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P Wittebol

Publications and source records attributed to P Wittebol.

7 recordsLinked to original sources
PubMed1979

Lower esophageal sphincter function after highly selective vagotomy.

We evaluate whether highly selective vagotomy (HSV) might disturb functional integrity of the lower esophageal sphincter (LES). Special interest was directed to changes in position of the LES in relation to the diaphragm, LES pressure, and pH reflux pattern. The conditions of 20 patients were evaluated by manometric studies and by 12-hour overnight pH measurements before and 14 days after HSV; five of them were also studied one year after HSV. The results indicate: (1) There is a slight elongation of the LES in the early postoperative phase, which seems to disappear after one year. (2) The position of the diaphragm as measured manometrically by the pressure inversion point descends in relation to the LES 14 days after HSV, and it does not seem to return to its original position after one year. (3) There is no significant change in LES pressure after HSV. (4) There is no increase in reflux after HSV.

Adult↗
PubMed1977

Comparison of postoperative coumarin, dextran 40 and subcutaneous heparin in the prevention of postoperative deep vein thrombosis.

A double-blind study was carried out to investigate the effectiveness of several preventive regimens in postoperative deep vein thrombosis (DVT). The regimens consisted of postoperative (p.o.) acenocoumarin, dextran 40 + p.o. acenocoumarin, subcutaneous (s.c.) heparin alone and s.c. heparin + p.o. acenocoumarin. The 313 patients studied were stratified according to age (40-60 vs. less than 60 years) and type of operation (laparotomy, thoracotomy, hip replacement). Dextran 40 + p.o. acenocoumarin was more effective than p.o. acenocoumarin alone, which acted as control. Subcutaneous heparin alone or together with p.o. acenocoumarin was not more effective than p.o. acenocoumarin alone during the first part of the study, when about 4000 IU twice daily were administered accidentally. When the dose had been changed to 5000 IU twice daily, better results were obtained (DVT) incidence 5.9%). The results were strongly influenced by age and type of operation. Almost no DVT occurred in patients below 60 years of age with elective abdominal surgery. The incidence of perfusion disturbances in lung scans in patients with DVT was lowest in those treated with s.c. heparin in combination with acenocoumarin.

Adult↗
PubMed1977

The effects of highly selective vagotomy on secretion and emptying of the stomach.

The results of a prospective study of 60 patients with nonobstructive duodenal ulcer treated by highly selective vagotomy show that the gastric acid secretion postoperatively is effectively reduced. Judgment of completeness of highly selective vagotomy is only possible by means of an intragastric pH-metry during operation. The Hollander test answers it insufficiently. In a number of patients, highly selective vagotomy caused a fast initial phase of gastric emptying of porradge. The impression is that the contractional activity of the antrum has the same pattern before and after highly selective vagotomy.

Adult↗