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PubMedDate not supplied

Post-thyroidectomy hypocalcemia: does arterial ligation play a significant role?

To assess the possible role of truncal ligation of inferior thyroid arteries on post-thyroidectomy hypocalcemia, a prospective study was carried out on 80 patients. Bilateral subtotal thyroidectomy was performed for non-toxic nodular goiter in two groups. Inferior thyroid arteries were ligated bilaterally in 50 patients but not ligated in 30 patients. In both groups mean serum calcium levels on the first and second postoperative days were found to be significantly lower than preoperative levels. However these falls were similar in both groups. We conclude that bilateral truncal ligation of inferior thyroid arteries is not a factor that may cause hypocalcemia due to vascular insufficiency of parathyroid glands.

Adult↗
PubMed2004

Saphenofemoral ligation as a safe and effective alternative for the treatment of chronic venous leg ulcer.

OBJECTIVE: To evaluate the effectiveness and safety of isolated saphenofemoral junction ligation for the treatment of chronic venous leg ulcer in comparison to traditional stripping procedure. METHODS: Thirty six patients (28 men and 8 women) with mean age of 42.3 +/- 8.7, presented with a venous leg ulcer. After taking a full history, they underwent examination for presence of edema, cellulitis or local ulcer infection. The site and size of ulceration were recorded and ankle-brachial pressure index (ABPI) was measured. Venous color Doppler ultrasonography was performed and venous valvular incompetence was assessed using Valsalva test and calf compression. Patients were divided into 2 groups. Group I, (n=10) assigned for long saphenous stripping, while group II, (n=26) assigned for saphenofemoral ligation and divided combined with ligation of major tributaries under local infiltration anesthesia. Mean operative time, postoperative complications and hospital stay were recorded. The study was carried out in Benha University Hospital, Egypt and Armed Forces Hospital, Khamis Mushayt, Southern Region, Kingdom of Saudi Arabia, between January 2000 and December 2001. RESULTS: The mean operative time and the hospital stay were significantly (p<0.05) reduced in group II compared to group I. The postoperative complications were significantly (x2=7.5, p<0.05) reduced in group II. Ulcer healing started after 3 months in group II and 6 months in group I, but, by 12 months, group II had a significant (x2=6.7, p<0.05) number of healed ulcers (n=22, 84.6%), compared to group I (n=7, 70%). CONCLUSION: The isolated ligation of saphenofemoral junction is a minimally invasive, safe and effective modality for treatment of chronic leg ulcer, and being easily performed under local anesthesia and considered to be a satisfactory procedure for treatment of leg ulcer in patients who are unfit for general anesthesia.

Adult↗
PubMed2004

Autogenous transplantation of a duct ligated pancreas: a functional and histological study.

CONTEXT: The use of foetal tissue is an emotive issue and attempts are being made to find suitable alternative replacements. A duct ligated pancreas resembles day 16-17 post-coitum foetal pancreas tissue, both being predominantly endocrine structures. OBJECTIVE: The aim of this study was to quantify the metabolic changes occurring in chemically induced diabetic rats over a 30 day period following transplantation of duct ligated tissue beneath the renal capsule. SETTING: Thirty normal Sprague-Dawley laboratory rats. DESIGN: The rats were grouped as transplant recipients (A), untreated diabetic (B), untreated normal (C), sham operated controls (D) and donors of duct ligated pancreatic tissue (E). INTERVENTIONS: Groups A and B received 60 mg/kg streptozotocin via a tail vein rendering them diabetic. Groups D and E underwent mid-line laparotomy under general anaesthesia with pancreatic duct ligation procedures performed on E in addition. MAIN OUTCOME MEASURES: Blood glucose was monitored daily in Groups A, B, C and D, and exogenous insulin was administered in Groups A and B as required. Glucose tolerance tests were performed on day 3.5 and after 30 days in Groups A (just prior to unilateral nephrectomy), B, C and D. In addition, in Group A, they were repeated one week after the removal of the grafted tissue. The removed grafts were processed for histological examination. RESULTS: The metabolic profile of the transplant recipients compared favourably with that of normal animals. CONCLUSION: A chemically or mechanically manipulated pancreas may respond to exogenous insulin therapy by undergoing some degree of regeneration or owing to the pluripotent stem cells thought to reside in the pancreas. Although insulin positive tissue was evident at the graft site, morphometric assessment, however, found no significant increase in the insulin secreting tissue in the pancreas compared to the untreated diabetic controls.

Animals↗
PubMed2004

[Effects of growth hormone on erectile function and number of nNOS-containing nerve fibers in internal iliac arterial ligation rats].

OBJECTIVE: To investigate the effects of growth hormone (GH) on the erectile function and the number of nNOS-containing nerve fibers in internal iliac arterial ligation rats. METHODS: Thirty-six mature male Wistar rats were randomized into 3 groups: GH intervention group, internal iliac arterial ligation group and sham operation group. After four weeks and eight weeks of treatment, one jalf of the rats of each group were selected respectively and tested for erectile function and then sacrificed for the detection of nNOS-containing nerve fibers by streptaridin-peroxidase immunohistochemistry techniques(SP method). RESULTS: After four weeks, the erection frequency and the number of nNOS-containing never fibers in the sham operation group significantly increased compared with the other two groups, which showed no significant difference(P > 0.05). There was no significant difference in erection rate among the three groups. After eight weeks, the number of nNOS-containing never fibers in corpus carvosum in the internal iliac arterial ligation group decreased compared with the other two groups, between which there was no significant difference. And there was no significant difference in erection frequency and erection rate among the three groups. CONCLUSION: Growth hormone can improve erectile function of internal iliac arterial ligation rats, which can be explained by the increase in the number of nNOS-containing never fibers in corpus carvosum of rats.

Animals↗
PubMed2003

The effects of nitric oxide synthase blockers on mesenteric blood flow with bile duct ligation.

BACKGROUND/AIMS: The aim of this study was to investigate the effects of nitric oxide synthesis inhibition by L-NNA (N-nitro-L-arginine) on mesenteric blood flow in bile duct ligated rats. METHODOLOGY: Forty female Wistar rats were allocated into four groups. Only common bile duct (CBD) was dissected with midline laparotomy (sham operated), CBD is ligated for obstructive jaundice (OJ group), with CBD dissection, 20 mg/kg L-NNA was given i.p. during 14 days (sham + L-NNA group), after CBD ligation, 20 mg/kg L-NNA was given i.p. during 14 days (OJ + L-NNA group). At the end of the 14th day, the rats were re-anaesthesized, phenylephrine was administered within the left jugular vein and, arterial blood pressure monitorization was done via left carotid artery. Blood flow of the mesenteric artery (SMA) was also recorded. Resistance of the SMA was calculated and in addition, pressure responses to phenylephrine were detected. Histopathological examination of the liver and blood analyses were done. RESULTS: The mean blood pressure levels of the rats with OJ were lower than the control group (P>0.05). Blood flow of the SMA and vascular resistance of the rats with OJ have no significant difference with other groups. In CBD ligated animals, mean blood pressure and mesenteric vascular resistance increased by L-NNA but there was no difference in mesenteric blood flow rate and vasoconstrictive response to phenylephrine. On microscopic examination of the liver with OJ, bile duct proliferation and minimal mononuclear reaction were observed which was not affected by L-NNA administration. CONCLUSIONS: Hypotension, low systemic vascular resistance, and a reduced sensitivity to vasoconstrictors are features of cirrhosis. In obstructive jaundice impaired vascular responsiveness to vasoconstrictor stimuli like as cirrhosis was not observed and also there was no improvement by L-NNA on histopathologic findings and liver function tests.

Animals↗
PubMed1992

Femoral pseudoaneurysm from drugs of abuse: ligation or reconstruction?

A plan for management of infected arterial pseudoaneurysm has evolved from our experience with 23 such aneurysms treated between 1981 and 1989 and followed for up to 66 months. Eighteen femoral artery aneurysms are the primary focus of this report. Because we were concerned about the high probability of amputation expected from acute interruption of the femoral artery, we were reluctant to limit initial management to ligation and debridement alone. However, significant complications developed in 12 patients who underwent revascularization, requiring 3 amputations and 13 secondary arterial operations in addition to debridements and skin grafts. In contrast, no amputations were required in six patients who underwent primary arterial ligation and debridement. We recommend primary ligation that controls the septic focus, removes the danger of hemorrhage, and is not accompanied by the threat of secondary arterial infection. After ligation, limb viability is assessed during surgery by presence of an audible Doppler signal at the ankle. Revascularization is considered only when absence of a Doppler signal indicates acute limb ischemia.

Adult↗
PubMedDate not supplied

[Patient evolution in different stages of hepatic failure submitted to eradication of esophageal varices with endoscopic ligation].

OBJECTIVE: To know the patients' progress with distinct stages of hepatic failure, according to the Child Pugh classification, who underwent esophageal varices eradication with the use of endoscopic band ligation. DESIGN: Descriptive, longitudinal, prospective and comparative study. CENTRE: Endoscopy Department of the Central Military Hospital, Mexico, D.F. METHODS: One-hundred twenty-four patients with esophageal varices and a history of bleeding, were submitted to various band ligation sessions every 4 weeks until the varices were eradicated and control sessions every 3 months. RESULTS: A total of 425 endoscopy sessions were performed of which 239 were ligature applications and 187 control sessions. Eradication of varices was achieved in 100% of the patients. Of the Child A, 2/3 of them were eradicated in one session and the other 1/3 with 2 sessions. The patients of the Child B class, 66% of varices were effaced in one session, 22% in two and 12% in three sessions. In the Child C group, 50% were obliterated in two sessions, 47% with three, 2% needed 4 sessions. The follow-up period was from 4 months being the minimum and 13 months the maximum (mean of 7 months). In 15% of the patients varices recurred. None were from the Child A group. Those pertaining to the Child B group varices reappeared in 7.3% of which 2/3 required another ligation session to eradicate them once again and the other 1/3 were removed in two sessions. In the Child C group the incidence of recidivation was 28%, 43% of these needing one session to eliminate them once again, 50% two sessions and 7% three sessions for complete eradication. Rebleeding appeared in 7.7% of the sample, all of them were from the Child C class. The occurrence of congestive gastropathy before ligature was 42%, and 73% at the conclusion of the follow-up period. Congestive gastropathy developed in 11% of the Child A patients after eradication, 34% of the Child B group and 38.5% of the Child C group. The incidence of gastric varices was 21% before ligature and at the end of the follow-up period 17% more developed gastric varices. None of the Child A patients developed gastric varices, 12% of group B and 24% of group C. From the (n = 124) 22.5% presented dysphagia as a complication which lasted less than one week and in 0.8% mucosal ulcer CONCLUSION: It is possible to eradicate esophageal varices by band ligation independently of the hepatic function reserve. A greater number of sessions is required to eradicate varices in the poor hepatic function group and the incidence of recidivation, rebleeding, and complications that developed such as gastric varices and gastropathy are more frequent in patients with poor hepatic function reserve.

Adolescent↗
PubMed2006

Treatment of infected pseudoaneurysm in drug abusers: ligation or reconstruction?

BACKGROUND: Recently, there has been an increase in the incidence of major vascular complications such as infected pseudoaneurysm due to intravenous drug use. OBJECTIVE: For better understanding of the existing controversies regarding the optimal surgical management of infected pseudoaneurysm, the present study was conducted. METHODS: Medical charts of 36 consecutive patients who underwent surgery in Taleghani Hospital, Tehran, Iran from 1996 through 2003, were retrospectively analyzed. RESULTS: We studied the hospital records of 33 cases; two patients had bilaterally infected pseudoaneurysms and one underwent an emergency reoperation. The total number of operations was 36. Eleven cases (30.5%) underwent ileofemoral reconstruction and 25 (69.5%) arteries were ligated. All patients presented with infected femoral or brachial pseudoaneurysms due to intravenous drug abuse. Postoperatively, there was no hemorrhage, vascular thrombosis, amputation, or mortality. Three cases (8%) had incisional infections (2 [18%] after reconstruction and 1 [4%] after ligation operation) and 7 patients (19%) had claudication (all after ligation). CONCLUSION: Ligation is the optimal management for infected pseudoaneurysm, because it is easy, cost-effective, and safe. Reconstruction is not recommended, because of an extended infection at the location of pseudoaneurysm and at the artificial graft site.

Adolescent↗
PubMed2006

[Experimental study and clinical application of early pedicle division of skin flap by ligation].

OBJECTIVE: To establish a new method of early cut-off skin flap by ligating to stegnosis pedicle and assess its feasibility and clinical application. METHODS: Twenty New Zealand rabbits were used to make skin flaps with the size of 8.0 cm x 4.0 cm on both sides of the back respectively. And one side was experimental group with the pedicles of skin flaps horizontally oversewn by several pairs of silk thread, the other side was control group. Two pairs of silk thread in the two sides of the pedicle of skin flap of experimental group were ligated on the 3rd day. On the 5th day the pedicle was wholly ligated. All pedicles were divided on the 6th day and the survival area of skin flaps were measured after 3 days. The tissue samples from the skin flaps were collected for histology test on the 4th and 6th day respectively. The pedicles of 78 random flaps from 48 patients were cut off after narrowing them by ligating. RESULTS: The mean flap survival rate of the experimental group was statistically higher than the control group. Histological examination results showed the density and diameter of blood vessel were increased in the skin flaps of the experimental group. The mean time for removal pedicles was shortened to 10 days, and no necrosis was found after resecting. CONCLUSIONS: This method is secure and convenient and the time of pedicle division can be shortened.

Adolescent↗
PubMedDate not supplied

Does truncal ligation of the inferior thyroid arteries during bilateral subtotal thyroidectomy affect serum calcium levels? A prospective, randomized, controlled study.

This study was designed to investigate the effect of truncal ligation of the inferior thyroid arteries on post-thyroidectomy serum calcium levels. This prospective, randomized study was carried out in 98 patients. In group 1, bilateral inferior thyroid arteries were ligated truncally during bilateral subtotal thyroidectomy procedure, whereas in group 2, ligation was not performed. In all patients, serum ionized calcium levels were measured preoperatively and on postoperative days 1, 2, 3 and 30. There were no statistically significant differences in serum ionized calcium values between group 1 and 2 on postoperative days 1, 2, 3, and 30 (P > 0.05). Laboratory hypocalcemia was found on postoperative days 1, 2, and 3 in 9 (9.2%), 15 (15.3%), and 2 (2.0%) patients, respectively. In all patients, laboratory hypocalcemia improved until postoperative day 5. It was thought that truncal ligation of the inferior thyroid arteries during bilateral subtotal thyroidectomy had no effect on post-thyroidectomy serum calcium levels.

Adult↗
PubMed2006

Surgical ligation of scrotal varicocele for male factor infertility is a valid option of treatment.

OBJECTIVE: To evaluate the role of surgical ligation of scrotal varicocele for treatment of male factor infertility. METHODS: We studied 60 patients who presented with infertility and were also found to have scrotal varicocele. Patients with other probable causes contributing to infertility were excluded. Diagnosis was made by clinical examination and scrotal ultrasonography. All the patients underwent either laparoscopic varicocelectomy or open retroperitoneal high ligation of the testicular veins. Operative time and hospital stay was recorded. All patients were evaluated for postoperative improvement of semen parameters and development of any postoperative complication. The results were analyzed by commercially available software. RESULTS: During the study period 5 patients were lost to follow up and were excluded. The rest of patients (n=55) were young, with age ranging from 20-35 years (Mean age 27.8 years, SD +/- 4.38). All patients had unilateral left sided varicocele; two patients (3.6%) had grade I varicocele, 21 patients (38.2%) had grade II varicocele and 32 patients (58.2%) had grade III varicocele. Statistically significant improvement in sperm density (p value < 0.05), sperm activity (p value < 0.05) and sperm morphology (p value < 0.05) was observed after the surgical ligation. The mean operative time was 54.88 minutes (SD + 13). The mean hospital stay in laparoscopic procedure was 33.4 (SD + 15.3). Minor complications were noted in 13 patients and included superficial wound infection in 3 patients, 6 patients exhibited testicular pain and persistence of varicocele in 4 patients. CONCLUSION: Surgical ligation of scrotal varicocele is asafe and effective mode of treatment of male factor infertility in selected population.

Adult↗
PubMed1975

The course and nature of acinar cell death following pancreatic ligation in the guinea pig.

The course and nature of acinar cell death (ACD) following pancreatic ligation in the guinea pig was studied as a possible model for human disease. Ultrastructural studies after various periods of ligation suggested a biphasic pattern of ACD. Early phase ACD involved only a small portion of acinar cells and occurred within a few hours of ligation. It was preceded by swelling and vesiculation of the rough endoplasmic reticulum. Morphometric measurements disclosed celular swelling at this time, and NaCl equilibration studies demonstrated a change in cellular osmoregulation. Late phase ACD, characterized by cellular wasting and autophagic vacuole formation, became prominent several days after ligation. Marked increases in lysosomal enzyme activities were found in tissue homogenates at this time, and acid phosphatase electron histochemistry localized the majority of this increased activity to lysosomes and autophagic vacuoles within the acinar cells. The etiology and nature of both phases of ACD are discussed.

Acid Phosphatase↗
PubMed2006

[Radiofrequency ablation therapy combined with suture and ligation surgery for patients with giant cavernous hemangiomas of the liver].

OBJECTIVE: To evaluate the feasibility and efficacy of radiofrequency ablation (RFA) therapy combined with suture and ligation surgery for patients with giant hepatic cavernous hemangioma (HCH). METHODS: Between June 2004 and June 2005, a total of 30 patients were treated by RFA therapy after suture and ligation surgery (SL group, n = 15, with 18 liver lesions) or RFA therapy without suture and ligation surgery (non-SL group, n = 15, with 17 liver lesions) under general anesthesia. All patients had obvious symptoms such as abdominal discomfort, pain and swelling. Preoperative diagnosis of HCH was established by means of ultrasonography, helical computed tomography (CT) scans, and magnetic resonance imaging (MRI). The mean maximum diameter of the lesions was 8.8 cm +/- 1.4 cm. All of the 35 lesions were located on the liver surface, in the caudate lobe of the liver, or adjacent to the gallbladder. Seven patients had chronic calculous cholecystitis, 6 common duct stones, 5 thrombocytopenias, and one posthepatitic cirrhosis. Thirteen of the 30 patients had previous laparotomy. Therapeutic efficacy and clinical data of RFA therapy were compared between these two groups. RESULTS: RFA therapy under ultrasound guidance was performed successfully in all the patients. Cholecystectomy was performed simultaneously for gallstones in 7 patients and for abutting of gallbladder from hemangioma in 2 patients. Choledochotomy with T-tube drainage was performed in 6 patients. The mean blood loss, the mean RFA time per lesion and reduction rate of maximum diameter of the lesions 6 months after RFA in the SL group and non-SL group were 88.0 ml +/- 22.4 ml vs. 255.0 ml +/- 71.7 ml (P < 0.001), 23.0 min +/- 7.5 min vs. 53.3 min +/- 16.0 min (P < 0.001), and 61.8% vs. 44.8% (P < 0.001) respectively. No severe complication related to RFA was observed in all patients. At a median follow-up of 12 months (6 approximately 17 months), a complete lesion necrosis was achieved on the contrast-enhanced helical CT scans in both groups. During the follow-up, all of the 15 patients were free of upper abdominal pain in the SL group, and 12 patients were symptom-free and 3 obtained significant amelioration of symptoms in the non-SL group. CONCLUSION: RFA therapy combined with suture and ligation surgery is a feasible, safe, and effective treatment modality for patients with giant HCHs. It can reduce blood loss, shorten RFA therapy time, and increase therapeutic efficacy of RFA. Intraoperative ultrasonography is a useful adjunct for increasing the therapeutic efficacy of RFA and reducing the complications related to RFA.

Adult↗
PubMed1990

The fate of residual saphenous vein after partial removal or ligation.

Duplex scanning was used to study residual greater and lesser saphenous vein segments in 14 limbs with previous partial distal greater saphenous vein removal, 19 limbs with partial proximal greater saphenous vein removal, 29 limbs with total greater saphenous vein removal, 10 limbs with high greater saphenous vein ligation, as well as 37 contralateral unoperated and 8 other normal limbs. Partial distal removal showed better preservation of residual greater saphenous vein than partial proximal removal, with greater preservation of "usable" length and greater average diameter. Compared to contralateral unoperated legs, partial distal removal, partial proximal removal, and total removal all showed a similar degree of compensatory lesser saphenous vein enlargement. High ligation showed no lesser saphenous vein enlargement but showed the best greater saphenous vein preservation, none had less than 85% preservation of potential length. Combining residual greater saphenous vein and lesser saphenous vein segments of usable caliber, 100% of high ligation, 93% of partial distal removal, and 74% of partial proximal removal had greater than 60 cm total length, and most total removal had greater than 40 cm usable residual lesser saphenous vein. Previous saphenous vein surgery should not categorically exclude patients as having no usable residual ipsilateral vein for bypass. Partial distal removal allows better preservation of length and caliber of residual greater saphenous vein than proximal harvest, with both showing equivalent lesser saphenous vein enlargement to those with total greater saphenous vein removal. High ligation, performed for early tributary varicosities, in patients with saphenofemoral but no perforator incompetence, gives excellent preservation of residual greater saphenous vein length and caliber. Sclerotherapy to tributary varicosities did not obliterate distal greater saphenous vein segments.

Humans↗
PubMed1990

[Experimental studies on extension of resectability of the liver in dogs with special reference to an extended hepatectomy in two stages after ligation of the portal vein branch].

The purpose of this study is to clarify the limit of extended hepatectomy, such as 84% hepatectomy for normal liver and 70% hepatectomy for Dimethylnitrosamine-induced cirrhotic liver in dogs, using ligation of the portal vein branch (PBL) in advance. Portal vein branch could be ligated up to 84% area in normal liver and 70% area in cirrhotic liver, for survival. Four weeks after PBL the non-ligated area of the liver was obviously enlarged, and the hepatic function was almost equal to that before PBL. Four weeks after PBL of 84% area in normal liver and 70% area in cirrhotic liver, the ligated area was resected by two staged procedure. Although the four-week survival rates after one staged 84% hepatectomy in normal liver and 70% hepatectomy in cirrhotic liver were 22.2% and 0% respectively, they markedly improved such as 66.7% and 50.0% after two staged hepatectomy respectively, and they were 42.1% and 30.0% respectively even if the death of PBL was count in. ICG Rmax prior to hepatectomy after PBL indicated clearly the functional resectability of the liver. The remnant liver function after two staged hepatectomy was significantly better than that after one staged hepatectomy, due to sufficient hepatic blood flow.

Animals↗
PubMed1989

[Regeneration of the rat submandibular glands after duct ligation].

The cytomorphologic changes associated with acinar cell recovery in the rat submandibular glands were examined by light and electron microscopic observation and immunohistochemical test using anti-bromodeoxyuridine antibody. Ligation of excretory ducts caused morphological disorganization of the gland parenchyma, with resultant disappearance of the acini, dilation of the ducts, pronounced fibrosis and infiltration of the inflammatory cells. At seven days after obstruction, the acinar cells shrunk and destroyed partly. However, the intercalated duct cells and the myoepithelial cells were unaffected by ligation. Immunohistochemically, bromodeoxyuridine (BrdU) labeled cells existed scatteringly in the original ducts through the period of duct ligation and unligation studied. In the glands after recanalization following 7 days of the duct ligation, the duct-like structures were recognized a progressive increase. There structures were significantly developed in number from 7 to 14 days after the unligation. However, the BrdU-containing nuclei were not almost found in the duct-like structures. At twenty one days after the removal of the obstruction, the regeneration of acinar cells was striking. At 28 days, the acini were almost normal size. In the unligated glands at 21 and 28 days, a variable number of BrdU-positive cells was found in acini. At this stage, the constituent cells of the duct-like structures occurred many vacuoles and a decrease in their secretory granules was marked. These cells were transformed into intercalated duct cells. These results suggest that the constituent cells of the duct-like structures are altered for intercalated duct cells. The regeneration of acinar cells is the result of cell recovery, not the result of de novo cell differentiation.

Animals↗
PubMed1989

Influence of splenectomy, partial splenectomy and splenic artery ligation on E. coli sepsis in rats.

Male Sprague-Dawley rats were allocated to four groups--sham operation, partial splenectomy, splenic artery ligation or total splenectomy, and 4 weeks after the operation 3 x 10(8) colony-forming units of Escherichia coli were injected intraperitoneally. Among the splenectomized rats the mortality was significantly (p less than 0.02) increased compared with the controls, while both partial splenectomy and splenic artery ligation did not influence survival. Blood clearance and organ (liver, spleen and lungs) uptake of intravenously injected, radiolabelled, heat-killed E. coli were determined 1 hour after the intraperitoneal challenge. Splenectomy caused a significant decrease in blood clearance. Splenic uptake of radiolabelled E. coli was significantly reduced following partial splenectomy and splenic artery ligation. The splenic operations increased hepatic uptake expressed per gram tissue. Splenectomy thus resulted in reduced blood clearance and increased mortality in Gram-negative sepsis, while the reduced splenic uptake following partial splenectomy or splenic artery ligation did not influence blood clearance of E. coli or mortality.

Animals↗
PubMed1989

[Indomethacin or ligation in the treatment of persistent ductus arteriosus: a report of clinical experiences].

A haemodynamically significant, patent ductus arteriosus in mechanically ventilated preterm infants can be closed by two means today, either medical or surgical. The aim of our project was to compare the efficiency of these two kinds of therapy over a period of two years in condition that the indication for closing was given in all cases according to the same principles. The PDA was closed by ligation in 16 cases, by medical means (Indomethacin) in 15 cases. The outcome was significant different. 93% of the preterm infants treated with Indomethacin survived, but only 56% of the ligation-group, the main cause of death was the broncho-pulmonary dysplasia. The reason was the posterior day of life at the time of ligation compared with the Indomethacin-group. The broncho-pulmonary dysplasia is the result of pulmonary overcirculation because of prolonged patiency of the PDA. Only preparatory reasons were responsible for the delay of the day of ligation (organisation of the paediatric surgical crew including anesthesia), whereas the beginning of the medical therapy could be decided autonomously and therefore the period of pulmonary overcirculation could be shortened.

Dose-Response Relationship, Drug↗