Laparoscopic cholecystectomy: a plea to preserve the sphincter of Oddi.
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Cholangiopancreatography, Endoscopic Retrograde↗
Biomedical subjects
G L Falk
Publications and source records attributed to G L Falk.
Early recovery from laparoscopic repair of hiatus hernia.
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Esophagitis, Peptic↗
Bleeding duodenal ulceration: the results of emergency treatment with highly selective vagotomy.
We report the results of a prospective study of all patients undergoing highly selective vagotomy (HSV) for bleeding duodenal ulceration (BDU) at Concord Hospital between 1979 and 1989. Highly selective vagotomy was undertaken in 63 patients (58 male, 5 female) with a median age of 69 years (range: 16-89). Fifty-five patients were reviewed, 7 patients having died in the peri-operative period and one being lost to follow-up. The mean period to review was 50 months (range: 1-120). Thirty-six patients have been followed-up for more than 24 months. Thirty-day postoperative mortality was 11% (7 patients). Combined major and minor morbidity was 41%. Postoperative rebleeding occurred in four patients (6.3%), three of whom died. Ulceration had recurred in two of 55 patients (4%). Symptoms have been evaluated in 55 patients since operation and 93% have been graded as Visick I or II. We conclude that HSV is effective in the emergency treatment of BDU and has few long-term sequelae.
Adult↗
Laparoscopic fundoplication: a preliminary report of the technique and postoperative care.
The technique of laparoscopic fundoplication and its hospital management are described. Thirty day results in seven patients demonstrate the decreased insult to the patient, early discharge and early return to usual function, similar to that seen in laparoscopic cholecystectomy.
Adult↗
Splenic injury. An assessment of splenic conservation.
Splenic salvage has been undertaken increasingly in the past decade. The optimal method is not determined in adults. Sixty-seven consecutive cases of splenic injury were reviewed during a time of change in management policy. Splenic salvage rose from 10% of cases in 1980-83 to 57% in 1984-88. Treatment by observation resulted in 46% of patients undergoing delayed laparotomy. Injury to other intra-abdominal organs required laparotomy in 23% of patients with multiple injuries. Operative splenic salvage in the adult is feasible and may result in a higher rate of splenic salvage.
Adolescent↗
Adenocarcinoma arising in a duodenal duplication cyst: a case report.
A case of adenocarcinoma complicating a pyloro-duodenal duplication cyst is reported. The diagnosis and therapy are discussed.
Adenocarcinoma↗
Highly selective vagotomy in the treatment of complicated duodenal ulcer.
Highly selective vagotomy has been utilized urgently in 33 patients with bleeding duodenal ulcer, 16 patients with pyloric stenosis and six patients presenting with perforated ulcer. Five patients died after surgery for bleeding duodenal ulcer, and two patients rebled after surgery. Forty-eight patients were reviewed at a mean of 28 months with an excellent outcome being obtained in 45 patients. Two of the three patients with poor results had proven ulcer recurrence while the third patient required reoperation for recurrent pyloric stenosis. No patient has suffered diarrhoea after vagotomy. Highly selective vagotomy is an effective treatment for urgent management of complicated duodenal ulceration and is without troublesome post-vagotomy symptoms.
Aged↗
Efficacy of tamoxifen as the primary treatment of operable breast cancer in the high risk patient.
An audit of 43 breast cancer patients, considered to be of high operative risk and treated only with Tamoxifen was performed. All cases were potentially operable. Good outcome was obtained in only one-third of patients. Salvage surgery had no operative mortality.
Adult↗
Intravenous rupture of abdominal aneurysms: diagnostic and pathological considerations.
Seven cases of abdominal arteriovenous fistula secondary to aneurysm are reported. There were five aortocaval fistulae, one aortolumbar vein fistula, and one iliac artery to vein fistula. Three of five aortocaval fistulae were diagnosed pre-operatively. One in-hospital death occurred, and one post-hospital death. An analysis of the diagnostic patterns is made in an attempt to increase pre-operative diagnosis.
Aged↗
Carotid endarterectomy. The timing of perioperative antiplatelet therapy by indium 111 labelled platelets study in canines.
Bilateral carotid endarterectomy (CEA) was performed in a series of 16 dogs, one of the arteriotomies being closed by direct suture and the other with an autologous vein patch. Platelets obtained at the induction of the anaesthetic were labelled with Indium 111 Oxine and subsequently re-infused prior to restoration of blood flow. Post-operative sequential platelet counts using a Selo CSZ counter were undertaken, which demonstrated a substantial rise at the sites of CEA. These counts rose to peak levels between 7-88 minutes after declamping with a median peak time of 20 minutes. Continued high levels of labelled platelet accumulation persisted for 48-96 hours following CEA and in some instances persisted for three weeks. These studies suggest that antiplatelet agents should therefore be active when carotid declamping occurs and administered for at least three weeks following CEA.
Animals↗