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Biomedical subjects

G Serio

Publications and source records attributed to G Serio.

At least 127 records · Page 7Linked to original sources

[Modification of an experimental model of chronic pancreatic and biliary fistula in the minipig (author's transl)].

An improvement in Corring's experimental model in the minipig is described. The model requires: -- a complete diversion of the biliopancreatic secretion and the possibility of its reintroduction into the duodenum; -- a particular anaesthesiological, technical and management problems taken up during the course of the research. Data are also given about basal pancreatic and biliary secretions in this particular experimental model.

Anesthesia↗

[Exocrine pancreas cancers: our experience (author's transl)].

The AA. report 136 cases of exocrine pancreas carcinomata that they have observed in 8 years in Surgical Hospital in Verona and they tackle diagnostic problems and surgical therapy. They confirmed the utility for the diagnosis of echotomography (ECO), computerizing axial tomography (T.A.C.), retrograde-endoscopic-cholangio-pancreatography (PTC). Considering the survival, at a distance of the cases that had an operation and life quality, the AA. incline, if possible, for a destroying surgical operation.

Adult↗

[Major hepatic resections for angioma].

6 cases of solitary angioma of the liver, treated with major hepatic resections, are presented (2 rt hemihepatectomies - 2 lt hemihepatectomies - 1 lt lateral sect. and 1 segmentectomy of the VIth). Their anatomopathological definition (solitary angioma, multiple angiomas, hemangiomatosis) is discussed in relation to the various therapeutic possibilities. From the diagnostic standpoint, an outstanding part is played by angiography. In addition to demonstrating the presence of hepatic mass, C.A.T. can, according to their experience, also allow diagnosis of quality on the basis of demonstration of vascular lacunae. It is considered that the treatment of choice of for solitary angiomas is surgery, which must be performed by skilled surgeons and consist in hepatic resections conduced by typical route. This is especially true for the giant forms, owing to their particular tendency to growth and spontaneous rupture. For small angiomas it is considered better in principle to remove them, generally by small cuneiform resections, unless they are situated in sites difficult to attack surgically and with high risk. In this case frequent check-up is necessary since, although they are sometimes found to be stationary and even in exceptional cases regressive, personal experience (2 cases) has demonstrated a tendency to expansion.

Adult↗

[Syndrome caused by extrinsic compression of the celiac trunk (apropos of 4 cases)].

On the basis of angiographic documentations the Authors report on 4 observations (3 men and 1 woman) of extrinsic compression of the coeliac trunk symptomatologically evidenced through abdominal pain attacks. All the patients were treated surgically by resection of the median arcuate ligament of the diaphragm. In one case distal pancreatic resection was also performed on account of accompanying chronic pancreatitis. The long-term results were excellent in 3 cases, and good in 1. The diagnosis and surgical indication were made possible after repeated biochemical and instrumental investigations in order to exclude different pathologies (vascular, biliary, pancreatic, gastrointestinal) which might account for the reported symptoms. There is still discussion on the unresolved problem of the pathogenesis of the pain, as well as on surgical tactic and the advisability of completing resection of the arcuate ligament by sympathicectomy or coeliac ganglionectomy.

Abdomen↗

[Pseudocystic pleural fistula documented by retrograde cholangiopancreatography].

The use of recently introduced methods such as computerised axial tomography (CAT), in addition to endoscopic retrograde cholangiopancreatography (ERCP), has in recent years led to attainment of new targets in the diagnosis of pancreatic diseases. The Authors present a clinical case of massive and recurring left pleural effusion in a patient with a pseudocyst at the level of the cauda pancreatis. They report the clinico-diagnostico-instrumental factors leading to pre-operative diagnosis of pseudocystic-pleural fistula.

Adult↗

[Cystadenocarcinoma of the pancreas. Considerations on a clinical case].

A case of pancreatic cystoadenocarcinoma treated surgically four years earlier as a pancreatic pseudocyst is reported. The problems of differential diagnosis between cystic tumours (cystoadenoma and cystoadenocarcinoma) and the more common pseudocystic lesions are analysed. Stress is laid on the importance of correct intra-operative diagnosis, mainly based on multiple biopsy of the cyst wall, and the need for radical exeresis.

Cystadenocarcinoma↗

[Supervision of the postoperative period in biliary shunt operations: validity of sequential hepato-biliary scintiphotography with 99mTc-HIDA].

The Authors' aim was to assess the effectiveness of Sequential Scintiphotography of the Liver with 99mTc-HIDA (SSFH) in the evaluation of post operative jaundice, in operations of biliary derivation (43 observations in 28 patients). SSFH proved to be highly reliable even in comparison with more laborious procedures (such as Transhepatic Cholangiography), and superior to equally simple procedures such as Echo Tomography and Computerised Tomography, evidencing itself as the investigation of choice for the study of this pathology, especially in long-term follow-ups.

Bile Ducts↗

The cancer of the papilla of Vater. Diagnosis, treatment and long term results.

Survey of 18 cases of cancer in the Papilla of Vater, which were observed during the years between 1971 and 1979 at the Surgical Clinic of Padua University - Seat of Verona - with particular regard to the diagnostic means and their reliability. The histological investigations gave the following results: All lesions were found to be adenocarcinomas; 6 cases well differentiated, 4 cases fairly well differentiated, 2 cases little differentiated, 3 cases indifferentiated. The following operations were carried out: 15 Duodenopancreatectomies, 3 Internal derivations of the biliary flow, one of which associated with gastroenteroanastomy. Of all the patients who underwent to the radical operation, 1 survived 3 years after the operation, and then was lost to the follow-up, 2 were surviving 19 months after the operation, 2 were surviving 12 months after the operation, 1 was surviving 10 months after the operation, 1 died 18 months after the operation, 7 died between the 2nd and the 12th month after the operation, 1 died in the postoperative period. Of those patients who underwent the palliative operation, none survived longer than one year.

Aged↗

[The biological results of duodenocephalopancreatectomy. Clinical evaluations based on a long-term follow-up].

The authors discuss the main features of the complex pathophysiology of patients subjected to duodenocephalopancreatectomy, and particularly the difficulties inherent in clinical assessment of the digestive and metabolic impairment consequent upon the duodeno-gastro-pancreatic mutilation. Out of a total of 57 cases of this description, they singled out for recheck 23 patients who had undergone duodenocephalopancreatectomy not less than six months and not more than seven years before (chronic pancreatitis, 11 cases; various malignancies of the periampullar area, 10 cases; Zollinger-Ellison syndrome, 1 case; retroperitoneal lymphoma, 1 case). Seventy-six per cent of patients who had been gainfully employed were able to resume their jobs after surgery. Steatorrhea, assessed in terms of fecal fats, was present in all cases; notwithstanding, 70% of the patients gained weight (average increase 7 kg). All patients were on enzyme replacement therapy. Only 4% developed diabetes, and none developed postoperative peptic ulcers. Conversely there was a high incidence (65%) of bone structure reshuffling, signally osteoporosis, probably imputable to steatorrhea and vitamin D malabsorption, plus the often associated increase of serum alkaline phosphatase activity.

Adult↗

[Alteratiions of calcium and phosphorus metabolism in patients treated with duodenoencephalopancreatectomy].

In a followup study of 14 patients treated by duodeno-cephalo-pancreatectomy at least one year before, the authors detected radiological evidence of bone tissue reshuffling in 64 per cent of the cases. Of these, 70 per cent showed high serum alkaline phosphatase content not attributable to cholestasis, liver metastasis, or specific bone disease. The authors call attention to the significance of this biochemical parameter for diagnostic purposes and therapeutic guidance.

Adult↗

[The problems of surgical tactics in the treatment of pancreatic pseudocysts and related complications].

On the basis of 45 cases of operated pseudocyst, the Authors tackle the problem of surgical tactis in treatment of these lesions and any complications. The paper outline the contribution that recent diagnostic methods--such as endoscopic retrograde cholangiopancreatography, computed tomography and ultrasonography--have made to solution of the problem and establishes the criteria for emergency or elective operation. In the first condition, consisting in cases of complications (haemorrhagic, suppurative, perforative etc.), abnormal development of pseudocysts and serious impairment of the patient's general conditions, the treatment of the pseudocyst generally takes the form of external drainage. The second condition, obtainable after a sufficient period of "ripening", usually consists in a cysto-digestive shunt or cysto-parenchymal demolition in view of the high morbidity arising from external drainage. Surgical treatment of the pseudocyst is completed by therapy of any basic chronic pancreatitis and by correction of probable associated lesions affecting the bile and digestive tracts and the splanchnic venous circulation. In the reported cases, 28 patients were treated by cysto-digestive shunt, 8 by cysto-parenchymal demolition and 9 by external drainage. There were 37 combined operations.

Hemorrhage↗

[Treatment of early and late complications of surgery of pancreatic pseudocysts].

Among 45 operations for pseudocysts the authors report 9 cases of complications, three of them early (haemorrhage and acute pancreatic necrosis) and six delayed (persistence of fistulae and relapse); in six of these surgery was performed and two of them died. Among the different types of surgery performed, external drainage proved to be the one most burdened by complications (2/3 of cases), while their incidence was far lower in internal shunt (2 cases out of 28) and cysto-parenchmal demolitions (one case out of eight). Attention is drawn to the danger of post-operative haemorrhage and the need to combat this complication with decision. For recurring pseudocysts and for fistulae which do not benefit from conservative treatment, the surgical operation, when it does not result in demolition, must be capable of correcting the canalicular alterations of the base pancreatitis.

Follow-Up Studies↗

[Percutaneous transhepatic biliary drainage].

The authors describe their experience in 23 cases of biliary tract drainage by the transhepatic-percutaneous approach in the course of obstructive jaundice of diversified origin. This can be done for essentially three reasons, namely to alleviate jaundice preoperatively, to provide permanent bile drainage in patients not amenable to surgery, and to relieve excess pressure in surgical anastomoses of the biliary passages. On the basis of biological considerations (relationship between severity and duration of cholestasis on the one hand and postoperative mortality and morbidity on the other), and in light of their own results, the authors argue in favor of this procedure, explaining that it is only mildly traumatic to the patient, easy to perform, attended by a low quota of complications, and above all effective as a drainage; also, it does not unduly prolong the preoperative period for patients scheduled for further and major surgery. Also in view of the current role of PTC in the diagnosis of obstructive jaundice, they submit that transhepatic-percutaneous drainage should be done right next to recognition of dilatation of the intrahepatic bile passages by CAT or echotomography.

Bile Duct Neoplasms↗

[Digestive hemorrhage as a complication of a pancreatic pseudocyst].

A study was made at the Padua University Second Surgical Clinic--located in Verona--on four cases of digestive haemorrhage in patients with pancreatic pseudo-cysts. The psysiopatological, diagnostic and therapeutic problems inherent in this pathology are discussed. In particular, attention is drawn to the need for and difficulty of marking a correct diagnosis in good time, and the utility, for such purpose, of endoscopic examinations and selective arteriography of the coeliac tripod and the superior mesenteric artery. Lastly, the various possibilities that surgery offers in the treatment of this disease are mentioned.

Adult↗

[Surgical treatment of gastric carcinoma in the elderly. Clinical considerations on a group of patients undergoing major surgical destruction].

A group of 24 patients in senile age was subjected to major demolition operations, for purposes of radical removal of gastric carcinoma (total gastrectomy, subtotal resection, oesophago-gastric resection). In six patients the major operation was widened by partial demolition of neighbouring organs (liver, colon, pancreas). The flattering results (both immediate and long-term) obtained from this operation and the progress reached in the knowledge and correction of the senile physiopathological alterations allow encouraging developments to be forecast for this surgery, the success of which is subject to careful tactical selections and to close multidisciplinary cooperation directed to strengthening vital reserves, assistance of main functions and prompt recognitions and treatment of any complications.

Age Factors↗