A patient with residual intra-/extra-hepatic bile duct stones, previously admitted in emergency for acute necrotic pancreatitis and cholangitis, underwent the following procedures: 1) endoscopic sphincterotomy and naso-biliary tube drainage; 2) surgical operation (choledocholithotomy, operative choledochoscopy and T-tube external biliary drainage); 3) extracorporeal shock-wave lithotripsy; 4) endoscopic sessions of fragmented stones removal. The above mentioned multimodal treatment, which resolved the intrahepatic lithiasis as shown 12 months later by endoscopic retrograde cholangiography, is therefore suitable in order to avoid, at least initially, invasive radiologic or surgical procedures, i.e. transparenchymal approaches, intrahepatic derivations and hepatic resections.

Bile Ducts, Intrahepatic↗

PubMedDate not supplied

Effect of fedotozine on human distal colon.

Fedotozine was rested in colonic strips removed during surgery from patients suffering from different diseases of the colon; the effects were compared to those of morphine and of the selective opiate agonist U-69593. Fedotozine did not affect the spontaneous motility of human colonic strips, unless very high concentrations were used. Fedotozine (10(-6)-3 x 10(-4) M) induced a concentration-dependent reduction of the excitatory effect induced by field stimulation, an effect which was partially mimicked by compound U-69593 and by morphine but not inhibited by naloxone. The cumulative dose-response curve to exogenous acetylcholine was inhibited by fedotozine (3 x 10(-4) M), whereas morphine had no effect up to 3 x 10(-4) M. In colonic strips incubated with [3H]-choline, fedotozine (10(-5)-10(-4) M) induced an erratic decrease of acetylcholine-release induced by electric stimulation. In our experimental model, the inhibitory effect of fedotozine does not seem to be related to opioid receptor activation.

Acetylcholine↗