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L Burgos

Publications and source records attributed to L Burgos.

At least 19 recordsLinked to original sources
PubMed1996

[CAA 19-9 and carcinoembryonic antigen in gallbladder cancer].

The aim of this work was to assess the diagnostic yield of serum tumoral markers, Ca 19-9 and carcinoembryonic antigen, in patients with gallbladder cancer. We studied 54 patients of whom 33 had gallbladder cancer and in 21 the tumor was removed previously and were presently free of disease. Twenty one patients with cholelithiasis were used as controls. Ca 19-9 was over 37 U/ml in 22 (65%) patients with cancer, in two patients free of disease and in two controls. The sensitivity and specificity of Ca 19-9 was 0.66 and 0.90 respectively. Carcinoembryonic antigen was over 2.5 ng/ml in 25 patients with cancer (56%) and its sensitivity and specificity was 0.75 and 0.71 respectively. Using a cutoff point of 4 ng/ml, these figures were 0.51 and 0.9 respectively. The better predictive capacity was given by a Ca 19-9 over 37 U/ml or a carcinoembryonic antigen over 4 ng/ml. It is concluded that, although the sensitivity and specificity of these markers was adequate in this work, one must bear in mind that studied patients had advanced tumors.

Adult↗
PubMed1996

[Gallbladder cancer: a review].

In Chile, gallbladder cancer is the tumor with the highest mortality rates among women. Cholelithiasis is the most common associated factor and the reduction in cholecystectomy rates could be an important factor in the incidence of gallbladder cancer. Unfortunately, the disease is diagnosed late and the study of the surgical piece is the main form of early recognition. The degree of gallbladder wall infiltration by the tumor is the simplest and best staging method that has prognostic value. Gallbladder fat must be considered as a separate tissue, since its biological behavior differs from that of the subserous. The treatment of these tumors is based in their dissemination modality that is mainly local and regional. Surgical resection and radiotherapy are potentially effective. However the detection of high risk patients that should be subjected to cholecystectomy should be the better therapeutic alternative.

Female↗
PubMed1996

[Pancreas divisium as a cause of chronic pancreatitis. Clinical case].

We report a 6 years old girl with chronic pancreatitis, presenting as recurring bouts of abdominal pain and hyperamylasemia, secondary to a lack of communication between the main papilla and pancreatic duct (pancreas divisium). The diagnosis was made during an intraoperative pancreatography and treatment consisted in a sphincteroplasty of the secondary papilla.

Child↗
PubMed1995

[Hereditary chronic pancreatitis. Report of a case].

Childhood hereditary pancreatitis is a rare entity of uncertain etiology, characterized by recurrent episodes of acute pancreatitis, abdominal pain and other unspecific symptoms. Among several therapeutic alternatives, pancreatojejunostomy is presently the treatment of choice. We report a 17 years old male with chronic hereditary pancreatitis that was treated with pancreatojejunostomy drainage.

Adolescent↗
PubMed1995

[Gallbladder cancer. Case-control study].

Gallbladder cancer is the principal oncological cause of death in chilean women and cholelithiasis is a well recognized risk factor. Aiming to unravel other risk factors for gallbladder cancer, we compared 50 patients subjected to cholecystectomy in whom a gallbladder cancer was found with 50 age and sex matched operated controls without cancer. Subjects were clinically assessed and interrogated about demographic, obstetrical features and feeding features. Multiples and early pregnancies were factors significantly associated to the development of gallbladder cancer. Twenty subjects (44%) with cancer knew that they had cholelithiasis and 41 patients in each group were symptomatic. It is concluded that pregnancy may be a risk factor for gallbladder cancer probably due to the lithogenic effect of its hormonal changes. Also, early cholecystectomy in symptomatic individuals may be an effective preventive measure.

Adult↗
PubMed1994

[Gallbladder cancer in the IX Region of Chile. Impact of the anatomopathological study of 474 cases].

We studied prospectively 474 cases (83% female with a female:male ratio of 5:1) of gallbladder carcinoma diagnosed in a period of 7 years. Twenty two percent of patients were younger than 50 years old. Ninety percent of tumors were adenocarcinomas. In 1987, 45% of cases were diagnosed in metastases compared to 1993, when only 10% of tumors were diagnosed in such histological material. Thirty four percent of tumors were not macroscopically identified; all these inapparent tumors were advanced in 1987, whereas 53% were incipient in 1993. Moreover, inapparent tumors had a significantly lower degree of gallbladder wall infiltration and higher degree of differentiation. Well differentiated tumors had a lesser degree of wall infiltration. It is concluded that the careful histopathological study of gallbladder cancer has allowed a thorough knowledge of the natural history and clinical presentation of gallbladder carcinoma.

Adenocarcinoma↗
PubMed1993

[Mutagen extraction from bile of patients with inflammatory biliary pathology: Ames test using blue rayon].

Gallbladder carcinoma is frequent in Chile. The aim of this study was to report the mutagenicity of whole human bile, using the Ames/Salmonella microsome assay with Salmonella typhimurium TA98. The bile of 19 patients, aged 23 to 64 years old, subjected to cholecystectomy was examined, and mutagen activity was found in 13 (72%). Mutagens were extracted using blue rayon and three dilutions for the eluted material from blue rayon were used (50, 100 and 200 ul). The best result was obtained using 200 ul. In some cases, the amount of revertive colonies was very high (over 5 times the control value). We propose that the bile from these patients possibly contains mutagenic substances with frame shift mutagenic activity and that these substances may be related to gallbladder carcinoma. Our results have addressed the importance of bile studies to elucidate the pathogenesis of gallbladder carcinoma.

Adult↗
PubMed1993

[Epithelial lesions associated with gallbladder carcinoma. A methodical study of 32 cases].

Using mapping techniques, 32 consecutive gallbladder carcinomas diagnosed in our department were studied. The defined lesions were dysplasia, carcinoma in situ and superficial spreading carcinoma. A total of 2257 lesions were recorded from 1072 inclusions. All the defined lesions were present in about 10% of all sections. However, if each case is considered separately, dysplasia was present in 81.3% of cases, carcinoma in situ in 65.6% of cases and superficial spreading carcinoma in 68.8% of cases. An isolated focus of atypical epithelium without anatomic relation with the main tumor was demonstrated in only 3 cases and a close relation between invasive carcinoma and dysplastic lesions was observed in the remainder. Infiltration of Rokistansky-Aschoff sinuses was observed in 40% of cases. We were not able to demonstrate, on histological basis, differences between superficial spreading carcinoma and carcinoma in situ. We conclude that atypical lesions of the gallbladder are not frequently seen and that their presence must prompt the search of a carcinomatous lesion by means of serial sections of all the histological sample.

Carcinoma in Situ↗
PubMed1992

Gallbladder cancer in Chile. A report on 54 potentially resectable tumors.

Fifty-four patients with potentially resectable gallbladder tumors, chosen from 205 cases diagnosed at the Pathologic Unit of the authors' institution, were included in a prospective protocol of management. Of the potentially resectable tumors, only four were indicated before cholecystectomy (7.4%). Inconspicuous tumors were frequently observed, explaining in part the poor results of ultrasonogram for diagnosis. Poorly differentiated tumors were related to a greater rate of metastasis and shorter survival. Likewise, younger patients were associated with a worse prognosis. Patients with tumor confined to the mucosal layer were followed-up only during their postoperative courses. Patients with tumor involvement of the subserosa or muscular layer were offered treatment of a second operation, which included a lymphadenectomy and a liver wedge resection. For patients with serosal involvement, a more aggressive approach was proposed. Metastatic lymph node involvement was found in 9 of the 25 (36%) patients in whom dissection was performed. However, tumor invasion of the liver was seen in 10 of the 24 (41.6%) patients who underwent a liver resection. Patients who had a curative resection had a significantly longer survival in comparison with those who had a palliative resection or simple cholecystectomy.

Adenocarcinoma↗
PubMed1991

[Inapparent cancer of the gallbladder].

Gallbladder cancer is the most common cancer in the Chilean female population. A prospective histological mapping of cholecystectomy pieces allowed the detection of 37 tumors not evident to the surgeon. Tumoral invasion engaged the mucous membrane in 7, the muscular layer in 8, the subserous layer in 12, the serous membrane in 5 and the surrounding adipose tissue of the gallbladder in 5 cases. 18 pts were reoperated on for resective oncological surgery. In 5 of these cases the ganglia, and in 6 the hepatic tissue behind the gallbladder were involved. Actuarial survival at 38 months was 48% (10 pts have died by the time of this publication). The prognosis of the disease was directly related to histological differentiation and to the degree of tumoral invasion. Gallbladder cancer has a poor prognosis even if the surgeon has no suspicion of the disease and a simple cholecystectomy is by no means a healing therapy.

Adult↗
PubMed1991

Experience in the surgical treatment of 331 patients with pulmonary hydatidosis.

Echinococcus disease is prevalent in Chile, with a rate of occurrence of 8.2 per 100,000. During a 15-year-period (1970 to 1985) we operated on 331 patients for pulmonary hydatidosis. Chest roentgenography was the main method of diagnosis. Among the total of 508 surgical procedures performed, pulmonary cystectomy was the most common (61.4%), whereas pulmonary resection was used in 31.4% of patients. The arc 5 test was used to confirm the diagnosis. Results were positive in 85% of the patients in whom it was done. There were 12.9% immediate postoperative complications in 12.9%, with late complications occurring in 4.10% and an overall mortality rate of 4.21%. These data suggest that hydatid cyst is still a common disease in our country, causing an important number of hospital admissions and a high percentage of complications.

Echinococcosis, Pulmonary↗
PubMed1991

Pancreatojejunostomy.

Pancreatoduodenectomy is a complex procedure associated with considerable mortality and morbidity. Pancreatojejunostomy is probably the main cause of morbidity, and controversy concerning the best type of reconstruction still exists. In this report the technique of pancreatojejunostomy is demonstrated. An end-to-side pancreatojejunostomy is performed on all patients. For patients with a pancreatic duct of less than 4 mm in diameter, the top of the pancreatic duct is inserted into a stab-wound of jejunum. It is secured with a purse-string suture. Furthermore, two layers of reinforcement are done. By using this technique, an end-to-side anastomosis was done on patients with soft glands and small ducts. In patients with a pancreatic duct greater than 4 mm, a three-layer anastomosis is done between pancreas and jejunum. This is a technique that allows the performance of an end-to-side anastomosis regardless of the pancreas consistency or pancreatic duct diameter.

Anastomosis, Surgical↗
PubMed1990

Operative findings in patients with early forms of gallbladder cancer.

Of 52 patients diagnosed as having gallbladder cancer in a 2-year period, 15 had no evidence of serosal involvement. Four of these 15 patients had tumour confined to the mucosa and did not undergo reoperation while 11 patients underwent lymph node dissection and hepatic wedge resection at a second operation. The correct diagnosis was suspected before the first operation in only one of 11 patients undergoing reoperation; the tumour was found microscopically in seven patients. Of the 11 patients who underwent reoperation, five had lymph node involvement, and three of these patients had both liver and lymphatic involvement. Our results underline the difficulty of establishing the diagnosis of gallbladder cancer before operation and the lack of major morbidity and mortality suggests that there may be value in reoperating on patients found to have gallbladder carcinoma without serosal involvement. Further follow-up is required to assess the long-term value of this approach.

Adult↗
PubMed1990

[Association of gallbladder and Vater's ampulla neoplasms. Report of a case].

A 54 year old female was operated on for ampullary carcinoma diagnosed by retrograde cholangiography. Histologic study of the gallbladder resected at operation revealed another carcinoma at that location. Pancreato-duodenectomy plus a double segmental resection of liver was performed. The patient remains in good condition 11 months after operation.

Adenocarcinoma↗