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Biomedical subjects

V Grădinaru

Publications and source records attributed to V Grădinaru.

At least 19 recordsLinked to original sources
PubMed1991

[Complicated postbulbar duodenal ulcers: the characteristics of the diagnosis and of the surgical procedure and management].

The paper reports on the authors' experience used on 164 patients with complicated postbulbar ulcers (12% of the duodenal ulcers) with hemorrhage (52 cases), perforation (9 cases), duodenal stenosis (13 cases), stenosis and penetration (36 cases) and pancreatic-biliary penetrations (36 cases). The frequency of hemorrhagic complication was of 31%. As the hemorrhage due to postbulbar ulcer is favoured by vascular fistula, the severe character of the hemorrhage and the frequency of the recurrence, mainly the cataclysmic one, impose the radical surgery as early as possible. The following were used: large Reichel-Polya's gastrectomy (26 cases with 7 deaths) Péan's gastro-duodenectomy (12 cases), Péan's hemigastrectomy+vagotomy (4 cases), gastrectomy for exclusion with hemostasis in situ and ligature of gastroduodenal artery (8 cases, of which 1 with vagotomy and 2 deaths) and pyloroplasty with vagotomy and hemostasis (2 cases). The postsurgical mortality was of 17%. In 9 cases with perforation: Reichel-Polya's gastrectomy in 5 patients (1 death), Péan's gastrectomy in 2 cases, excision pyloroplasty and suture of the perforation in one case, respectively, were used. In the postbulbar ulcers penetrating into the pancreas or into the hepatic pedicle associated with stenosis (36 cases) the following were performed: Reichel-Polya's gastrectomy (7 cases), Péan's gastrectomy (7 cases of which 2 with vagotomy) gastrectomy for exclusion of ulcer in 19 cases, of which 5 with vagotomy, Péan's hemigastrectomy+vagotomy (3 cases). The 36 cases of ulcers penetrating into pancreas were solved as follows: gastrectomy for exclusion (16 cases of which 5 with vagotomy), Reichel-Polya's gastrectomy (10 cases of which 1 with vagotomy), Péan's gastrectomy (10 cases of which 2 with vagotomy). In 13 patients with stenosed ulcers, Reichel's-Polya's gastric resection (10 cases), Péan's gastrectomy, gastrectomy for exclusion and gastrojejunostomy (in one case each) were performed. The conclusions may be drawn that the postbulbar ulcers are complicated ulcers that require differentiated surgical treatment, as early as possible, for diminishing the postsurgical morbidity and mortality (7.5% mortality).

Duodenal Ulcer↗
PubMedDate not supplied

[Hepatodigestive shunts in the treatment of cancer of the liver with obstructions of the intrahepatic bile ducts].

The authors discuss the inductions and the usefulness of hepato-digestive derivations in the treatment of hepatic cancers associated with obstruction of intra-hepatic biliary pathways. A total of 32 hepato-digestive derivations in the left hepatic lobe have been carried out in a number of 62 cases, the remaining 30 cases being treated by a double hepato-digestive derivation on the III-rd and the VI-th segment (hepatogastro- or hepato-jejunostomy with or without disjointed--"in omega"--100 p). Pre- and intraoperational cholangiography is considered as mandatory in view of selecting the type of the intervention.

Bile Duct Neoplasms↗
PubMedDate not supplied

[Chronic pancreatitis: anatomico-clinical and surgical therapy characteristics. Our experience with 321 cases].

Chronic pancreatitis of biliary origin, frequently located in the cephalic portion of the organ, etiopathogenically dependent on biliary lithiasis, the anatomoclinical evolution of which is complicated by their presence, have a better prognosis, and are usually reversible following therapy of the biliary affections. Persistent chronic pancreatitis proper, usually of the recurrent type, associated with calcification and the development of pancreatic stones, and with pseudocysts, although rare in our country, raise diagnostic difficulties from the standpoint of surgery, and have a reserved prognosis. The authors have evaluated a total of 321 cases hospitalized between 1960 and 1987 with chronic pancreatitis of biliary origin (252 cases--78.5%), and chronic pancreatitis proper, not associated to biliary affections (69 cases--21.5%). Male patients totalled 33.6% of all cases. The authors stress the high frequency of chronic pancreatitis associated to biliary lithiasis (181 cases), in contrast with pancreatitis associated to nonlithiasic cholecystopathies (38 cases), or to postoperative cholecystic disturbances (33 cases). Chronic pancreatitis non-associated to biliary affections totalled 69 cases, of which 24 were of the persistent type, 13 were of the recurrent type, one had calcifications, two had pancreatic stones, four followed acute pancreatitis, six were complicated by pancreatic abscesses, and 9 were complicated by pseudocysts. The duration of biliary and pancreatic disturbances was between 3 and 5 years in 43.9% of the cases, and between 6 and 10 years in 21.3%. Chronic pancreatitis achieves a complex clinical syndrome, the dominant feature being the painful biliopancreatic syndrome associated to obstructive jaundice (42.4%), angiocholitis (47.6%), weight loss (46%), hepatic and renal failure (10.9%), diabetes (8.4%), and a tumoral mass (15.7%). Indirect surgical interventions aimed at suppressing the biliary factor were carried out in 291 patients, with very good results in 56% of the cases, good results in 32%, mediocre in 7%. In 2.4% of the cases surgery failed to improve the condition of the patients. Direct interventions on the pancreas, which consisted either in pancreatic decompression or in exeresis of the gland have been performed in 30 patients. Drainage of pancreatic abscesses was done in 6 patients (2 deaths), cystic-digestive anastomoses were performed in 8 patients, Wirsung-jejunostomy in 3 patients (1 death), cystostomy in one patient, distal pancreatectomy in one patient (deceased), viscerolysis and novocaine infiltration in 11 patients. In the 321 cases of chronic pancreatitis operated by direct and indirect procedures very good

Adolescent↗
PubMedDate not supplied

Chronic pancreatitis. Anatomo-clinical and surgical treatment characteristics.

Chronic pancreatitis of biliary origin, often localized in the cephalic region of the gland and etiopathogenetically related to biliary lithiasis whose anatomoclinical evolution is thus complicated, has a good prognosis. Chronic pancreatitis proper, persistent, recurrent calcifying with pancreatic lithiasis and with pseudocysts, more rare in Romania, raises difficulties of diagnosis and of surgical treatment, the prognosis being doubtful. In a group of 321 patients (33.6% males and 66.4% females) with chronic pancreatitis of biliary origin (252 cases) and chronic pancreatitis proper unrelated to biliary diseases (69 cases), indirect surgery--to remove the biliary factor--(291 patients) and direct surgery on the gland for pancreatic decompression or even gland exeresis (30 patients) were performed. The results obtained in the 321 patients after indirect and direct surgery were very good in 52% of the cases, good in 34%, moderate in 8%, failure in 2.5%; the mortality was of 2.9%.

Adolescent↗