Biomedical subjects

H D Ritchie

Publications and source records attributed to H D Ritchie.

At least 37 records · Page 2Linked to original sources

PubMed1975

Sphincter patency and hepatic BSP uptake after biliary sphincterotomy.

An attempt has been made to assess the patency and function of the choledochoduodenal junction after biliary sphincterotomy by estimating the first arrival time of injected bromsulphalein (BSP) in duodenal aspirate and the effect of morphine on this. Studies on 49 patients 1--12 years after this operation showed the arrival time to be normal in 47, but in 2 cases there was delay, which suggests that stenosis may develop in time in abot 4 per cent of cases. This had not been detected clinically, radiologically, or by liver function testing. Although it did not effect the BSP arrival time in T-tube bile, morphine was found to prolong the duodenal arrival time in control patients and also after sphincterotomy of the type used, indicating that the protective mechanism of the sphincter region may not have been destroyed by this operation. Abnormal BSP retention in plasma has been reported up to 5 years afte supraduodenal exploration of the bile ducts in 30 per cent of cases. Similarly, in the present study after biliary sphincterotomy plasma BSP levels were above normal in 14 of 49 patients, suggesting that this abnormality reflects the original pathological condition rather than the type of operation used to deal with it.

Cholecystectomy↗

PubMed1975

13-norleucine motilin versus pentagastrin: contrasting and competitive effects on gastrointestinal myoelectrical activity in the conscious dog.

In conscious fasted dogs, with chronically-implanted electrodes in stomach and small intestine, typical aborally-propagated interdigestive myoelectric complexes were induced by the infusion of 13-nor-leucine motilin (13-Nle-M); whereas when the normal interdigestive activity was abolished by the infusion of pentagastrin, the resulting 'postprandial' pattern of activity was not significantly modified by the administration of 13-Nle-M. Results from this study provide further evidence that Motilin as well as Gastrin may be involved in the control of gastrointestinal motility in dogs.

Animals↗

PubMed1974

Letter: Academics in the community.

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Research Support as Topic↗

PubMed1974

Gilbert's syndrome in patients with gallbladder stones.

Patients with Gilbert's syndrome suffer from an abnormality which makes them jaundiced from time to time. A number also develop gallstones and come to cholecystectomy. If this condition has not been recognized these patients may subsequently run the risk of unnecessary operations on their bile ducts from the mistaken assumption that the intermittent episodes of jaundice which are a feature of the syndrome are due to a stone which has been left behind. Such a case history is reported here.In an attempt to determine how frequently these conditions coexist a prospective study was carried out on patients about to undergo cholecystectomy for stones in the gallbladder. Gilbert's disease was found to be present in 2 of 67 males (3.2% +/- 0.8%) but not in 184 females. Hence it seems that about 1 in every 30 males subjected to cholecystectomy may be expected to have this abnormality.It is suggested that this places an obligation on the clinician to have liver function tests done on at least two occasions preoperatively in male patients with cholelithiasis in an attempt to detect this abnormality and avoid this surgical pitfall.

Adult↗

PubMed1974

Technique of transduodenal exploration of the common bile duct. Duodenoscopic appearances after biliary sphincterotomy.

A simple technique for performing biliary sphincterotomy is described. From an experience of 150 such operations this has been found to provide satisfactory access for exploring the biliary tree and makes T-tube drainage unnecessary. Duodenoscopic observation up to 9 years after the operation showed that the sphincteric region had healed without stenosis. Sphincteric activity had not been completely abolished.

Adult↗

PubMed1973