Search PubMed⌕ Search

Biomedical subjects

M Guelrud

Publications and source records attributed to M Guelrud.

At least 55 records · Page 3Linked to original sources
PubMed1983

Endoscopic cholangiopancreatoplasty: hydrostatic balloon dilation in the bile duct and pancreas.

Specially designed catheters containing durable polyethylene balloons have been employed in the treatment of strictures of the bile duct and pancreas and the sphincter of Oddi during the performance of endoscopic retrograde cholangiopancreatography (ERCP). Twenty-four patients with strictures of the distal common bile duct and/or dysfunction of the sphincter of Oddi and six patients with proximal biliary strictures comprised the biliary group, while six patients with strictures of either the primary pancreatic duct or accessory systems made up the pancreatic group. No significant complications occurred following biliary dilation, while uncomplicated, mild pancreatitis was associated with pancreatic manipulation. The early results of hydrostatic dilation are encouraging, but larger series and longer term follow-ups are necessary before its efficacy can be determined.

Adult↗
PubMed1983

Pressures in the sphincter of Oddi in patients with gallstones, common duct stones, and recurrent pancreatitis.

To determine the significance of manometric pressure, measurements of the sphincter of Oddi in a control group and in patients with cholelithiasis with common duct stones with and without recurrent pancreatitis were studied. Sphincter of Oddi pressure was recorded continuously and by station pull-through by a triple lumen catheter. The basal sphincter of Oddi pressure, the mean pressure gradient between common duct and duodenum, and the sphincter of Oddi wave amplitude were measured. There was no significant difference between control subjects and patients with gallstones and common duct stones. In patients with common duct stones and recurrent pancreatitis the basal sphincter of Oddi pressure, the pressure gradient between common duct and duodenum, and the wave amplitude were significantly increased over control patients. These studies suggest that abnormalities in the sphincter of Oddi motor function are more common in patients with common duct stones with recurrent pancreatitis than in similar patients without pancreatitis.

Acute Disease↗
PubMed1983

Sphincter of Oddi pressure in chagasic patients with megaesophagus.

Autonomic denervation is found throughout the entire length of the digestive tract in Chagas' disease. Anatomic evidence of myenteric ganglia reduction in chagasic gallbladders has been noted; however, the sphincter of Oddi has not been studied. The purpose of this study is twofold: first, to determine sphincter of Oddi pressure in 11 patients with chronic Chagas' disease and megaesophagus, and to compare the results with those obtained in 27 control subjects; and second, to evaluate the effect of cholecystokinin-octapeptide on sphincter of Oddi pressure in both groups of patients. Sphincter of Oddi pressure was recorded continuously via an endoscopically placed triple-lumen catheter inserted into the papilla and directed into the common bile duct. Basal sphincter of Oddi pressure was 12.9 +/- 1.1 mmHg in controls as compared with 44.9 +/- 4.7 mmHg in chagasics with megaesophagus. Mean common bile duct/duodenum gradient pressure was 4.1 +/- 2.4 mmHg in controls as compared with 13.1 +/- 2.7 mmHg in chagasics. Amplitude of sphincter of Oddi phasic contractions in the control group was 102.4 +/- 5.5 mmHg as compared with 140.5 +/- 9.2 mmHg in the chagasic group. Pulse dose of intravenous cholecystokinin-octapeptide produced a decrease of basal sphincter of Oddi pressure with inhibition of sphincter of Oddi phasic contractions in both chagasic and control patients. In chagasic patients, a neural abnormality in the sphincter of Oddi segment could explain the observed high basal pressure and high amplitude of phasic contractions. Chagasic patients with sphincter of Oddi pressure abnormalities, demonstrating sphincter of Oddi relaxation after cholecystokinin-octapeptide, may have neural impairment limited to preganglionic fibers, while the postganglionic inhibitory nerves remain at least partially intact.

Adolescent↗
PubMed1983

Endoscopy retrograde cholangiography.

Since introduction of endoscopic cannulation of the ampulla of Vater, endoscopic retrograde cholangiopancreatography has become a widely used procedure for evaluating suspected biliary tract and pancreatic disease. ERCP is a somewhat sophisticated technique that can be successfully mastered by the trained endoscopist after a reasonable commitment of time and good training. The ability to cannulate the papilla of Vater under direct vision to facilitate the opacification of the ductular structures of the biliary tract and pancreas has influenced our current approach to biliary and pancreatic disease by providing an expedient diagnosis and thus specific management.

Adult↗
PubMed1980

Motor function abnormalities in acute caustic esophagitis.

Severe motor abnormalities in the human esophagus injured by acid correlated with the degree of mucosal esophageal damage observed by esophagoscopy. In mild caustic esophagitis, motor function remained normal. In severe esophagitis, motor alterations included decrease or absence of high resting pressure in the lower esophageal sphincter with normal swallowing response. In the body of the esophagus, manometric findings were variable and consisted of high resting esophageal pressure, absence of motor response after swallowing, nonperistaltic contraction, and delayed swallowing response. At follow-up motility studies 1 month after injury, esophageal motor function had returned to normal. We suggest that these abnormalities, which could be related to edema or a transient damage of mucosal sensory nerves, contributed to dysphagia.

Acute Disease↗
PubMedDate not supplied

Forceful balloon dilation: an outpatient procedure for achalasia.

The initial treatment of choice in patients with achalasia is balloon dilation. Heretofore, this procedure was performed on an in-hospital basis resulting in high patient cost. This study evaluated the safety and efficacy of pneumatic dilation as an outpatient procedure. Sixty-one procedures were performed on 50 patients at two centers. An overall treatment success rate of 95% (47 of 50 patients) was achieved. Two patients had elective surgical treatment and a third underwent surgery for perforation secondary to dilation. A total of three patients complained of post-procedure chest pain within 4 hours and were hospitalized. Two had perforations; one required surgical repair. The third patient had resolution of symptoms. We conclude that performing balloon dilation as an outpatient procedure is safe, efficacious, and cost effective.

Adolescent↗
PubMedDate not supplied

Somatostatin prevents acute pancreatitis after pancreatic duct sphincter hydrostatic balloon dilation in patients with idiopathic recurrent pancreatitis.

The purpose of this study was to determine whether prophylactic somatostatin infusion can prevent pancreatitis after hydrostatic balloon dilation of the pancreatic duct sphincter segment in 16 patients with idiopathic recurrent pancreatitis. This study demonstrated that prophylactic administration of somatostatin before, during, and after the procedure diminished the incidence and severity of acute pancreatitis. We recommend consideration of such prophylaxis in patients undergoing this procedure.

Acute Disease↗
PubMedDate not supplied

Effect of local instillation of alcohol on sphincter of Oddi motor activity: combined ERCP and manometry study.

The effect of local instillation of alcohol on sphincter of Oddi motor activity was determined by endoscopic manometry. Sphincter of Oddi pressures and motor function were compared in eight cholecystectomized subjects with normal sphincter of Oddi motor function and in four patients with chronic alcoholic pancreatitis. The effect of local instillation of 3 ml of 40% alcohol was compared with water instillation. In cholecystectomized subjects, alcohol produced a significant increase of basal sphincter of Oddi pressure from 21.0 +/- 2.8 mm Hg to 95.8 +/- 83 mm Hg (p less than 0.01) without significant changes in the amplitude, duration, and frequency of phasic contractions. In patients with alcoholic chronic pancreatitis, alcohol instillation resulted in a significant increase of basal sphincter of Oddi pressure from 32.5 +/- 4.8 mm Hg to 225.1 +/- 105 mm Hg without changes in amplitude, duration, and frequency of phasic contractions. Two patients with chronic alcoholic pancreatitis had a tonic contraction of the sphincter of Oddi with transitory and mild epigastric pain. Local instillation of alcohol increases sphincter of Oddi motor activity which may play a role in the pathogenesis of alcoholic pancreatitis.

Adult↗