[Peritoneo-jugular shunt in the treatment of refractory ascites (LeVeen shunt). Clinical case series and personal experience].
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Biomedical subjects
Publications and source records attributed to M Muri.
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An evaluation of total hemolytic complement activity (CH100) after fasting or intestinal bypass was performed in rats. The experiment lasted 6 days. Three groups, of 5 animals each, were studied. On the 1st day, basal values of total complement (TC), albumin and body weight were determined. Group A received normal, ad libitum feeding, group B started on a 'water only' diet, group C underwent intestinal bypass. On the 4th and 6th day the parameters were assessed. TC mean values were significantly lower in groups B and C, as compared to group A, on the 4th as well as on the 6th day (p less than 0.01 by Mann-Whitney's U test). Body weight showed a similar trend. Differences in albumin were never statistically significant. Limitations of the analytical method are discussed. The data show that fasting or bypass-induced malabsorption may determine an early decrease in total hemolytic complement activity, though a development of an immune deficiency is not proved.
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A patient with a pancreatic fistula, with a defunctionalized duodenum (subsequent to a previously performed Billroth II gastrectomy for cancer and choledochojejunostomy for metastatic infiltration in the bile duct) was submitted to prolonged synthetic somatostatin infusion (48 h). There was a mean reduction of 80% in pancreatic output, with no changes in the composition of sodium, potassium, and calcium, an increase in chloride and a decrease in bicarbonate. An increase in amylase was noted. The unique clinical features of this case have provided direct confirmation of the inhibiting action of somatostatin on the exocrine pancreas.
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The Authors report 22 cases treated with palliative operations for malignancy of the pancreas or distal common bile duct with jaundice and discuss criteria of choice and advantages of using the gallbladder or bile duct. Besides survival, rate of disappearance and late recurrence of jaundice are considered according to type of surgical procedure.