Biomedical subjects

Juan Celis Zapata

Publications and source records attributed to Juan Celis Zapata.

5 recordsLinked to original sources

PubMedDate not supplied

[Barrett's esophagus].

The first part of this report reviews the definition, history and clinical aspects of Barrett s Esophagus. The next section explains the results obtained at INEN, Lima Peru. The first case of Barrett s Esophagus complicated with Adenocarcinoma was diagnosed in 1956. The prevalence of Barrett s Esophagus in 3,904 patients who were administered endoscopy examinations is 0.64%. The evaluation of 40 patients with Barrett s Esophagus indicated that it has a greater incidence in males than in females (3:1). The average age of patients with Barrett s Esophagus is 60 years and its incidence increases as they grow older. It manifests itself in 40 year old persons and is specially strong from 55 to 64 years of age. Dysplasia is associated with Intestinal Metaplasia. The frequency of the epidermoid carcinoma is of 96% and for adenocarcinoma of 4% in the period of evaluation of 15 years (1985-1999). There is no difference in the tendency of epidermoid carcinoma and esophagus adenocarcinoma during the same evaluation period. The incidence of Barrett s Esophagus adenocarcinoma is higher in males than in females: (6:1). Intestinal metaplasia is found in 13/14 patients evaluated in relation to the esophagus adenocarcinoma. Long segment Barrett s Esophagus, is found in 13/14 patients complicated with adenocarcinoma. The average size of the long segment Barrett s Esophagus is of 6 cm in the patients with adenocarcinoma.

Barrett Esophagus↗

PubMedDate not supplied

[Value of the preoperative carcinoembryonic antigen as an independent prognostic factor in cancer of the colon and rectum].

The carcinoembryonic antigen (CEA) has diverse applications when dealing with patients with colon-rectal cancer. The clinical value may be divided between preoperative evaluation of the tumor extension and its prognosis and the postoperative monitoring of the recurrence. We carried out this study to investigate and determine whether there is a relation between the preoperative value of the CEA and survival and if it may be considered as an independent prognosis factor in colon-rectal cancer. We evaluated 122 patients with colon-rectal cancer, who had had curative surgery and we analyzed different variables in univaried and multivaried form, to determine independent prognosis factors (CEA, sex, age, degree of differentiation, tumor size, ganglionar compromise, and the level of wall infiltration). The ganglionar compromise, the level of intestine wall infiltration and the CEA preoperative value lower than 5 ng/ml had a significantly higher survival than those with values higher than 5 ng/ml, regardless of other factors. We concluded that the preoperative determination of Carcinoembryonic Antigen represents a non-invasive study clinically useful in dealing with colon-rectal cancer and that its value has a significant statistical value as an independent prognosis factor in colon-rectal patient survival.

Adenocarcinoma↗

PubMedDate not supplied

[Central pancreatectomy. Indications and perisurgical results of a pancreatic tissue conservation technique].

INTRODUCTION: Proximal or distal pancreatectomy is the standard treatment for non-resectable benign pancreatic tumors. These procedures imply a radical resection as well as a significant loss of distal normal pancreatic tissue for the standard resection, which may cause an endocrine and/or exocrine pancreatic failure. PURPOSE: Report our experience in central pancreatectomy for the treatment of benign/low malignancy potential tumors in the body and neck of the pancreas by emphasizing the indications and perisurgical results. METHODS: Prospective study of patients with suspected benign tumors in the body of pancreas. SURGICAL TECHNIQUE: Resection of central pancreas through a Roux-en-Y pancreatojejunal anastomosis. RESULTS: From March 1997 to May 2005, 12 patients underwent central pancreatectomy through pancreatojejunal anastomosis. 6 benign tumors were found in the islets of Langerhans: 3 microcystic cystadenomas, 1 mucinous cystadenoma, 1 pseudopapillary solid tumor, and 1 serous cystadenoma. Morbidity rate was 33.3% with no post-surgery deaths. Pancreatic failure was not reported during follow up. CONCLUSION: Some selected cases of benign/low malignancy potential tumors may be treated with central pancreatectomy and pancreatojejunal anastomosis with acceptable morbidity levels and minimum mortality levels. The benefit from preserving the greatest extension of healthy pancreatic tissue as possible is translated into a preservation of the endocrine and exocrine functions of the pancreas.

Adolescent↗

PubMedDate not supplied

[Laparoscopic treatment of insulinoma: surgical technique and perisurgical results].

AIM: Our experience with the laparoscopic treatment of pancreatic insulinomas is reported. PATIENTS AND METHODS: Four patients with clinical and radiological diagnosis of insulinoma were treated between January 2000 and September 2005. RESULTS: All the patients were laparoscopically approached to attempt the tumor enucleation. In three cases complete enucleation was possible; the remaining case was converted to perform the resection of the middle portion of the pancreas. One patient developed a pancreatic fistula that closed spontaneously. In all cases histological evaluation of the tumor showed benign islet cell tumor. Blood glucose levels returned to normality. CONCLUSION: Laparoscopic enucleation of pancreatic insulinoma is a feasible and safe technique.

Adult↗

PubMedDate not supplied

[Reconstruction following proximal pancreatoduodenectomy by simplified pancreatojejunal anastomosis. Operation results in 198 patients].

INTRODUCTION: The pancreatojejunal anastomosis is considered the weak spot when carrying out a duodenopancreatectomy, because it causes most of the complications following a Whipple surgery. Here we present a series of cases using a single technique for performing this anastomosis. MATERIAL AND METHODS: During the period between October 2002 and August 2005, 49 duodenopancreatectomies were performed at the 3AII Department of the National Hospital Edgardo Rebagliati Martins (H.N.E.R.M.) in 31 of these cases a lateral mucosa to mucosa pancreatojejunal anastomosis was carried out by the same surgeon. RESULTS: The most frequent complication was infection of the operating wound followed by pancreatic fistula and intra-abdominal hemorrhage and the overall morbidity was 29%. Pancreatic fistula developed in 13% of the cases; however, no patient required additional treatment and the fistula closed maximum twenty days after the surgery. On average, patients resumed oral food intake after 6 days and remained hospitalized for 16 days. Mortality was 3%, because a patient developed a pseudo-aneurysm of the hepatic artery, which ruptured 17 days after the operation. CONCLUSIONS: The mucosa to mucosa pancreatojejunal anastomosis is a safe technique with a low index of pancreatic fistula and mortality.

Adolescent↗