Biomedical subjects

R De la Cuadra

Publications and source records attributed to R De la Cuadra.

4 recordsLinked to original sources

PubMed1992

Gallstone ileus.

A retrospective analysis of 74 patients with gallstone ileus detected during the period between 1975 and 1987 was performed at the Surgical Department. The group comprised 55 females and 19 males, with a mean age of 64.8 years. Previous biliary symptoms had been observed in 76% of the cases and in 58% there had been concomitant disease. The main duration of symptoms previous to admission was 3.4 days. In 85% of the cases complementary diagnostic procedures were performed. The triad of air in the biliary tract, air-fluid levels and ectopic stone was found in only 9.5% of the cases. The preoperative diagnosis of gallstone ileus was made in 31% of the patients. The preoperative period was 2.2 days. The main surgical procedure was enterolithotomy in 92% of the cases, the site of impaction being the terminal ileum in 65%. Only in 1 case was simultaneous biliary tract surgery and enterolithotomy performed. Overall, the 30-day postoperative mortality rate was 13.5%, with intra-abdominal sepsis as the main cause of death. Sixteen patients were submitted to biliary surgery 2 to 6 months later, and no deaths occurred.

Adult↗

PubMed1990

[Duodenal diverticula and its relations with choledocholithiasis].

The incidence of duodenal diverticula was accomplished by four different methods (autopsy, post operative cholangiography, ERCP and upper gastrointestinal X rays); the relationship with common bile duct stones, also was analyzed. The study was developed in the José Joaquín Aguirre Clinic Hospital and Paula Jaraquemada Hospital. The lower incidence was 0.72% in autopsy group and the highest was 8% in patients diagnosed by ERCP. All the diverticula were unique and located in the second duodenal portion. A minimal difference in sex groups was encountered. We did'nt find a major incidence of choledocholithiasis in the population with duodenal diverticula.

Adult↗

PubMed1989

Indications and results of choledochoduodenostomy in benign biliary tract diseases.

During a 12-year period ending December 1987, 17,200 operations for biliary tract disease were performed at the Dept. of Surgery of the University of Chile. Choledochoduodenostomy was performed in 140 of these patients operated upon for benign biliary tract and/or gallbladder diseases. The indications for this procedure were choledocholithiasis, stenosis of the sphincter of Oddi, compression of the extrahepatic biliary duct, stenosis of the distal biliary duct and duodenal diverticula. The postoperative course was uncomplicated in 126 patients (90%). The mortality rate was 4.2%. Although the mortality was somewhat greater in patients with acute cholangitis, the difference was not significant, and no significant relation could be established with other factors that might affect mortality. Choledocholithiasis is the main cause of benign obstruction of the biliary tract in Chile. This is also the most frequent indication for external choledochoduodenostomy and is a promising method even in the presence of an infection of the biliary duct.

Adult↗

PubMed1985

Surgical treatment of high gastric ulcer.

The purpose of this study has been to review the late results of surgical treatment of 244 patients with endoscopically proved benign chronic gastric ulcer located 5 cm or less from the cardia. In five patients, a total gastrectomy with esophagojejunostomy was performed. Proximal gastrectomy was used in 3 patients, mesogastrectomy in 5 patients, a partial Schoemaker's procedure in 73 patients, Pauchet's procedure in 70 patients, and Csendes' procedure in 23 patients. Nonresective procedures were employed in 67 patients and included the Kelling-Madlener procedure in 23 patients, pyloroplasty alone in 10 patients, gastrojejunostomy alone in 4 patients, local or wedge excision of the ulcer in 9 patients, and vagotomy and pyloroplasty in 21 patients. The follow-up evaluation was performed in 91 percent of the patients (mean 9 years postoperatively, range 5 to 15 years), with emptying endoscopy in all nonresected patients. A high mortality was observed after total or proximal gastrectomy, as well as after nonresective procedures. After the other resective techniques, low postoperative morbidity and mortality were observed. No recurrent ulcer was seen after the resective procedures. Based on these results, we propose that when the ulcer is located 5 cm below the cardia, Schoemaker's or Pauchet's procedure should be performed; if the ulcer is located 2 cm or less from the cardia, Csendes' procedure or the Kelling-Madlener procedure should be employed.

Adult↗