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Biomedical subjects

J Hoevels

Publications and source records attributed to J Hoevels.

At least 55 records · Page 3Linked to original sources
PubMed1979

Percutaneous transhepatic insertion of a permanent endoprosthesis in obstructive lesions of the extrahepatic bile ducts.

A Teflon endoprosthesis for permanent bile drainage was inserted in 13 patients following percutaneous transhepatic puncture and catheterization of the bile duct system. Twelve patients had extrahepatic cholestasis because of a malignant tumor, whereas one patient had chronic inflammation involving the hepatoduodenal ligament (secondary to Crohn's disease) with obstruction of the extrahepatic bile ducts. The drainage periods varied from 1 week to 8 months. The endoprosthesis was regarded as partially effective in seven patients whereas in six cases the drainage through the endoprosthesis was insufficient and external bile drainage through a percutaneous transhepatic catheter was necessary. Infection of the bile duct system during the drainage period with a percutaneous transhepatic catheter and/or bile duct endoprosthesis occurred in 10 patients. Spontaneous dislocation of the endoprosthesis occurred in varying degrees in five patients. One patient developed an intrahepatic aneurysm adjacent to the puncture tract and died because of liver insufficiency following therapeutic embolization of the aneurysm and most of the hepatic arteries by injection of gelfoam particles into the common hepatic artery. Patients in whom palliative treatment by insertion of a permanent bile duct endoprosthesis may be suitable were defined.

Adult↗
PubMed1979

Spontaneous intermittent reversal of blood flow in intrahepatic portal vein branches in cirrhosis of the liver.

The intrahepatic portal venous flow in cirrhosis of the liver was evaluated by percutaneous transhepatic portography and hepatic arteriography. Spontaneous reversal of flow in segmental portal vein branches was documented. Changes in hepatic arterial inflow and portal venous pressure may result in intermittent changes in the direction of flow in segmental portal venous branches within the cirrhotic liver. Segmental reversal of blood flow seems to be the precursor of total hepatofugal portal flow.

Adult↗
PubMed1979

[A comparative diagnostic study of malignant lesions of the liver by infusion angiography and percutaneous transhepatic portography (author's transl)].

The diagnostic effectiveness of percutaneous transhepatic portography (PTP) was evaluated in 21 patients with primary and metastatic liver carcinoma, who also had infusion hepatic angiography. The findings at PTP were compared with unequivocal tumor changes demonstrated at infusion hepatic angiography in all cases. PTP revealed tumors in 14 of 21 cases. The location, size and number of the tumor(s) were decisive for their detectability at PTP. Solitary lesions smaller than 2 cm in the central parts of the liver escaped detection, whereas lesions larger than 7 cm in the left lobe and 6 cm in the right lobe were demonstrated in all cases. Multiple metastases of 1--2 cm were detected in most cases. Lesions smaller than 4 cm were better shown by the sinusoidal phase at PTP, where lesions larger than 5 cm were better delineated by the portal venous phase.

Adult↗
PubMed1979

Percutaneous transhepatic portography in bile duct carcinoma. Correlation with percutaneous transhepatic cholangiography and angiography.

In 16 patients with carcinoma of the extrahepatic bile ducts, percutaneous transhepatic portography (PTP) and cholangiography (PTC) were performed. Fourteen of these patients also had angiography, which failed to show the tumor in 7 cases. Findings indicating non-extirpability of the tumor were demonstrated by angiography in 3 patients. At PTP non-extirpability was confirmed in these cases. PTP further indicated non-extirpability in one patient and gave hints of infiltration of the liver by the tumor in 5 patients because of intra or extrahepatic invasion of the portal vein.

Adenoma, Bile Duct↗
PubMed1979

Comparison of monomer, dimer and non-ionized medium at urography with simulated compression; an experimental study in the rabbit [author's transl].

Density, estimated through renal pelvic volume as calculated according to previous experiments (Owman 1978) and urinary iodine concentration, is suggested to be more accurate than, and complementary to, mere determination of urine iodine concentration and diuresis when evaluating and comparing urographic contrast media experimentally. More reliable dose optima are probably found when calculating density rather than determining urine concentrations. Of the examined media in this investigation, metrizamide and P 268 are by far superior, giving higher density, higher urinary concentrations, and metrizamide also less diuresis.

Animals↗
PubMed1979

Clinical aspects of nonsurgical percutaneous transhepatic bile drainage in obstructive lesions of the extrahepatic bile ducts.

Percutaneous transhepatic cholangiography (PTC) with subsequent external bile drainage by nonsurgically established percutaneous transhepatic intubation of bile ducts was performed in 105 patients with obstructive jaundice. Recovery of liver function and improvement in the patients' general condition prior to radical or palliative surgery, nonsurgical palliation in advanced cases of malignancy as well as relief of postoperative leakage from a biliodigestive anastomosis are the indications for the bile drainage technique used in the present study. Clinical aspects such as optimal period of preoperative drainage, frequency of catheter dislodgement, and rate of complications such as cholangitis, bile leakage to the abdominal cavity and risk for peritoneal hemorrhage are discussed. Two deaths occurred within this series.

Adult↗
PubMed1979

Obliteration of esophageal varices by PTP: a follow-up of 43 patients.

The percutaneous transhepatic portal vein catheterization (PTP) with selective obliteration of the coronary vein and/or the short gastric veins in treating bleeding esophageal varices was introduced in 1974. In order to prevent recanalization of the vessels Bucrylate (isobutyl-2-cyano-acrylate) has been used in 43 patients 55 times during a period of 34 months (October 1975 to July 1978). The obliterative treatment was followed by rebleeding in 35% of the cases and continued bleeding occurred in two patients. Fourteen patients were treated on 16 occasions during acute bleedings, and five of these (36%) died within two months from a portal vein thrombosis caused by the obliterative procedure. Because of these findings PTP with obliteration of the veins feeding the esophageal varices is not recommended as an elective way of treatment. It should only be used in the acute bleeding patient when transesophageal sclerosering therapy, continuous vasopressin infusion and balloon tamponade have failed. Fifty-six per cent of the patients acutely treated stopped bleeding for more than one week, thus avoiding an emergency shunt or devascularization operation which are associated with a high mortality rate.

Adolescent↗
PubMed1979

Angiographic findings in adrenal masses.

The angiographic findings in 34 patients with adrenal lesions were reviewed, including 11 adrenal metastases, 9 adrenal pheochromocytomas, 4 adrenal cortical carcinomas, 4 adrenal cortical adenomas, 3 cases of adrenal hyperplasia and 3 cases of adrenal invasion from carcinoma of the upper pole of the kidney. The results indicate differential diagnostic difficulties in distinguishing among these various entities by angiography.

Adenoma↗
PubMed1979

Adrenal angiography in Sipple's syndrome.

Adrenal angiography was performed in 8 patients with Sipple's syndrome. Seven patients had pheochromocytomas and one bilateral adrenal medullary hyperplasia. In 4 cases the pheochromocytomas were bilateral. The angiographic findings are discussed and it is concluded that no typical angiographic appearance of pheochromocytoma appears to exist.

Adrenal Gland Neoplasms↗
PubMed1979

Porto-systemic collaterals in cirrhosis of the liver. Selective percutaneous transhepatic catheterization of the portal venous system in portal hypertension.

In 93 patients with cirrhosis of the liver and portal venous hypertension the main tributaries of the portal vein were examined by percutaneous transhepatic catheterization. The appearance and degree of porto-systemic collaterals were analysed. Esophageal varices were demonstrated in 82 patients. No correlation was found between the portal venous pressure and the extent of porto-systemic communications.

Adolescent↗
PubMed1978

Percutaneous transhepatic intubation of bile ducts for combined internal-external drainage in preoperative and palliative treatment of obstructive jaundice.

Percutaneous transhepatic intubation and combined internal-external drainage of the biliary system was performed in 15 patients with occlusion of the extrahepatic bile ducts due mainly to cholangiocarcinoma, metastases of the hepatoduodenal ligament, and tumors of the periampullary region. The technique is described and the value of the procedure in temporary decompression and combined internal-external bile drainage prior to radical surgery is demonstrated. Its advantages as a palliative method are evident in far-advanced malignancy when extensive and complicated surgical procedures are ill-advised.

Adult↗
PubMed1978

[Results of percutaneous transhepatic portography (author's transl)].

The technique, indications, contraindications and complications of percutaneous transhepatic portography based on the experience of 300 cases are described. The advantage of this method is discussed and compared with transjugular and transumbilical portography.

Esophageal and Gastric Varices↗
PubMed1978

Topographic relation of portal vein to extrahepatic bile ducts. A combined portographic-cholangiographic study in 25 cadavers.

The extrahepatic course of both portal vein and bile ducts and their interrelation are analysed by simultaneous portography and cholangiography in 25 adult cadavers. The findings are correlated with the topographic anatomy in the porta hepatis, the hepatoduodenal ligament, and the duodeno-pancreatic region. Minor variations of the interspace between the bile ducts and the portal vein and superior mesenteric vein are demonstrated. The results of this investigation are discussed with respect to the clinical experience that carcinomas of the proximal part of the extrahepatic bile ducts often engage the bifurcation and the main stem of the portal vein, whereas the confluence of the portal vein and the superior mesenteric vein is more often affected by cancer of the head of the pancreas.

Adult↗
PubMed1978

[Percutaneous transhepatic intubation of bile ducts for combined internal and external drainage in extrahepatic cholestasis (author's transl)].

In 37 patients with extrahepatic cholestasis of different origin, percutaneous transhepatic intubation of the bile ducts was performed for combined internal and external drainage. In 5 cases with stones in the extrahepatic bile ducts and in 12 cases with periampullary tumors, the bile ducts were drained preoperatively. In 3 of these patients, temporary drainage was performed because of postoperative complications. Thirteen patients with non-resectable tumors received a permanent drainage as palliation. In 4 patients temporary drainage was performed during radiation/cytostatic therapy. One patient with an iatrogenic bile duct lesion and one patient with an inflammatory tumor in the liver hilum had a drainage catheter placed because a bile duct resection with creation of a biliodigestive anastomosis was not possible. In one patient with a non-resectable periampullary carcinoma the drainage catheter was replaced by a teflon bile duct endoprosthesis inserted by the percutaneous transhepatic approach. The complications of non-operative percutaneous transhepatic bile drainage are discussed.

Adenoma, Bile Duct↗
PubMed1978

The surgical treatment of chronic intestinal ischemia.

The mortality in acute intestinal ischemia is high, and 50% of such patients have previous attacks of abdominal angina due to chronic intestinal ischemia. Vascular reconstruction is remarkably successful in relieving the symptoms of chronic intesintal ischemia and for this reason angiographic examination is recommended in all patients in whom chronic intestinal ischemia is suspected. If the diagnosis is established by arteriography with appropriate supporting evidence, vascular reconstruction should be performed.

Adult↗
PubMed1978

Percutaneous transhepatic portography.

The technique, indications, contraindications and complications of percutaneous transhepatic portography and selective catheterization of the major and minor veins draining the splanchnic organs based on the experience of 200 cases are described. The advantage of this method is discussed and compared with transjugular and transumbilical portography.

Adult↗