Search PubMed⌕ Search

Biomedical subjects

J A Vennes

Publications and source records attributed to J A Vennes.

At least 19 recordsLinked to original sources
PubMed1991

Thermal ablation of the gallbladder.

Gallbladder ablation by means of injection of hot contrast medium was attempted in 13 dogs. Room temperature contrast medium was injected into the gallbladders of two additional dogs (controls). After midline laparotomy was performed to expose the gallbladder, temperature probes were placed in the liver adjacent to the gallbladder, and on the surface and in the lumen of the gallbladder. A 7-F catheter with multiple side holes was placed into the gallbladder. The cystic duct was clamped during the procedure. After injection of boiling contrast medium, the mean temperature in the gallbladder lumen was 80 degrees C; in the adjacent liver, 43.5 degrees C; and on the gallbladder surface, 45.8 degrees C. After the procedure, the cystic duct was unclamped, temperature probes and catheter were removed, and the laparotomy was closed in standard fashion. In the hot contrast medium group, one dog each was sacrificed at 2, 4, 8, and 12 weeks, and at 6 months. Six animals were sacrificed at 1 year. The gallbladder was completely ablated in 11 of 13 animals in the hot contrast medium group. One dog was sacrificed at 8 days because of bile leakage, and another was sacrificed at 17 days because of gallbladder rupture. The two control animals were sacrificed at 12 and 13 weeks, and their gallbladders were normal at that time.

Animals↗
PubMed1990

A new mechanical lithotripter for the treatment of large common bile duct stones.

A prospective uncontrolled multi-center trial of a prototype mechanical lithotripter was performed in 30 patients with common bile duct calculi. Standard endoscopic sphincterotomy had failed to remove all stones, primarily because of large size (26 patients). Stone size ranged from 13 to 35 mm. Forty-three of 45 stones (97%) were successfully captured, fragmented, and extracted with this newly designed mechanical lithotripter. The overall success rate of 93% using this simple and inexpensive modality compares favorably with other methods under investigation for the treatment of common bile duct stones not amenable to routine endoscopic measures.

Duodenoscopy↗
PubMed1979

Gastrinoma associated with common bile duct obstruction and the ectopic production of ACTH.

A case of adrenocortical hyperfunction due to ectopic production of ACTH by a gastrin-producing tumor of the pancreas is described. Cushing's syndrome preceded the appearance of the overt Zollinger-Ellison syndrome by 2 years and was treated by bilateral adrenalectomy. The Zollinger-Ellison syndrome was initially treated with cimetidine, which successfully reduced the secretion of gastric acid. Because the pancreatic gastrinoma continued to grow, causing obstruction of the common bile duct, biliary diversion and total gastrectomy were performed. There is evidence that the pancreatic gastrinoma was the source of the ectopic production of ACTH and possibly secretion. The role of Histamine-2 blocking agents as therapy in the Zollinger-Ellison syndrome is discussed.

Adrenocorticotropic Hormone↗
PubMed1979

Significance of the nonopacified gallbladder in endoscopic retrograde cholangiography.

Failure to visualize the cystic duct and gallbladder during endoscopic retrograde cholangiography, while obtaining satisfactory opacification of the rest of the biliary system, is a radiographic sign of undetermined meaning. The diagnostic implication of this finding was analyzed in 63 patients with pathologically proven diagnoses. One patient was normal at surgery. Three groups of abnormal patients had: (1) obstructing lesions of the distal common bile duct (35 patients); (2) primary lesions of the cystic duct or gallbladder (19 patients); or (3) obstructing lesions about the common hepatic/cystic duct junction (8 patients). The results indicate that obstructing lesions of the distal common bile duct may cause stasis of bile within the biliary system, increased biliary pressure, and sludge formation that prevent the flow of contrast material through the cystic duct and into the gallbladder, which can cause nonopacification. If the extrahepatic biliary system is of normal caliber without evidence of an obstructing process, nonfilling of the cystic duct and gallbladder is highly predictive of pathology.

Biliary Tract Diseases↗
PubMed1978

The normal cholangiogram.

This paper describes the measurements of the normal cholangiogram as demonstrated by endoscopic retrograde cholangiopancreatography. Two groups of patients were studied. There were 49 patients who had normal livers and no evidence of biliary tract disease. In addition, there were 25 patients with known liver disease and an apparent normal extra-hepatic biliary tract. The extrahepatic bile duct was measured in three regions: (1) the common hepatic duct (above the cystic duct and below the bifurcation); (2) the prepancreatic portion (below the cystic duct and above the pancreas); and (3) the interpancreatic portion (bile duct within the pancreas). These measurements ranged from 2.1 to 9.2 mm. Although the common bile ducts were generally quite uniform in caliber, there were instances where each portion was the largest diameter in an individual case. There was slight increase in bile-duct caliber with age. This study showed somewhat smaller measurements than previously reported and may relate to case selection in this or previous studies.

Adolescent↗
PubMed1978

Cholangiographic abnormalities in patients with inflammatory bowel disease.

Twenty patients with inflammatory bowel disease, abnormal liver function tests and abnormal endoscopic retrograde cholangiograms were found to have a spectrum of abnormalities affecting the intra- and extrahepatic biliary trees. The intrahepatic systems were abnormal in all patients and demonstrated ductal stenosis, ectasia, decreased arborization and major duct obstruction. The extrahepatic systems were abnormal in 75 percent of cases with stenosis, diverticula formation and mural irregularity being the most frequent abnormalities. The value of endoscopic retrograde cholangiography in this patient group is to exclude extrahepatic obstruction, establish a nonoperative diagnosis, and assist in determining the method of treatment.

Adenoma, Bile Duct↗
PubMed1977

Endoscopic retrograde intrahepatic cholangiogram: radiographic findings in intrahepatic disease.

Endoscopic retrograde intrahepatic cholangiograms were evaluated in 107 patients and correlated with intrahepatic diagnoses determined by liver biopsy. Included were normal livers (six), cirrhosis (38) portal fibrosis (14), cholangitis (22), metastases (11), and miscellaneous diagnoses (16). Results suggest that differentiation of the normal from the abnormal intrahepatic biliary system using the endoscopic retrograde intrahepatic cholangiogram is possible, and that certain patterns of abnormality prevail within given disease categories. The cholangiogram in cirrhosis is marked by ductular stenosis, diminished arborization, tortuosity, and approximation of the intrahepatic ducts. Sclerosing cholangitis demonstrates focal stenoses with concomitant ectasias and frequent similar involvement of the extrahepatic system. Chronic cholangitis and portal fibrosis are frequently associated with extrahepatic obstructing lesions and increased intrahepatic ductal caliber, but demonstrate no distinguishing intrahepatic characteristics. Intrahepatic metastases, polycystic liver disease, and primary hepatic neoplasm produce mass effects consisting of ductal displacement, narrowing, and obstruction. The potential of endoscopic retrograde intrahepatic cholangiography in evaluating the intraheptic biliary tree is significant; specifically in separating normal from abnormal, in distinguishing between intrahepatic processes, and as an adjunct to liver biopsy in determining the extent and location of intrahepatic abnormalities.

Bile Ducts, Intrahepatic↗
PubMed1976

The normal endoscopic pancreatogram.

Pancreatograms of 102 patients with proved normal pancreatic status were reviewed to establish normal standards of pancreatic ductal morphology, and precise details of ductal course, position, length, caliber, and variant anatomy were analyzed. The ampulla was found at the level of the second lumbar vertebra in 75% of cases, while the pancreatic duct crossed the spine at L1 in most cases. Mean ductal diameters were 3.1, 2.0 and 0.9 mm in the head, body, and tail of the pancreas, respectively.

Adolescent↗
PubMed1976

The significance of pancreatic ductal obstruction in differential diagnosis of the abnormal endoscopic retrograde pancreatogram.

Apparent obstruction of the main pancreatic duct was seen on the endoscopic retrograde pancreatogram in 50 patients. The final diagnosis was pseudocyst in 15, neoplasm in 15, chronic pancreatitis in 8, acute recurrent pancreatitis in 3, and abscess in 2. Seven patients were normal. This series emphasizes the broad differential approach necessary when confronted with ductal obstruction. Diagnosis is facilitated by accurate evaluation of the ductal and extraductal characteristics, especially the ductal detail at the point of termination.

Acute Disease↗
PubMed1976

Diagnostic accuracy of endoscopic retrograde cholangiopancreatography in hepatic, biliary, and pancreatic malignancy.

This paper reports the radiographic findings in 84 cases of biopsy-proven pancreatic and biliary malignancies studied by endoscopic retrograde cholangiopancreatography. In the 73 successful studies a diagnosis of tumor could be made in 67 patients (92%). The study was successful in 40 of 43 patients with pancreatic carcinoma and the diagnosis could be made in 37 on the basis of stenosis or obstruction of the ducts. There were 33 successful studies in the 41 patients with miscellaneous tumors including primary bile duct, ampullary, gallbladder, metastatic carcinoma, lymphoma, and hepatoma. A diagnosis of tumor was made in 30 studies. As has been observed in carcinoma of other hollow structures, the hallmark of malignancy in the pancreatic and biliary tract is obstruction and stenosis. This study indicates that malignant disease of the pancreas and tract is accurately assessed by this endoscopic method.

Bile Duct Neoplasms↗