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R J Wale

Publications and source records attributed to R J Wale.

6 recordsLinked to original sources
PubMed1991

Percutaneous laparoscopic cholecystectomy: the first fifty.

A series of 50 percutaneous laparoscopic cholecystectomies was performed by one surgeon between 7 June and 25 October 1990 using a modified technique as described by Dubois. There were 42 females and 8 males, the average age being 44 years with a range of 14-76 years. The average operating time was 80 min, ranging from 35 to 210 min. Postoperative stay averaged 2.9 days and there was an average of 11 days to return to work. Complications consisted of a subhepatic bile collection requiring open drainage, one minor wound infection and one minor abdominal wall haematoma. Laparoscopic cholecystectomy is a safe technique for removing the gall-bladder resulting in a rapid convalescence and early return to work. The initial learning curve is long and careful case selection should be carried out in this phase.

Adolescent↗
PubMed1985

Prospective study of the Angelchik anti-reflux prosthesis.

Fifty patients with medically refractory gastro-oesophageal reflux were treated by the insertion of an Angelchik anti-reflux prosthesis. All patients had a pre-operative upper gastrointestinal endoscopy, 32 were investigated with 15 h overnight oesophageal pH studies combined with oesophageal bile sampling and 20 underwent oesophageal manometric studies. At pre-operative endoscopy 45 patients had evidence of oesophagitis and the 5 who did not had pathological reflux demonstrated on overnight pH testing. Postoperatively the main clinical problem was dysphagia which appeared to settle with time but left one-third of patients with mild dysphagia at the end of 12 months. A further 12 per cent had residual moderate to severe dysphagia which required the removal of the prosthesis in five patients (10 per cent). In only one patient was the dysphagia due to prosthetic migration and this was the first patient in the series. Subsequently, we have had no problems with prosthetic migration, disruption, or erosion into the oesophagus. The overnight pH studies confirmed the efficacy of the prosthesis in preventing reflux which correlated with symptomatic improvement. We conclude that, while the Angelchik anti-reflux prosthesis is an effective device, it has a disturbingly high incidence of postoperative dysphagia though this appears to settle with time, leaving around 10 per cent of patients with severe dysphagia which will necessitate removal of the prosthesis and one-third with mild dysphagia which may settle with the further passage of time.

Adult↗
PubMed1985

Anterior resection of the rectum--a simplified stapling technique.

The use of a double stapling technique in anterior resection of the rectum eliminates the necessity for a rectal stump pursestring and removes the problem of tissue pouting on the spindle of the circular EEA stapler when a voluminous rectum is pulled onto it with the pursestring. We have used this technique in 20 patients with tumours in the middle and lower thirds of the rectum without complication. This technique may reduce contamination in the pelvis and certainly shortens operating time. Cost effectiveness of the technique should be evaluated in busy centres where the benefit would appear to be greatest.

Humans↗
PubMed1983

Familial occurrence in carcinoid tumours.

Two family groups with familial carcinoid tumours with metastases are presented. These are the fourth and fifth family groups to be reported which do not occur within the setting of the multiple endocrine neoplasia (MEN) syndrome. Relatives of patients with carcinoid tumours having persistent vague abdominal pain or gastrointestinal symptoms should be investigated.

Adult↗