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Biomedical subjects

M L Kinnison

Publications and source records attributed to M L Kinnison.

25 records · Page 2Linked to original sources
PubMed1985

Nonoperative management of benign postoperative biliary strictures.

Selected benign biliary strictures can be treated safely and successfully by percutaneous balloon dilatation. Primary biliary strictures appear to be less responsive to balloon dilatation alone and require stenting with large catheters (16-20 F) for several months to permit scarring around the catheter. A long period of healing around such a large-bore stent is crucial to the success of such treatment. The most important physiologic indicators for successful dilatation are a long period of stricture challenge with a catheter placed proximal to the dilated segment to allow bile to drain internally across the previously strictured segment, and a near anatomic result as demonstrated by cholangiogram.

Adolescent↗
PubMed1985

Biliary catheter drainage complicated by hemobilia: treatment by balloon embolotherapy.

Seventeen patients experienced severe hemobilia following percutaneous (nine patients) or surgical (eight patients) placement of biliary drainage catheters. Fourteen patients bled early after catheter placement (0.5-32 weeks; mean, 5.4 weeks) and three bled late during long-term biliary drainage (1.1-3.6 years; mean, 2 years). Hepatic angiography demonstrated the source of bleeding in 15 (88%) patients (hepatic artery pseudoaneurysm in ten, hepatic artery-portal vein fistula in four, varix along the tube tract in one) but showed no source of bleeding in two. Thirteen patients with hemobilia were treated with embolotherapy, using detachable balloons in 12. The advantages of this technique included the ability to flow-direct the balloon without selective catheterization; the ability to test-inflate the balloon at the site of the aneurysm or fistula during angiographic study and adjust its position before detachment; and preservation of the hepatic artery proximal and distal to the inflated balloon, thus preserving hepatic function following embolization.

Adult↗
PubMed1985

Percutaneous transhepatic biliary drainage for bile leaks and fistulas.

Percutaneous transhepatic cholangiography and biliary drainage were performed in 12 patients with major injuries to the bile ducts manifested by biliary leaks and fistulas. Eleven of the 12 patients had had inadvertent biliary trauma during surgery. In six patients, the biliary leaks sealed with percutaneous drainage. In other patients requiring definitive surgical procedures on the biliary tract, initial percutaneous drainage allowed these procedures to be delayed until the patients' clinical condition improved. Percutaneous biliary drainage is an important adjunct to the management of patients with traumatic extravasation of bile into the peritoneal cavity or biliary-cutaneous fistula.

Abscess↗
PubMed1985

Cost incentives for peripheral angioplasty.

Hospital costs and length of stay for 86 patients with peripheral vascular disease treated by bypass or percutaneous transluminal angioplasty (PTA) were assessed. The length of stay averaged 4-4.5 times longer, and the total hospital charge was 3-3.7 times greater, for bypass than for PTA. These charges are discussed in relation to current diagnosis-related groups (DRGs) and the allowed reimbursement from the Federal Prospective Payment System. In appropriately selected patients with peripheral vascular disease, PTA should be the treatment of choice from both medical and financial points of view.

Aged↗
PubMed1981

Radiographic diagnosis of tonsillar cyst presenting as dysphagia.

Tonsillar retention cysts are common and most often asymptomatic. The radiographic demonstration of a retention cyst in a symptomatic patient is reported. Emphasis should be placed on the oropharynx during barium swallow examinations in appropriately symptomatic patients. Tonsillar retention cysts should be included in the differential diagnosis of mass lesions in this area.

Aged↗
PubMedDate not supplied

Digital subtraction spinal cord angiography in patients undergoing thoracic aneurysm surgery.

Thoraco-abdominal aortic replacement can be associated with a high incidence of paraplegia. Because the major source of blood supply to the thoraco-abdominal spinal cord is through the anterior spinal artery of Adamkiewicz, reimplantation of intercostal and lumbar arteries could reduce the risk of this operation. We used intraarterial digital subtraction angiography (DSA) for preoperative localization of the anterior spinal artery in 12 patients. This vessel was successfully located in 9 patients, with DSA providing good quality images in all patients. Preoperative knowledge of the origin of this vessel was helpful in the planning of the operation in all patients, but its efficacy as a routine procedure was not established.

Adult↗