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T A Ruffolo

Publications and source records attributed to T A Ruffolo.

8 recordsLinked to original sources
PubMed1994

Gallbladder ejection fraction and its relationship to sphincter of Oddi dysfunction.

Theoretically, relative distal common bile duct obstruction due to sphincter of Oddi dysfunction may be a cause of poor gallbladder evacuation observed on quantitative cholescintigraphy. In this study, the relationship of sphincter of Oddi dysfunction to the gallbladder ejection fraction by quantitative cholescintigraphy was explored. Eighty-one patients with biliary-type pain and otherwise normal evaluations underwent quantitative cholescintigraphy, sphincter of Oddi manometry, and ERCP. Abnormalities of stimulated quantitative cholescintigraphy and/or sphincter of Oddi manometry were present in 70% of this study group. Manometric evidence of sphincter dysfunction was present in patients with similar frequency irrespective of the degree of gallbladder evacuation. In conclusion, abnormalities of quantitative cholescintigraphy and sphincter manometry appear to be independent factors, although frequent findings in this patient population.

Adolescent↗
PubMed1992

Laparoscopic cholecystectomy and ERCP with sphincterotomy in an elderly patient with situs inversus.

Situs inversus viscerum (transposition of the viscera) is a rare condition with a genetic predisposition that is autosomal recessive. We present a patient with situs inversus, cholelithiasis, and choledocholithiasis who was successfully treated via laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography with sphincterotomy. This paper further expands the application of these techniques and shows that they can be safely and effectively applied in the setting of situs inversus, although attention must be paid to the details of left-right reversal.

Aged↗
PubMed1991

Complications of endoscopic sphincterotomy. A prospective series with emphasis on the increased risk associated with sphincter of Oddi dysfunction and nondilated bile ducts.

Mostly retrospective series with limited use of sphincter of Oddi manometry have indicated that early complications are more common when endoscopic sphincterotomy is performed for sphincter of Oddi dysfunction than for common duct stones. The current study was undertaken to prospectively evaluate the frequency and type of complications of endoscopic sphincterotomy performed for sphincter of Oddi dysfunction compared with endoscopic sphincterotomy performed for other conditions. Four hundred twenty-three patients underwent sphincterotomy for sphincter of Oddi dysfunction (166), common duct stone(s) (163), tumor (60), and miscellaneous reasons (34). Patients were observed in the hospital for at least 24 hours after the procedure, and 30-day follow-up data were obtained. The overall complication rate was 6.9%, but complications were more frequent when sphincterotomy was performed for sphincter of Oddi dysfunction than for all other indications (10.8% vs. 4.3%; P = 0.009). Precut sphincterotomy was more frequently required in the sphincter of Oddi dysfunction group (21.1% vs. 11.7%, P = 0.009) but was no more likely to result in a complication (6.2%) than standard sphincterotomy. The risk of a complication was considerable for a small-diameter common bile duct (less than or equal to 5 mm), particularly when sphincterotomy was performed for sphincter of Oddi dysfunction (37.5%). The overall 30-day mortality rate was 1.7%, but the procedure-related mortality rate was believed to be 0.2%. It is concluded that endoscopic sphincterotomy for sphincter of Oddi dysfunction is more hazardous than for other conditions, particularly when a small common bile duct is present.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMedDate not supplied

Correlation of basal sphincter pressures measured from the bile duct and the pancreatic duct in patients with suspected sphincter of Oddi dysfunction.

If basal sphincter of Oddi pressures measured from the pancreatic duct and the bile duct are essentially equal, then measurement of basal pressures from only one duct would be adequate in evaluating sphincter of Oddi dysfunction. We report a series of 88 patients whom we evaluated with sphincter of Oddi manometry. Cannulation of both the biliary sphincter segment and pancreatic sphincter segment was achieved in these patients. Basal sphincter pressures were measured (normal, less than 40 mm Hg). In 45 of the 88 patients (51%), normal sphincter of Oddi basal pressures were seen in both ducts. Elevated basal sphincter of Oddi pressures were seen in both ducts in 28 of 88 patients (32%). In 15 of 88 cases (17%) there was an elevation of only one sphincter segment. Elevation in only the biliary sphincter segment occurred in 7 of 88 patients (8%). Elevation in the pancreatic sphincter segment alone occurred in 8 of 88 patients (9%). We conclude that sphincter of Oddi manometry of both the pancreatic and bile ducts is needed if complete manometric information is desired.

Bile Ducts↗