical results in 31 patients.

Thirty-one patients with symptomatic pancreatitis and pancreas divisum were treated prospectively by inserting an endoprosthesis into the dorsal pancreatic duct for drainage. Pain was a feature characteristic of all 31 patients; of these 92% had an improvement in their subjective complaints of pain after sphincterotomy and insertion of a prosthesis in the minor papilla. During a two-year follow-up period, 84% (26/31) of the group showed improvement in all the signs and symptoms associated with their pancreatitis, and this improvement was sustained in all patients for at least several months. A group of twenty-six patients subsequently underwent pancreatic surgery for recurrent symptoms. Those patients who had improved with endoscopic drainage did significantly better following surgical drainage than those who had shown little or no improvement with an endoprosthesis. On the basis of the above preliminary results, we recommend preoperative insertion of an endoprosthesis into the dorsal duct as a therapeutic predictor of eventual surgical outcome.

Adolescent↗
PubMed1988

Duodenoscopic sphincterotomy in patients with gallbladders in situ: report of a series of 1272 patients.

We present a prospective, unrandomized, uncontrolled series of 1272 patients in whom endoscopic sphincterotomy (ES) was performed, and who had not previously undergone cholecystectomy. These patients were culled from our combined experience of a total of 4177 patients in whom ES was performed over the last 13 yr. Of the group reported here, 1208 patients had demonstrable gallbladder stones, and 64 had acalculous gallbladders. The group included 896 females and 396 males whose mean age was 73.3 yr and who ranged from 17 to 101 yr old. Cholangitis was present in 317 patients (25%), and gallstone pancreatitis in 134 (10.5%) patients. After sphincterotomy, 109 patients (8.6%) developed cholecystitis; 23 developed this within 48 h, and 86 developed this within 10 days of the procedure. Emergency surgery was performed on 25 of these patients, and 84 responded to medical therapy alone. Two deaths occurred within 30 days of sphincterotomy (0.15%), in both cases following emergency surgery in elderly patients. One hundred-eight patients underwent elective cholecystectomy within 3 yr of their sphincterotomy because of recurrent symptoms referrable to the biliary tract. In a subset of 337 patients in whom long-term followup was possible, two patients died of complications related to recurrent cholecystitis, both at approximately 2 yr after sphincterotomy. Although followup was less than optimal in this large series of patients, the data presented here suggest that an intact gallbladder is not a contraindication to ES in the management of common bile duct stones, and that the morbidity and mortality of ES compare favorably over the long and short term with surgical management.

Adolescent↗
PubMedDate not supplied

The needle knife: a valuable tool in diagnostic and therapeutic ERCP.

Using monopolar electrocautery technique, we have used both an electrified guide wire and a needle-tipped sphincterotome to successfully enter the common bile duct, subsequently image it, and perform therapeutic procedures when by virtue of the patient's anatomy, or because of tumor, this had not been possible using conventional ERCP catheters. In an initial group of 45 patients using the needle-tipped sphincterotome, clinically significant complications occurred in 3 patients but were not of a serious nature. The technique was an effective method for achieving both diagnostic ERCP and therapeutic maneuvers in 43 of 45 patients. We stress that this technique should only be attempted by those with long experience in ERCP and related procedures.

Ampulla of Vater↗
PubMedDate not supplied

Mechanical lithotripsy of common duct stones.

Over the past 8 years we have utilized various types of mechanical lithotriptors to crush common bile duct stones. The procedure was performed in 93 patients with an overall success rate of 94%. However, because many accessories were in a developmental stage, entrapment of stones was not always possible on the first attempt, and the procedure was repeated in some patients a second or third time. During the interim, while awaiting another attempt at lithotripsy, cholangitis was prevented by leaving a prosthesis in place. A variety of lithotriptor models from different manufacturers have proven effective. We recommend that endoscopists use these devices to rid the bile duct of retained stones.

Gallstones↗