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Biomedical subjects

D J Hay

Publications and source records attributed to D J Hay.

15 recordsLinked to original sources
PubMed1994

[Laparoscopic cholecystectomy--experiences in a British district general hospital].

In the first year after the introduction of the new technique a complication rate of 3.3% was calculated from the evaluation of 118 laparoscopic cholecystectomies. The only severe complication noted was a perforation of the transverse colon following the insertion of a 10 mm port. Henceforth, open laparoscopy is performed in difficult cases. Hereby, to ensure a more secure sealing of the initial incision, an endotracheal tube can be used as the camera port. The conversion rate was found to be 9%, whereby in 50% of acute cholecystitis an open procedure had to be adopted. The use of a Nd-Yag-Laser in 24 cases proved to be of no apparent advantage. Intraoperative cholangiograms were carried out selectively to demonstrate the anatomical situation, or in cases where common bile duct stones were suspected. Within a year, it was possible to reduce the mean operating time from 130 min to 80 min. The postoperative stay was on average 3.7 days. From an economic point of view, the substantially shorter hospitalisation period outweighs the longer operating time. However, more stringent and precise standards with respect to an overall concept in diagnosing and treating common bile duct stones would be beneficial.

Cholecystectomy, Laparoscopic↗
PubMed1983

A prospective randomized trial of vagotomy in chronic duodenal ulceration: 4-year follow-up.

A total of 153 patients (124 male and 29 female) with uncomplicated chronic duodenal ulceration were studied in a prospective, randomized trial of proximal gastric vagotomy (PGV) and truncal vagotomy and pyloroplasty (TVP), conducted in four Manchester hospitals. Of these, 137 patients have now been followed up for 2.5 to 5.5 (mean 4.1) yr. There have been 15 (21 per cent) recurrent ulcers following PGV compared with 5 (7.5 per cent) after TVP (P less than 0.05). A satisfactory functional result was obtained in 82 per cent of patients after TVP compared with 73 per cent following PGV and there was little difference between the groups with regard to the incidence of dumping, heartburn and vomiting. There was significantly more diarrhoea following TVP (13 per cent) compared to PGV (1.4 per cent) but this represented only a minor clinical problem.

Adult↗
PubMed1983

Randomized trial of elective highly selective or truncal vagotomy in chronic duodenal ulceration.

Between 1973 and 1976, 153 patients (124 men, 29 women) with uncomplicated, chronic, duodenal ulcer were entered into a prospective randomized trial of highly selective vagotomy (HSV) or truncal vagotomy and pyloroplasty (TVP). The study was conducted in four Manchester hospitals and the operations were performed by consultants or chief registrars. The follow-up was conducted by personal interview using a standardized questionnaire. The medical gastroenterologist did not know which type of operation the patient had had. The patients who had symptoms were referred back to the surgeon who performed the operation. The clinical laboratory and follow-up data were analysed by computer. There were no operative deaths. Three patients died from unrelated causes, 13 were lost to follow-up; 137 (89.5%) were followed up for a mean of 4.1 years (range from 2.5 to 5.5 years). A modified Visick grading was used to assess the results of surgery. The outcome was good in 82% after TVP and 73% after HSV. This difference and those in the incidences of early or late postprandial dumping, bilious vomiting, weight loss, anemia and heartburn were not significant. Diarrhea was more frequent after TVP (13.4%) than after HSV (1.4%); although the difference was significant (p less than 0.025), this complaint did not present a serious clinical problem. Ulcers recurred in 15 (21.4%) patients following HSV and in 5 (7.5%) after TVP; this difference was statistically significant (p less than 0.05).

Adult↗
PubMed1981

Effective of highly selective vagotomy upon the lower oesophageal sphincter.

Recently highly selective vagotomy has been suggested as both a cause of gastro-oesophageal reflux and a potential cure. This study was designed to investigate whether this operation produced any change in the resting pressure or the length of the lower oesophageal sphincter in patients undergoing highly selective vagotomy. A group of patients undergoing truncal vagotomy and drainage were also studied for comparison. No alteration in the resting pressure or length of the lower oesophageal sphincter was noted after either operation. It is therefore unlikely that interference with the sphincter is responsible for post-vagotomy reflux.

Esophagogastric Junction↗
PubMed1980

Assessment of the rapid pullthrough technique in oesophageal manometry.

The lower oesophageal sphincter pressure was measured by infusion manometry using the rapid pullthrough technique in two studies designed to evaluate this technique. The first study performed was an assessment of its reproducibility in individual subjects on separate occasions. We conclude that the rapid pullthrough technique does not give reproducible results. The second study compared the lower oesophageal sphincter pressure obtained by this technique with that by the standard station pullthrough technique. We conclude that the results are not comparable.

Esophagogastric Junction↗
PubMed1979

Spread of steroid-containing foam after intrarectal administration.

The spread of a steroid-containing foam from the rectum was studied in eight normal controls and eight patients with ulcerative colitis proved by biopsy. A standard dose of foam was labelled with technetium-99m adsorbed on to microspheres of Amberlite resin. Immediately after the foam was administered the extent of spread varied considerably, though in no instance did it extend beyond the rectosigmoid. Further scans at 120 and 240 minutes showed no further spread. It is concluded that a steroid-containing foam has a topical effect only on the rectal mucosa.

Administration, Topical↗
PubMed1979

The reproducibility of the station pullthrough technique for measuring lower oesophageal sphincter pressure.

The results are presented of two studies of the station pullthrough technique for lower oesophageal manometry. The first part of the work is an assessment of the reproducibility of this technique using both an infused tube system and a system of subminiature, intraluminal strain gauge transducers. The second part of this report describes a study into the effect that the position of the recording hole on the probe may have in relation to the measured pressure for the lower oesophageal sphincter.

Adult↗
PubMed1979

Carcinoid tumour as a complication of ulcerative colitis.

Patients with long-standing ulcerative colitis have an increased chance of developing a carcinoma of the colon, especially when the inflammatory process involves the entire colon, but no case of a carcinoid tumour of the colon occurring in a patient with ulcerative colitis has been reported.

Carcinoid Tumor↗