Biomedical subjects

S Apostolidis

Publications and source records attributed to S Apostolidis.

5 recordsLinked to original sources

PubMed1999

Myoelectric assessment of large bowel viability: an experiment in dogs.

OBJECTIVE: To design a device for myoelectric assessment of intestinal ischaemia and compare it with every day surgical experience and Doppler signals recorded on the bowel wall. DESIGN: Experimental study. SETTING: Thessaloniki university hospital, Greece. MATERIAL: 12 adult mongrel dogs. INTERVENTIONS: On the first day the large intestine was devascularised for a length of 20 cm, 5 cm away from the ileocaecal valve, and the threshold of the electric stimulus (mA) required to produce a contraction of the normal large bowel was recorded. On the second day, measurements were made on the ischaemic segment of the large bowel at 0.5 cm intervals. Bowel resection and anastomoses were done at the stimulus level of 40 mA. RESULTS: The mean (SD) stimulus threshold of the normal large intestine was 12.2 mA. The necrotic intestine demanded current stimulus of 100 mA or failed to contract. On the eighth postoperative day the animals were killed to assess anastomotic healing. Of the 12 anastomoses made at the 40 mA stimulus point, only one ruptured. The 40 mA limit of the stimulus level seems to be of value in assessments of bowel viability in vivo. CONCLUSION: The use of a personal computer as a read out device makes myoelectric analysis easier and more reliable in the assessment of intestinal viability. This method may have a clinical application.

Anastomosis, Surgical↗

PubMed1998

External biliary fistula.

We report 210 cases of external biliary fistula treated in our clinics between 1970-1992. In 7 cases, fistulas were formed after iatrogenic bile duct injury, in 4 cases after exploration of common bile duct, in 4 cases due to disruption of biliary-intestinal anastomosis, and in 2 cases due to liver trauma. In 85 cases bile leak was observed after cholecystomy, in 103 cases after hydatid disease surgery, and in 4 cases after the passage of P.T.C. catheter. In one patient the appearance of the fistula was due to spontaneous discharge of a gallbladder empyema. 173 cases were managed conservatively, and 37 cases surgically.

Biliary Fistula↗

PubMed1996

Subtotal cholecystectomy.

Subtotal cholecystectomy has been carried out in 34 patients from 1972 to 1992. In the same period 1620 total cholecystectomies were performed. The indications were severe inflammation and/or severe fibrosis in 31 patients, and Mirizzi syndrome type 1 in 3 patients. The morbidity was insignificant, but one patient died, due to severe sepsis. In follow up studies ranging from 6 months to 9 years, there was one patient with retained stones in the common bile duct. No other post cholecystectomy sequelae were noticed in the remaining 32 patients. Subtotal cholecystectomy is a safe, feasible and definitive operation in patients for whom the standard operation could be dangerous. This operation is less burdensome to the patient, and is accompanied by fewer complications than ordinary cholecystostomy.

Adult↗

PubMed1996

Acute cholecystitis in aged patients.

The aim of this study is the analysis of the results in 62 patients over 70 years of age with acute cholecystitis treated in our Department from 1970 to 1990. The clinical picture in 47 patients was mild and in 15 severe. In 14 cases (10 calculous, 4 acalculous) the acute cholecystitis subsided with antibiotics (Group A). In 48 more cases (45 calculous, 3 acalculous) following 1-3 days conservative treatment, operation was undertaken. Besides acute cholystitis there was gangrene of gallbladder in 10, choledocholithiasis in 7 and choloperitoneum without perforation in 7 cases. Cholecystostomy in 25, cholecystectomy in 15 and cholecystectomy with exploration of the bill duct in 8 cases was performed (Group B). There was one death in group A and 3 deaths in group B. The hospital stay was 20 days. In conclusion the clinical findings in acute cholecystitis in the aged are usually mild. In the case of failure of medical treatment, after 2-3 days emergency surgery should be performed.

Acute Disease↗

PubMed1996

Hanging noncalculous gallbladder.

The removal of acalculous and not acutely inflamed gall-bladder in patients with typical biliary pain remains a questionable procedure. This study was conducted to present our experience. In the period 1982-90, 1089 cases of calculous and acalculous gallbladder disease were treated in our clinic. In this period, 27 patients were subjected to cholecystectomy because of an acalculous, non inflamed gallbladder which was elongated lying in an abnormal position with a long cystic duct. The mean duration of symptoms supportive of cholelithiasis, was 5 years. Oral cholecystogram and ultrasonography led to the diagnosis and other causes of chronic abdominal pain were excluded. There were 13 lumbar, 9 pelvic and 5 iliac gallbladders, with poor function in 20 of them. During cholecystectomy, the organ was invested by peritoneum and suspended in 7 cases from a mesentery. On pathological examination mild chronic inflammation was reported in 19 cases and minimal changes in 8. The minimum follow up was one year and the maximum 9 years. Complete relief of symptoms was achieved in all the cases. In conclusion, cholecystectomy should be offered in these symptomatic "hanging" gallbladders.

Adult↗