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At least 451 records · Page 25Linked to original sources
PubMed1989

[Physiopathology of hypertrophic stenosis of the pylorus: a proposal].

The aim of this report is finding a physiopathologic explanation for the Infantile Hypertrophic Pyloric Stenosis. We studied two groups: The group one were children with infantile hypertrophic pyloric stenosis (n = 43) and the group two were infants who died at one month old due to a non-related cause. We studied the pylorus in both groups, took biopsies and found neurological and muscular lesions with muscular hypertrophy and degeneration of the myenteric plexus of Auerbach. We suggest the diagram of self-maintenance of the lesions.

Humans↗
PubMed1989

Pylorus-preserving total pancreatectomy and segmental pancreas autotransplantation.

12 patients affected by periampullary neoplasms underwent surgery consisting of modified pylorus-preserving total pancreatectomy. In 8 of these patients, a segmental pancreas autotransplantation was performed by anastomosing the splenic to the femoral vessels in the Scarpa's triangle. The pancreas was treated by irradiation to inhibit the exocrine function. Gastric emptying was studied in 9 survivors by upper gastrointestinal barium series. In 6 patients gastric emptying and pyloric function were also evaluated by radionuclide studies. In 3 patients the transplanted pancreas had to be removed within the second postoperative week because of graft thrombosis, infection or hemorrhage. In a mean follow-up of 16 months (range: 6-20 months) the remaining 5 transplants showed a good endocrine activity until the beginning of antiblastic treatment for hepatic metastasis (3 cases), pancreatic fibrosis (1 case) or the patient's death (2 case). At present no graft is still functioning.

Adult↗
PubMed1988

[Cephalic duodenopancreatectomy with preservation of the pylorus].

We report a technique of cephalic pancreatico-duodenectomy preserving the pylorus which differs from that initially devised by Longmire and Traverso. Restoration of digestive tract continuity consists successively of end-to-end duodeno-jejunal anastomosis, end-to-side choledoco-jejunal anastomosis and end-to-side pancreatico-jejunal anastomosis. The simple technique has the advantage of restoring a perfectly physiological circuit. It seems to produce satisfactory immediate and mid- or long-term results with improvements in the patients' comfort.

Duodenum↗
PubMed1986

Pylorus preserving pancreatoduodenectomy for gastrinoma. A case report.

A case of a young female patient affected by Zollinger-Ellison syndrome with occult gastrinoma during exploratory laparotomy, is reported. On the basis of transhepatic portal catheterization the patient underwent pylorus preserving pancreatoduodenectomy according to Longmire-Traverso. A malignant gastrinoma of the duodenal wall, 2 mm in diameter, was observed on the operative specimen in the suspected gastrinogenic area. The procedure led to complete clinical recovery of the patient who did not respond to the medical treatment of the ulcer. The prognosis was good with oncologic radicality of surgery confirmed at follow-up and excellent digestive function.

Adult↗
PubMedDate not supplied

[Gastric resection with preservation of the pylorus with a variant of pyloroplasty].

The authors present the case of a female patient with gastric ulcer of the small curvature of the stomach who showed a particular neuropsychical lability, in whom emergency surgery was performed before it was possible to obtain data concerning the behaviour of the gastric acidity. In an attempt to avoid the postoperative dumping syndrome the authors performed a medio-fastric resection, removing the area with the ulcer and maintaining the antro-pylorus. For the obtention of a good drainage of the remaining stomach a variant of the pyloroplastia technique was associated.

Female↗
PubMed1979

[Double pylorus (author's transl)].

Smith and Tuttle described in 1969 for the first time a double pylorus; since then this anomaly has been found repeatedly. The pathogenesis is still discussed; the anomaly may be congenital or acquired. A case report is given of a patient with double pylorric ulcer.

Aged↗
PubMed1983

[Combined effect of FM-100 and several anti-ulcer agents on ulcer induced by ligation of the pylorus in rats].

Single administration of FM-100 (50, 200 mg/kg, i.p.), cimetidine (200, 800 mg/kg, i.d.), pirenzepine (5, 20 mg/kg, i.d.) and ASS (20, 80 mg/kg, p.o.) dose-dependently prevented ulcer formation in pylorus-ligated rats. FM-100 and pirenzepine dose-dependently decreased the volume of gastric juice with a slight increase in the pH, but scarcely influenced pepsin activity. The inhibitory effect of cimetidine on gastric secretion was characterized by an elevation in the pH of the gastric juice. ASS at 80 mg/kg, showing antiulcerogenic activity, had a weak antacidic effect on gastric juice without affecting the volume and pepsin activity. By the combination of FM-100 (50 mg/kg, i.p.) with cimetidine (200 mg/kg, i.d.), pirenzepine (5 mg/kg, i.d.) or ASS (20 mg/kg, p.o.), the preventive effects of these drugs on ulcer formation was augmented; and the combined administration of FM-100 with cimetidine or pirenzepine also enhanced the inhibitory effects of these drugs on gastric secretion.

Aluminum↗
PubMed1984

A natural spreader for the pylorus.

General and pediatric surgeons commonly treat hypertrophic pyloric stenosis. A skillful pyloromyotomy without complications culminates in a gratifying experience. An instrument designed for this purpose should be safe, versatile and easy to use. A modified curved, 6 inch clamp facilitates doing a pyloromyotomy by implying the same action as other more commonly used instruments. The natural spreader for the pylorus is easy to make and it is also relatively inexpensive.

Humans↗
PubMed1993

A novel reconstructive technique for pylorus-preserving pancreaticoduodenectomy: avoidance of early postoperative gastric stasis.

In 30 patients a reconstructive technique was used after pylorus-preserving pancreaticoduodenectomy in which the anastomoses were constructed in the sequence: duodenojejunal, hepaticojejunal (8-10 cm distal) and finally duct-to-mucosa pancreaticojejunal to a separate Roux loop. Indications for surgery included periampullary tumours, (n = 13), carcinoma of the head of the pancreas (n = 10) and chronic pancreatitis (n = 4). No patient required prolonged (> 7 days) nasogastric intubation for primary gastroparesis in the early postoperative period. Postoperative morbidity (17% overall) delayed recovery and return of gastrointestinal function in one patient with a minor biliary leak (closed with 5 days' somatostatin treatment). Other morbidity included gastrointestinal haemorrhage (n = 1), wound infection (n = 2) and respiratory infection (n = 2). There were no pancreatic leaks. One patient died from a subhepatic abscess (mortality 3%). Retrospective investigations, at 3-18 months postoperatively, included endoscopy (normal in 20 patients, none taking anti-ulcer therapy), gastric emptying studies in the first 10 patients (no delay) and bentiromide test in 12 patients considered to have normal pancreatic remnants (all patients > 24% PABA excretion index). All patients who underwent resection for tumour returned to their preoperative weight.

Adult↗
PubMed1997

Groove pancreatitis with recurrent duodenal obstruction. Report of a case successfully treated with pylorus-preserving pancreaticoduodenectomy.

Groove pancreatitis is a rare subtype of chronic pancreatitis that is difficult to distinguish from pancreatic carcinoma. Most reported patients have undergone a Whipple procedure because pancreatic cancer was not ruled out. We report a case of groove pancreatitis in a patient who presented with recurrent duodenal obstruction without biliary stricture. The diagnosis of groove pancreatitis was based on characteristic episodes of repeated duodenal obstruction and the absence of radiographic evidence of cancer. Subsequently, our patient underwent a successful pylorus-preserving pancreaticoduodenectomy (PPPD). PPPD is a favorable alternative to the Whipple operation for duodenal obstruction resulting from this disease.

Adult↗
PubMedDate not supplied

Postoperative delayed emptying in pylorus-preserving pancreatoduodenectomy using pancreaticogastrostomy: comparison of the reconstruction position.

BACKGROUND/AIMS: We frequently use pancreaticogastrostomy after pylorus-preserving pancreatoduodenectomy (PpPD). Although it is a useful and effective technique, it sometimes requires prolonged delayed emptying. We considered the best position for pancreaticogastrostomy in such a way as to reduce this period of delayed emptying. MATERIAL AND METHOD: From 1991 to 1996, 17 patients whose blood sugar was controlled and who were kept on H2 blocker were selected from among 25 patients who underwent PpPD and were reconstructed by pancreaticogastrostomy. We investigated the history of the relationship between reconstruction position and delayed emptying, reconstruction position and minor leakage, minor leakage and delayed emptying, reconstruction position and stomach mobility without leakage. RESULTS: The delayed emptying was shorter for a reconstruction position in the area above the angulus rather than below it. CONCLUSION: The results suggest that the area above the angulus is the preferred site for pancreaticogastrostomy after PpPD.

Adult↗
PubMed1997

Laparoscopic pylorus-preserving gastrectomy with intracorporeal hand-sewn anastomosis.

To prevent stapled stenosis after laparoscopic local gastric resection by using autosuturing devices, we developed a technique for laparoscopic pylorus-preserving gastrectomy with intracorporeal hand-sewn anastomosis. We describe this procedure and present two case reports. The intracorporeal hand-sewn anastomotic technique is an important advance in the field of minimally invasive laparoscopic surgery.

Aged↗
PubMed1997

The oncological approach to pylorus preserving pancreatoduodenectomy (PPPD) in pancreas malignancies.

There has been a considerable debate about whether pylorus preservation significantly detracts from the radicality in a palliative procedure where a conventional Whipple operation would have been curative. We know now, that the extending radicality of the Whipple operation does not improve the long-term survival rates. Our results of 127 PPPD and 54 Whipple procedures in pancreas malignancies from 1985 to 1996 showed the nutritional benefits of the PPPD group as compared to the standard Whipple group. 84% (99/121) vs. 24% (13/50) were able to gain postoperatively. The long-term survival rates of both groups and the results in the literature are similar.

Breath Tests↗
PubMedDate not supplied

The effects of omeprazole, a proton pump inhibitor, on early gastric stagnation after a pylorus-preserving pancreaticoduodenectomy: results of a randomized study.

BACKGROUND/AIMS: To determine the effects of Omeprazole, a proton pump inhibitor (PPI), on gastric stasis following a pylorus-preserving pancreatico-duodenectomy (PPPD) by means of a randomized trial of PPPD patients. METHODOLOGY: Forty-two PPPD patients were randomly divided into two groups: Group 1 (n=24) received a PPI through a jejunal tube after PPPD, whereas Group 2 (n=18), serving as controls, received a saline solution through a jejunal tube and no medication after a PPPD. The daily volume and total acidity of the gastric juice, aspirated via nasogastric tube, were measured each day for 7 days following PPPD. RESULTS: In Group 1 the mean daily aspirated volume of gastric juice was 160.2 ml, and the mean maximum volume was 222.8 ml on the first postoperative day. In Group 2, six patients were withdrawn from this study for therapy on the third or fourth postoperative day due to gastric bleeding and/or a large amount of excreted gastric juice (in excess of 2,000 ml). The mean daily aspirated volume of gastric juice in the remaining Group 2 patients was 787.4 ml, and the mean maximum volume was 1,039 ml on the third postoperative day. Gastric secretion was significantly lower in Group 1 (p<0.05). Further, the total acidity of the gastric juice was significantly lower in Group 1 than in Group 2 for each of the 7 postoperative days (p<0.05). CONCLUSIONS: These results indicate that postoperative administration of a PPI significantly suppresses the volume and acidity of the gastric juice after PPPD.

Aged↗