Sixty-eight patients with bleeding oesophageal varices due to cirrhosis of the liver who have had an emergency portasystemic shunt are reviewed. The reasons for the emergency shunt surgery and the results are described and discussed. The low postoperative mortality is attributed to careful case selection. Apart from clinical and serological factors, the importance of the bromsulphthalein excretion test is stressed. Emergency shunts are now undertaken by the author in patients whose serum bilirubin is less than 2-5/100 ml and bromsulphthalein retention less than 10 per cent in 30 minutes. This is in marked contrast to the author's previous series in which there was a 30 per cent mortality. The poor results in patients treated conservatively and the disparity between the author's results and those of other reported series are reviewed and discussed.

Adult↗

PubMed1976

Carcinoma of the periampullary region: a review of a personal series of 87 patients.

Eighty-seven patients with carcinoma of the periampullary region treated by the author are reviewed. The clinical presentation and investigations are reported, and it is emphasized that the poor prognosis of this disease is due to the delay in presentation and diagnosis. Consequently, in most cases treatment can only be palliative, and the various forms of treatment are discussed.

Adult↗

PubMed1976

Surgical management of pancreatic trauma.

Ninety-one patients treated for pancreatic injuries are reviewed. Difficulty of diagnosis, including the surgical management of these injuries and their complications, are discussed in detail. The presence of associated multiple injuries, delay in diagnosis, and lack of sound surgical principles of treatment are directly proportional to the rate of complication and mortality.

Adolescent↗

PubMed1976

The surgical management of hepatic trauma.

The personal experience of 179 patients with hepatic injuries is reviewed by the author. Difficulties in diagnosis and other problems encountered are discussed. The methods of management of the injuries and his operative technique are discussed. The increasing incidence of violence and large-scale civil disturbances coupled with fast automobiles have shown the changing concept in the type of injuries and the need for more aggressive treatment.

Abdominal Injuries↗

PubMed1975

Early management of corrosive burns of the oesophagus.

One hundred and sixteen patients with early corrosive burns of the oesophagus treated by the author are reviewed. It is emphasized that the all important aspect of management of these patients is prophylactic treatment to avoid stricture of the oesophagus. Early treatment consists of intravenous fluid therapy, broad spectrum antibiotics, sedation, parenteral hydrocortisone and more importantly maintaining the patency of the oesophagus followed by dilatation. The importance of early barium meal studies and oesophagoscopy is stressed.

Adolescent↗

PubMed1975

Management of primary liver cell carcinoma.

A review of 352 patients with primary liver cell carcinoma treated by the author is presented. The poor rate of resectability (7 per cent) has necessitated various forms of treatment over the years. These are described in detail. Based on this experience, the current form of treatment for nonresectable carcinoma is summarized. Although it is too early to assess this form of treatment, initial results appear to be promising. A second report in the near future is planned.

Age Factors↗

PubMed1975