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Biomedical subjects

V F Moreira

Publications and source records attributed to V F Moreira.

At least 37 records · Page 2Linked to original sources
PubMed1992

Endoscopic sphincterotomy and gallstone pancreatitis: some answers and more fuel for the flames.

We review standard management for patients with gallstones and common duct stones in the light of endoscopic sphincterotomy. As the sole treatment that procedure needs to be compared to surgical approaches, but now that laparoscopic cholecystectomy is available, there is some uncertainty about which surgical option should stand in comparison. We review salient points in the literature to urge further long term prospective comparisons of endoscopic sphincterotomy and surgical approaches.

Acute Disease↗
PubMed1992

[Treatment of residual choledochal calculi in patients with Kehr's T drainage: role and results of endoscopic sphincterotomy].

The results of sphincterotomy in the treatment of residual gallstones after cholecystectomy in a series of 62 patients, bearers of a T tube are reported. The mean time after surgery was 26.4 +/- 19.2 days. The procedure was technically successful in 59/62 (95.1%). Stones were passed spontaneously or were retrieved in 55/62 patients (88.7%). In four patients gallstones persisted in spite of sphincterotomy. All were operated with favorable results. Complications were observed in 4 patients (6.4%), without mortality. Sphincterotomy is a safe and relatively efficient technique in the treatment of cholecystectomized patients with residual gallstones and a T tube drainage.

Adolescent↗
PubMed1991

[Endoscopic choledochoduodenostomy in the treatment of impacted calculi in Vater's papilla].

In a series of 204 patients with common duct stones, sphincterotomy was not possible in 10, due to an impacted stone in the papilla. An endoscopic choledocho-duodenostomy was performed which was effective in all cases. One patient suffered a retroperitoneal perforation which was managed medically. This technique is an effective alternative to sphincterotomy in the treatment of impacted papillary stones. Retroperitoneal perforation is a major risk to be taken into account.

Aged↗
PubMed1991

Choledocholithiasis in cirrhotic patients: is endoscopic sphincterotomy the safest choice?

Of the 18 endoscopic sphincterotomies performed on 18 cirrhotic patients for choledocholithiasis, a mortality rate of 16.6% was registered. However, this figure can be limited to 6.6% if we take only successful sphincterotomies (15/18, 83.3%) into account. After closely reviewing relevant literature, it would appear that operative mortality in comparable cases is much higher. We therefore recommend that endoscopic sphincterotomy, despite higher mortality rates when compared to the general population, should be the initial choice of management of choledocholithiasis in cirrhotic patients.

Aged↗
PubMed1991

[The value of endoscopic biopsy in the diagnosis of carcinoma of Vater's ampulla].

In a series of 23 ampullary carcinomas, confirmed by the pathological examination of the duodenopancreatectomy specimens, 17 were biopsied during the previous ERCP examination. Biopsies were diagnostic of carcinoma in 12 (70.5%). Among 11 exophytic tumours biopsy was positive in 8 (72.7%) while in 6 tumours growing inside the papilla biopsies were positive in 4 (66.6%) (NS). It is concluded that endoscopic biopsy may be diagnostic in two-thirds of ampullary carcinomas.

Adenocarcinoma↗
PubMed1990

[Is endoscopic retrograde cholangiopancreatography useful in the diagnosis of cholangiocarcinoma?].

We have been interested in demonstrating the usefulness of the reverse endoscopic cholangiopancreatography, a technique already accepted in extrahepatic biliary pathology and the cholangiocarcinoma diagnosis. First of all we reviewed those cases diagnosed as cholangiocarcinoma using the REC and we found that only in 14 (60.9%) of a total of 23 cases the diagnosis was confirmed by surgery, resulting in a false positive ratio of 39.1%. In the second analysis of 22 patients who underwent surgery and whose surgical diagnosis was cholangiocarcinoma, we confirmed a correct presurgery diagnosis by REC in 14 (63.6%) with a false negative ratio of 36.3% which could be reduced to 26.3% after excluding the technically incorrect explorations or those in which only the pancreatic ductus was visualized. We conclude that cholangiocarcinoma diagnosis by REC has a high false positive or negative ratio, thus, treatment, specially non surgical, of a possibly malignant stenosis or obstruction of the bile duct can not only be based on choleangiopatic findings.

Adenoma, Bile Duct↗