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Biomedical subjects

K V Robbins

Publications and source records attributed to K V Robbins.

7 recordsLinked to original sources

Pancreatic response to percutaneous biliary drainage: a prospective study.

To evaluate the effects of percutaneous biliary drainage (PBD) on the pancreas, serum amylase levels were measured for 7 consecutive days after PBD and compared with baseline values in 50 patients who underwent a total of 53 PBD procedures. Of the 45 patients with normal baseline serum amylase levels, 12 patients (24%) developed postprocedural hyperamylasemia without clinical symptoms and five patients (10%) developed postprocedural hyperamylasemia with clinical signs of pancreatitis. Five patients who presented with elevated baseline serum amylase levels demonstrated decreases into the normal range after placement of stents without initiation of bowel rest or liquid diet. The level of biliary obstruction proved insignificant, as did the nature of the obstructing disease, in determining which patients would experience hyperamylasemia or pancreatitis after PBD. It is concluded that the frequency of pancreatic insult from PBD may be more common than previously reported and that patient susceptibility is not dependent on the level of biliary obstruction or the nature of the disease.

Adult

Endoscopy as an adjuvant to biliary radiologic intervention.

Twenty-two patients underwent 24 percutaneous biliary procedures guided with choledochoscopy, an adjunctive percutaneous biliary technique. All but four procedures were performed through established percutaneous tracts; the others, through tracts less than 4 weeks old. The procedures were done for the following reasons: removal of calculi (n = 15), electrohydraulic lithotripsy (n = 1), biliary duct biopsies (n = 8), cauterization of a bleeding tract (n = 1), and evaluation of biliary-enteric anastomoses (n = 11). The only complication was one case of severe nausea after choledochoscopy. This patient required overnight hospitalization and medical treatment. All procedures were technically successful, except one case in which the tract was undersized. All patients received intravenously administered antibiotics before and after the procedure. It is concluded that choledochoscopy is a safe, atraumatic, and well-tolerated method of evaluating and treating biliary disease and that it markedly reduces radiation exposure. It can be performed rapidly with minimal sedation on an in- or outpatient basis.

Adult

Angioscopically monitored saphenous vein valvulotomy.

Angioscopy was used during in situ saphenous vein bypass grafting in seven patients. We were able to visualize valve incision, immediately identify and correct incomplete valvulotomy, identify side branches as potential arteriovenous fistulas, and assess distal anastomotic integrity. We encountered no retained valve cusps after angioscopy, as verified by Doppler ultrasound and completion angiography. Angioscopy verified distal anastomotic integrity in all patients with distal vein grafts large enough to accept the angioscope. Angioscopy requires minimal time, is relatively easy to use, serves as an adjunct to Doppler ultrasound and completion angiography, and has future potential as a therapeutic tool.

Aged

Percutaneous angioscopy. Work in progress.

The cardiovascular applications of flexible fiber-optic technology are imminent because of recent advances in miniaturization. In the work described here, angioscopy, or vascular endoscopy, was performed in the cadaveric aorta and in the systemic and pulmonary circulations of the canine model and selected human patients. Subsequent to our development of percutaneous techniques, clinical trials have ranged from lower-extremity venoscopy to aortic-root arterioscopy. Angioscopy could be clinically useful because of relative or absolute contraindications to iodinated contrast material. The ability to see in color and three dimensions may afford some other advantages to angioscopy over conventional angiography.

Animals