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Biomedical subjects

P Dhar

Publications and source records attributed to P Dhar.

58 records · Page 4Linked to original sources
PubMedDate not supplied

Gastric outlet obstruction in carcinoma gall bladder.

BACKGROUND: Gastric outlet obstruction is occasionally reported to occur in advanced gall bladder malignancy and may require palliative surgery. A review of 39 patients who required gastroenterostomy for symptomatic or incipient gastric outlet obstruction in carcinoma gall bladder is presented. METHODS: This retrospective review included 24 women and 15 men over nine years who underwent gastrojejunostomy for locally advanced neoplasms of the gall bladder. RESULTS: Twenty two patients with carcinoma gall bladder had symptomatic gastric outlet obstruction whereas in 17 patients gastrojejunostomy had been performed for intraoperatively assessed impending obstruction. Thirty-four patients had concomitant jaundice. In most cases, there was obstruction of the first two parts of the duodenum, mostly by direct tumoral infiltration (64%). All patients underwent anterior gastrojejunostomy, with billoenteric bypass in 15 patients. There were two postoperative deaths. Eight patients developed postoperative delayed gastric emptying; all settled on conservative management, though two patients had recurrent refractory vomiting. Thirty patients had no vomiting till a follow up ranging from 36 days to 11 months. CONCLUSIONS: Gastric outlet obstruction may frequently complicate gall bladder cancer and a satisfactory palliation can be achieved in most patients by gastrojejunostomy.

Adult↗
PubMedDate not supplied

Complicated choledochal cysts.

Choledochal cysts have a potential for causing a variety of complications. This article presents the incidence, types, and presentation of complications in patients with choledochal cysts and the results of surgery in these patients. Prospectively collected data of 81 patients with choledochal cysts treated at a tertiary care center were retrospectively analyzed. Sixteen (20% of surgical patients; 100% of study group) patients were found to have a complicated choledochal cyst that either manifested as an atypical presentation or necessitated a change in the treatment planning. Eight (50%) of these patients had complications of infective nature, and another 8 (50%) had noninfective complications. Fifteen (94%) patients with complications were adults and 11 (63%) patients had Todani type-IVa cysts; a cystic type of intrahepatic component in 10 patients. Five (31%) patients had undergone prior cystenteric drainage operations. Excision of the choledochal cyst was possible in 14 (88%) patients under both emergency and elective situations; cyst excision was performed in the second stage after an initial external drainage procedure in two of these patients. There was no mortality and no major postoperative complications. Complications of choledochal cysts are more likely in adult patients and in those with both intra- and extrahepatic cysts (Todani type-IVa). Despite the presence of complications, the choledochal cyst can be safely excised in a majority of patients.

Adolescent↗