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S K Teplick

Publications and source records attributed to S K Teplick.

104 records · Page 6Linked to original sources
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Ultrasound of hemobilia: a clinical and experimental study.

Clinical observations on patients with hemobilia secondary to percutaneous biliary procedures and laboratory studies on animals with experimentally induced hemobilia indicate that the presence of fresh blood or clot within the biliary tree may yield an erroneous impression of duct size in ultrasound examinations. Recognition of this potential source of error becomes increasingly important as the use of percutaneous procedures for the relief of biliary obstruction increases.

Animals↗
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Effects of gallstone solvents on commonly used catheters.

PURPOSE: To determine what interaction and effect different cholesterol gallstone solvents have on catheters used for gallstone chemolysis. MATERIALS AND METHODS: Five types of catheters used for biliary procedures were chosen: polyethylene, Percuflex, silicon, Silitek, and polyurethane. The solvents chosen were methyl tert-butyl ether, ethyl propionate, isopropyl acetate, and N-propyl acetate. After incubation of the catheters in the solvents for 72 hours, they were air dried. Weight and area changes were determined for each catheter. Additionally, carbon-13 nuclear magnetic resonance (NMR) spectroscopy was performed for analysis of composition changes. RESULTS: Three catheters--silicone, Silitek, and polyurethane--showed changes in their physical characteristics that would make them less desirable for stone chemolysis. The silicone catheter showed changes in elastic texture as well as marked weight reduction. The Silitek and polyurethane catheters had similar, but less dramatic changes. C-13 NMR analysis of collected solvents showed that commonly used plasticizers were leached out of some catheters. CONCLUSION: These results suggest that all catheters are not suitable for use with all solvents. The choice of catheter should be made based on the solvent in use. The polyethylene catheter performed best under the conditions and endpoints used in this study.

Catheterization↗
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Percutaneous transcholecystic approach to the rendezvous procedure when transhepatic access fails.

PURPOSE: Extrahepatic biliary obstruction can be managed endoscopically or percutaneously. When endoscopic therapy fails, percutaneous drainage with or without endoscopic assistance may be performed. However, transhepatic drainage may itself be unsuccessful. In such patients, a transcholecystic approach combined with endoscopic therapy was used to achieve biliary drainage. MATERIALS AND METHODS: After attempts at transhepatic biliary drainage failed, a percutaneous cholecystostomy was performed in four patients, with subsequent cannulation of the common bile duct, endoprosthesis insertion, or papillotomy. RESULTS: The success rate was 100%, with no major complication or procedure-related mortality. Slight bleeding from a sphincterotomy was the only minor complication. CONCLUSION: When percutaneous transhepatic access to the bile duct fails, the transcholecystic route can be safely used with care to successfully achieve biliary drainage.

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Intravenous cholangiography in the rhesus monkey. part I: Determination of optimal iodipamide dose during a one-hour infusion.

One-hour infusion intravenous cholangiography with iodipamide was performed in 3 rhesus monkeys with intact enterohepatic circulations. A series of four different doses including standard (0.3 ml/kg) and "double dose" (0.6 ml/kg) levels were compared. The 0.6 ml/kg dose resulted in significantly higher biliary iodine excretion and concentration than the lower two doses. A 1.2 ml/kg dose probably increased biliary iodine concentration a small amount when compared to the 0.6 ml/kg dose but did not increase iodine excretion. Peak iodine excretion and concentration occurred, on the average, at one hour. The excretion of iodine in the bile demonstrated no inhibitory effect on the concomitant excretion of bile salts.

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