The incidence of carcinoma of the large bowel in the United States is higher than for any other site. In Japan it is about one quarter as frequent, and the cause of this discrepancy appears to be more environmental than genetic on the basis of migrant studies. The incidence of carcinoma in familial polyposis approaches 100% and in villous adenoma the incidence of carcinoma is 40-50%. The relation of adenomatous polyps to carcinoma is not so strong, yet there is a notable association between the occurrence of polyps and carcinoma in the same bowel. With modern surgical techniques, the risk of removing polypoid lesions of the colon transabdominally appears much lower than the average risk of leaving such lesions alone unless and until they give signs and symptoms of carcinoma. The greater use of the colonoscope should, however, greatly reduce the need for laparotomy.

Adenoma↗

PubMed1975

Pancreaticogastrostomy: a further evaluation.

The anastomosis between the remaining pancreas and the intestinal tract after various types of pancreatic resection has been the site of complications responsible for considerable morbidity and mortality. After Whipple resections reestablishment of pancreatic-intestinal continuity has generally been accomplished in some manner between the pancreas and upper jejunum. This suture line has at times failed, often as the result of postoperative pancreatitis, giving rise to hemorrhage, abscess, and fistula formation. Since 1963, 25 patients undergoing pancreaticoduodenal resection have had some portion of their pancreas implanted into the back wall of the stomach. The operations have been done by the resident and senior staff of the Department of Surgery at the University of Pennsylvania. Morbidity has decreased and operative mortality has fallen from 20-30% to 8%. The technique is not difficult and there seems to be less tendency for the anastomosis to leak. Pancreatic function is usually adequate. The procedure is useful after radical resection of the pancreaticoduodenal region or at times after pancreatic trauma.

Aged↗

PubMed1975

Intraoperative demonstration of the mesenteric lymph channels.

The mesenteric lymphatic channels are readily demonstrated at laparotomy by injecting methylene blue directly into the mesenteric lymph nodes. Flow through the lymphatic system can be augmented by temporarily compressing the superior mesenteric vein.

Humans↗

PubMed1975