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Biomedical subjects

B E Walker

Publications and source records attributed to B E Walker.

At least 91 records · Page 5Linked to original sources
PubMed1974

Clinical results of parietal cell vagotomy (highly selective vagotomy) two to four years after operation.

In Leeds and Copenhagen 271 patients were treated electively for duodenal ulcer by parietal cell vagotomy without drainage between 1969 and 1972 inclusive, with no operative deaths. 108 patients have been followed up 2-4 years since operation. Gastric stasis necessitating re-operation occurred in only 2 cases. Gastric ulcer developed in 2 cases, and in 3 cases recurrence of the duodenal ulcer was suspected but was unconfirmed at re-operation. Uncontrolled comparison with the results of partial gastrectomy and of vagotomy with drainage, as performed at these two centers, has shown that after parietal cell vagotomy without drainage there is a much lower incidence of dumping, diarrhea and bile vomiting, and, on overall assessment, a greater proportion of perfect or very good results.

Adult↗
PubMed1973

Plasma and urinary zinc in patients with malabsorption syndromes or hepatic cirrhosis.

Plasma and urinary zinc have been measured in 19 patients with malabsorption and 21 patients with hepatic cirrhosis. The results have been compared with those of 20 control subjects and 23 patients with a variety of other diseases. The diurnal variation in plasma zinc levels has been confirmed and is of such magnitude that this must be taken into account in comparing results in groups of subjects. Plasma zinc levels, both fasting and after a meal, are significantly lower in patients with cirrhosis (71 and 60 mug/100 ml) and malabsorption (76 and 64 mug/100 ml) than in controls (97 and 81 mug/100 ml). In the patients with cirrhosis or malabsorption similar correlations exist between plasma zinc and plasma albumin, suggesting that the low plasma zinc levels may be, at least in part, dependent on the plasma albumin level. Urinary zinc excretion is increased in cirrhosis, but not in malabsorption, indicating that increased urinary loss is unlikely to explain the low plasma levels.

Celiac Disease↗
PubMed1972

Incidence of dumping after truncal and selective vagotomy with pyloroplasty and highly selective vagotomy without drainage procedure.

The incidence of dumping after truncal or selective vagotomy with pyloroplasty and highly selective vagotomy without a drainage procedure was assessed both clinically and experimentally. At a gastric follow-up clinic dumping was found to be significantly less frequent in patients who had undergone highly selective vagotomy without a drainage procedure than in patients who had undergone truncal or selective vagotomy with pyloroplasty (P < 0.05 or < 0.001, respectively). Hypertonic glucose given by mouth provoked the onset of dumping in 20% of patients with duodenal ulcer before operation, in 73% after truncal vagotomy and pyloroplasty, in 80% after selective vagotomy and pyloroplasty, and in 47% after highly selective vagotomy. The test meal also produced significantly greater decreases in blood pressure and increases in pulse rate in patients who had undergone vagotomy with pyloroplasty than in patients who had undergone highly selective vagotomy.

Blood Pressure↗
PubMed1972

Vagotomy without diarrhoea.

The incidence of diarrhoea after three types of vagotomy was assessed "blind" at a gastric follow-up clinic one year after operation. Diarrhoea was recorded in 24% of patients after truncal vagotomy and pyloroplasty, in 18% after selective vagotomy and pyloroplasty, but in only 2% of patients after highly selective vagotomy without a drainage procedure. The incidence of diarrhoea was significantly less (P < 0.01) after highly selective vagotomy than after either of the other procedures.Hypertonic glucose solution given by mouth to 15 representative patients from each group and to 15 patients before operation provoked the onset of diarrhoea in 67% of the patients who had undergone truncal vagotomy and pyloroplasty, in 60% of those who had undergone selective vagotomy and pyloroplasty, in 13% of those who had undergone highly selective vagotomy without a drainage procedure, and in none of the preoperative patients. Again the difference between the "highly selective" group and the other two groups of vagotomized patients was statistically significant.It is suggested that postvagotomy diarrhoea is attributable both to unregulated gastric emptying after truncal or selective vagotomy with a drainage procedure and to the extragastric denervation produced by truncal vagotomy. "Postvagotomy" diarrhoea can be virtually eliminated by using highly selective vagotomy without a drainage procedure.

Diarrhea↗