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Biomedical subjects

M T Turunen

Publications and source records attributed to M T Turunen.

9 recordsLinked to original sources
PubMed1986

Results of sphincteroplasty in patients with spastic sphincter of Oddi. Predictive value of operative biliary manometry and provocation tests.

The predictive value of different preoperative provocation tests and operative biliary manometry was studied in a series of 22 patients undergoing sphincteroplasty for suspected spastic sphincter of Oddi (SPO). The result of the operation was good in 59%, 54%, and 71% of patients in groups with a positive codein test, a positive endoscopic retrograde cholangiopancreatography filling pain sign, and positive fentanyl test, respectively. Common bile duct pressure (CBDP) did not differ significantly between the SPO spasm group and control patients, but in the fentanyl test the CBDP elevation was significantly higher (p less than 0.01) than in controls (7.7 versus 3.3 mm Hg). It was concluded that the operative fentanyl test seems to be useful in predicting the response to surgery (sphincteroplasty) in patients with post-cholecystectomy biliary-type pain and suspected SPO spasm.

Adult↗
PubMed1986

Effects of alfentanil and fentanyl on common bile duct pressure.

The effects of alfentanil (7.5 or 15 micrograms/kg) and fentanyl (1.5 micrograms/kg) on common bile duct pressure were examined by using an indwelling postoperative T-tube in 36 conscious, unpremedicated patients. All opiate doses significantly (P less than 0.001) increased the pressure. There was no significant difference among the groups in the peak pressures nor in the times to peak pressures. Fentanyl had a significantly longer duration of effect on pressure.

Adult↗
PubMed1985

Manometry with needle cholangiography. Results in 70 patients.

Cholangiomanometry is evaluated in 70 patients using a new technique based on needle cholangiography. In 94% of the patients the results of cholangiomanometry were in agreement with the final operative diagnosis. In two patients out of 20, common duct stones did not cause changes in the biliary pressure. In 14 patients re-operated on for postcholecystectomy pains, the increase in intrabiliary pressure due to a fentanyl dose was significantly higher than that in the control patients. Cholangiomanometry is recommended for selective use to complement needle cholangiography in biliary re-operations and in operations after biliary pancreatitis.

Adult↗
PubMed1984

Manometry with needle cholangiography. A new technique.

A new method of cholangiomanometry developed on the basis of operative needle cholangiography is described. The pressure of the common bile duct is recorded during continuous infusion using two different speeds. The procedure is complemented by pressure controlled injections of a contrast medium and by fentanyl test to study the function of the sphincter of Oddi.

Cholangiography↗
PubMed1984

Effect of anaesthesia on fentanyl-induced changes in human intracholedochal pressure.

Intracholedochal passage pressures (ICPP) were measured during halothane, enflurane and isoflurane anaesthesia as well as during anaesthesia without any volatile agent and in patients with a postoperative T-tube. There were no statistically significant differences in the mean ICPP between the study groups (altogether 49 patients). After i.v. fentanyl 0.1 mg a similar pressure increase (mean 0.5 kPa) was recorded in all anaesthetized groups as compared to a threefold increase (mean 1.6 kPa) in the postoperative group (p less than 0.001) with maximum at about 7 min in all groups. Intraoperative fentanyl did not cause surgically adverse effects i.e. false obstruction due to spasm in the operative cholangiography. It is concluded that all inhalation anaesthetics attenuate the ICPP response to fentanyl.

Adult↗
PubMed1984

Routine operative needle cholangiography in cholecystectomy for gallstones. A prospective study of 486 patients.

Operative needle cholangiography (CG) and its routine use in cholecystectomy for gallstones were prospectively studied in a series of 486 patients. The failure rate of needle CG was 0.6%, and in 6.6% of the series adequate CG films were obtained first after repeated examination. There were no postoperative complications attributable to the CG technique. The sensitivity of the method to reveal common duct stones was 100% as judged from 5 to 7 years of follow-up, while the sensitivity of the classic signs suggesting common duct obstruction was 89% when calculated on combined signs. The respective specificities in regard to choledocholithiasis were 91 and 67%. Among 203 patients with clinically suspected common duct stones, CG yielded normal findings in 110 and was false positive in 11 (54 and 5.4%). Among the 283 patients without clinical suspicion of common duct stones, 9 proved to have such stones and in 14 the CG was false-positive (3.2 and 4.9%). The greater than 3% incidence of choledocholithiasis which was clinically unsuspected (11% of all cases of common duct stone), and the circumstance that choledochotomy could be avoided in about half of the patients with clinically suspected stone, advocate routine performance of CG. We believe the needle technique to be the CG procedure of choice in most cases. The possibility of reducing the incidence of false-positive findings is discussed.

Adolescent↗
PubMed1984

Choledochoscopy versus postexploratory cholangiography in prevention of retained common duct stones.

A prospective comparison of flexible choledochoscopy with postexploratory T-tube cholangiography for detecting retained common duct stones was performed in a series of 197 consecutive patients undergoing cholecystectomy and choledocholithotomy. After common duct exploration and apparent removal of stones more missed stones were detected and successfully removed in the choledochoscopy group (n = 15) than in the cholangiography group (n = 7). Retained stones occurred in one of 75 patients (1.3%) after choledochoscopy, in 7 of 79 (8.9%) undergoing T-tube cholangiography only and in 5 of 43 (11.6%) with no postexploratory control. The difference was significantly (p less than 0.05) in favour of choledochoscopy. The operation time was not significantly prolonged and there was no increase in postoperative complications due to choledochoscopy. Choledochoscopy is considered to be the best means of reducing the rate of retained common duct stones and it is recommended after every choledocholithotomy.

Cholangiography↗