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Biomedical subjects

F Burcharth

Publications and source records attributed to F Burcharth.

At least 127 records · Page 7Linked to original sources
PubMed1979

Percutaneous transhepatic portography. I. Technique and application.

Percutaneous transhepatic portography with selective catheterization of the portal vein and its tributaries was performed on 120 patients, of whom 71% had cirrhosis of the liver. The technique was improved by ultrasonically guided puncture, and the procedure was successful in 96% of the examinations. Collateral veins were visualized in 81% and esophageal or gastric varices in 69% of the patients with portal hypertension. The procedure was performed with little risk and discomfort, and portograms of high quality were obtained. Other applications of percutaneous transhepatic catheterization of the portal vein system are discussed.

Adolescent↗
PubMed1979

Percutaneous transhepatic portography. II. Comparison with splenoportography in portal hypertension.

Percutaneous transhepatic portography and splenoportography were compared in 67 patients with portal hypertension. Portograms were evaluated without knowledge of the identity of patients. Factors evaluated included technical success of the examination; visualization of the portal vein, splenic vein, and other tributaries; contrast medium density, portal blood flow direction; presence and type of collaterals and varices; and liver size and configuration. Percutaneous transhepatic portography proved superior with regard to delineation of the portal venous system and esophageal varices. A definite diagnosis of portal vein thrombosis was possible only with the transhepatic approach.

Adolescent↗
PubMed1979

Percutaneous transhepatic portography. III. Relationships between portosystemic collaterals and portal pressure in cirrhosis.

The relationships among collateral veins, gastroesophageal varices, extrahepatic shunting, and free portal pressure were studied by percutaneous transhepatic portography in 57 patients with cirrhosis of the liver. The size of esophageal varices was related to the size of the coronary and short gastric veins and to the portal pressure. The size of gastric varices was related to cephalad collaterals from the spleen and splenic vein, but not to portal pressure. Portosystemic shunting was associated with collaterals in the lower abdomen, but not with varices or portal pressure.

Adult↗
PubMed1979

Percutaneous transhepatic catheterization technique of the portal venous system.

The most widespread technique for catheterization of the portal venous system is the percutaneous transhepatic with selective catheterization of the portal tributaries. The procedure is most often used for portography in patients with liver cirrhosis, but can also be used for pharmacoligic, metabolic and hemodynamic studies. By selective catheterization of the gastrooesophageal veins varices can be obliterated. Selective catheterization of the pancreatic veins with blood sampling for hormone assay may diagnose and localize endocrine pancreatic tumours.

Catheterization↗
PubMed1979

Acute gastrointestinal bleeding detected with abdominal scintigraphy using technetium-99m-labeled albumin.

In 24 patients admitted with gastrointestinal bleeding 36 scintigraphic studies of the abdomen were performed after intravenous injection of technetium-99m-labeled albumin. In 12 patients bleeding from the esophagus, stomach, duodenum, biliary tract, or colon was visualized. In the other 12 patients, in whom the bleeding seemed to have subsided, the investigation showed no scintigraphic signs of hemorrhage. Scintigraphy was also negative in five controls who had no bleeding. The method is non-invasive and easy to perform. Our study suggests that it is reliable, but a controlled trial is necessary to evaluate the diagnostic value of the method.

Acute Disease↗
PubMed1979

Endoprosthesis for internal drainage of the biliary tract. Technique and results in 48 cases.

In 48 patients with obstructive jaundice caused by unresectable lesions, a polyethylene tube was inserted into the biliary tract using a percutaneous transhepatic technique. This endoprosthesis provided permanent internal drainage without an external catheter. In 27 patients, bilirubin declined to anicteric or subicteric levels and pruritus subsided. In six patients, endoprosthesis had an intermediate effect, with moderate falls in bilirubin and improvement of their general condition. This method does not seem to increase the risk of percutaneous transhepatic cholangiography, which precedes insertion. It is recommended for patients with inoperable bile duct obstruction and may replace surgical biliodigestive anastomoses in patients with unresectable lesions.

Adult↗
PubMed1979

Localization of gastrinomas by transhepatic portal catheterization and gastrin assay.

Gastrinomas were localized by concurrent blood sampling in the hepatic vein and portal vein tributaries in 10 of 12 Zollinger-Ellison patients. In one patient, the portal vein could not be catheterized; in the other, a gastrin gradient could not be picked up in either of two examinations. Six of the patients were subsequently operated upon: 5 had pancreatoduodenal resection and 1 had laparotomy at which metastases were found. Four of the resections were probably curative as the patients have done well without treatment since with concentrations of gastrin in serum near zero. The observation period ranges from 17 to 20 mo. It is concluded that transhepatic catheterization of the hepatic vein and portal vein tributaries with blood sampling for gastrin determination permit the verification of the Zollinger-Ellison diagnosis and the localization of the gastrinomas. The latter may lead to the selection of a curative operative treatment in some of the patients.

Blood Specimen Collection↗
PubMed1978

Does the oesophageal balloon compress oesophageal varices?

The pressure transmitted to the oesophageal wall was measured in 3 patients with bleeding oesophageal varices controlled by balloon tamponade. The pressure transmitted was considerably lower than the pressure inflated, and all patients suffered retrosternal pain when the transmitted pressure rose to 40 mm Hg. Furthermore, the diameters of oesophageal balloons of 23 Sengstaken-Blakemore tubes (Rüsch) were measured at increasing inflation pressure. The compliance was very high. All balloons bulged at median inflation pressures of 75 mm Hg, and the pressures fell to a median of 55 mm Hg unaffected by further inflations. The diameter at 40 mmHg was 27.3 mm. In the light of these observations it remains still to be explained how the oesophageal balloon of the Sengstaken-Blakemore tube effects haemostasis in bleeding oesophageal varices.

Esophageal and Gastric Varices↗
PubMed1978

Obstructive jaundice in pancreatitis investigated by percutaneous transhepatic cholangiography.

Obstructive jaundice is a rare complication of alcoholic pancreatitis. In three patients with persistent jaundice, percutaneous transhepatic cholangiography demonstrated either stenosis and dislocation of the common bile duct due to pancreatic pseudocysts or stenosis due to pancreatic fibrosis. These stenoses were easily differentiated from obstructions due to tumours or common duct stones. We suggest that percutaneous transhepatic cholangiography is valuable in pancreatitis with jaundice.

Acute Disease↗
PubMed1978

Transthoracic suturing of bleeding esophageal varices without esophagotomy. Preliminary report.

Suturing of bleeding esophageal varices by transthoracic esophagotomy is frequently followed by leakage in the suture line. To avoid this complication we suggest transesophageal suturing without esophagotomy. The technique was evaluated in five normal pigs and applied to two patients with bleeding esophageal varices. Esophagus both in the pigs and the patients tolerated the procedure well and the bleeding from the esophageal varices stopped. We suggest application of this procedure for bleeding esophageal varices instead of emergency portocaval shunt operation.

Aged↗
PubMed1977

Percutaneous transhepatic cholangiography in diagnostic evaluation of 160 jaundiced patients. Results of an improved technic.

Percutaneous transhepatic cholangiography (PTC) was carried out in 160 patients with jaundice in whom the diagnosis could not be established by means of conventional methods of investigation. In PTC, selective catheterization of the common bile duct was employed and cholangiograms of high quality were obtained. In patients with obstruction of the biliary passages, the catheter was left indwelling centrally in the biliary passages for external bile drainage. The investigation, thus, did not necessitate immediate operation in these patients. PTC was successful in 113 of the 115 patients with obstructive jaundice. In forty-five patients the suspicion of obstruction could be discharged. Normal biliary passages were demonstrated in twenty-six patients. In nineteen patients it was impossible to cannulate the biliary tree and this was tantamount to nonobstructive jaundice. Complications occurred in six patients, but were not exclusively due to PTC. PTC provides a possibility for differentiation between obstructive and nonobstructive jaundice and thereby laparotomy can frequently be avoided. The incidence of complications may be maintained at an acceptable, low level provided the technic is meticulously observed.

Biliary Tract Diseases↗
PubMed1977

Treatment of retained bile duct calculi with T-tube infusion of sodium cholate and heparin.

A series of 26 patients with retained radiolucent bile duct calculi diagnosed at postoperative cholangiagrophy through the T-tube is presented. All patients were treated with infusion of 15-20 g sodium cholate in 1000 ml saline and 20,000 units of heparin in 1000 ml saline per 24 hours. In 19 of 26 patients (73 per cent) the calculi disappeared. No complications were encountered. This treatment is recommended prior to reoperation in all patients with retained radiolucent bile duct calculi diagnosed by postoperative cholangiography through the T-tube.

Adult↗