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Biomedical subjects

V Pegan

Publications and source records attributed to V Pegan.

8 recordsLinked to original sources
PubMed1994

Sphincter of Oddi function studied by radioimmunoassay of biliary trypsin in patients with bile duct stones and in controls.

The trypsin level in bile was studied by radioimmunoassay in a prospective series of 63 patients with gallstone disease but without signs or symptoms of cholecystitis or pancreatitis in order to find indirect evidence of a retrograde flow of pancreatic juice. Mobile duct stones were present in 18 patients and impacted stones in 12. The remaining 33 patients had stones only in the gallbladder and served as controls. The average intraoperative trypsin level of the ductal bile was normal, both in the control group and in the group with stones occluding a potential retrograde reflux of pancreatic juice. After removal of the impacted stones, the bile showed a significantly higher trypsin level. The average intraoperative trypsin level for the group with mobile stones was significantly higher than that of the control group, and was further increased 10 days postoperatively. The trypsin level of ductal bile from 23 of the 30 patients (77%) with bile duct stones exceeded that of the 33 patients with stone-free bile ducts, indicating an inflow of pancreatic juice to the bile ducts of patients with bile duct stones. The present results correspond well to those in a previous report on retrograde phasic contractions of the sphincter of Oddi in the majority of patients with bile duct stones. This dysfunction of the sphincter, which persisted for 10 days after surgical stone removal, may be the primary disorder, probably consisting of a retrograde propulsive activity of the sphincter of Oddi.

Adult↗
PubMed1992

Extended excision of the ampulla of Vater--a new operative technique for elderly patients.

This report describes a 72-year-old female patient treated by extended excision of recurrent ampullary carcinoma. The procedure comprised pylorus-preserving resection of the descending segment of the duodenum, and excision of a large portion of the pancreatic head using an ultrasonic surgical dissector. Restoration of food transit, pancreatico-jejunal and choledocho-jejunal anastomosis by a Roux-en-Y reconstruction was readily accomplished. The operation, which has the advantage of being more radical and accurate than the standard excision of the ampulla of Vater, and less time-consuming and mutilating than the Whipple procedure, may be indicated in elderly patients with ampullary carcinoma.

Age Factors↗
PubMed1989

[Single-layer closure of a subcostal incision using a monofilament absorbable suture material--comparison of polydioxanone (PDS) and polyglyconate (Maxon)].

In 114 and 108 patients who were operated upon the biliary tract with a subcostal incision and closed in one layer with Polydioyanone (PDS) and Polyglyconate (Maxon), the authors analysed the frequency of the complications in the healing of the operative wound. A superficial infection in the wound appeared in 1% and 0.9% of the patients in the PDS and Maxon group, while a deep infection of the wound appeared in 0.8% and 0% (P less than 0.05). In "contaminated" wound patients, the frequency of the deep infection of the wound was not significantly larger than the "clean" operations (P less than 0.05). The total frequency of the deep infection of the wound in 222 patients was 0.4%. There was no dehiscence of the wound abscesses or ligature fistulas. 4 months following surgery 92% and 90% of the patients from the PDS and Maxon group were checked; an incisional hernia was preceded by an infection of the surgical wound in both the PDS (0.9) and Maxon (1%) group. Risk-factors (older patients, sex, overweight and icterus) did not have any effect on the healing of the wounds. In 66% of the patients of the PDS and 62% of the Maxon group, the gallbladder bed was not drained. The difference in the development of complications in the healing of the surgical wound between the two drained groups was not statistically significant (P less than 0.5). With a one layer closure of the subcostal incision with PDS or Maxon, complications in the healing of the wound were significantly reduced. The purpose of our study was: a clinical evaluation and comparison of the two monofilament absorptive suture materials-Polydioxanone (PDS) and Polyglyconate (Maxon) during a one layer closure of surgical interventions on the biliary tract, and evaluation of certain risk-factors in the healing of the surgical wounds.

Absorption↗
PubMed1989

[Surgical treatment of echinococcal hepatic cysts with pericystectomy].

The authors present their 2-year experience in treating echinococcus cysts of the liver by pericystectomy and the Cavitron ultrasonic vibrator-aspirator. The treatment consists of total pericystectomy involving no opening of the cyst. Patients treated at the University Department of Gastroenterologic Surgery, Ljubljana, are presented. In conclusion, the authors stress the significance of proper operative technique and instruments in the management of echinococcus cysts of the liver.

Adolescent↗
PubMed1977

[Pancreatic lesions].

The rate of lesions of pancreas is on the increase in these latter years. With these lesions very different therapeutical methods are applied. Some surgeons give full preference to the resection with anastomosis, the others prefer one or two anastomoses without the resection and the rest of them the resection without anastomosis. Successful treatment of the damaged pancreas dependens to a high degree on the proper diagnosis, on the appropriate primary therapy, which hampers the development of the acute pancreatitis and on the rational operative proceedings.

Abdominal Injuries↗