Abstract:
:In a 4-year review of 509 patients with chronic pancreatitis, the incidence of clinically manifest fixed common bile duct (CBD) stenosis was 9% (45 patients). In 76% this was alcohol related, and pancreatic calcification was present in 51%. All patients presented with unrelenting jaundice and five (11%) had cholangitis. The mean serum bilirubin (165 +/- 108, normal 0-17 mumol/l), alkaline phosphatase (1790 +/- 1143, normal 73-207 U/l) and gamma glutamyl transferase (798 +/- 660, normal 7-64 U/l) were markedly raised. Diabetes occurred in 8 (18%). A biliary drainage operation was performed in 43 patients and 11 had concomitant pancreaticojejunostomy. Endoscopic retrograde cholangiopancreatography (ECRP) provided valuable information preoperatively in outlining both biliary and pancreatic disease in selecting patients for dual ductal drainage. Minor complications not related to biliary anastomosis occurred in 14%. Four patients died (9%), two from pseudocyst-related haemorrhage. Jaundice was successfully relieved in all and did not recur during follow-up. No secondary biliary cirrhosis was encountered, but varying degrees of portal fibrosis were present in 75% of liver biopsies. The commonest biliary pathogen was E. coli. It is recommended that a biliary bypass operation be performed when the diagnosis is radiologically confirmed and no improvement occurs within 1 month.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Huizinga WK,Thomson SR,Spitaels JM,Simjee AEsubject
Has Abstractpub_date
1992-03-01 00:00:00pages
119-23; discussion 123-5issue
2eissn
0035-8843issn
1478-7083journal_volume
74pub_type
杂志文章abstract::Two patients undergoing inguinal herniorrhaphy developed transient quadriceps paresis after local inguinal nerve block. One sustained a compound fracture of the distal tibia and fibula. The importance of warning the patient and of increasing the awareness of nursing staff to the possibility of quadriceps weakness afte...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::Brachytherapy involves the therapeutic implantation of a radio-active seed source into, or close to, prostate cancer. We report the rare case of a 76-year-old man who presented with a prostate abscess after months of intractable pelvic pain following prostate cancer treatment with iodine-125 brachytherapy. Despite mul...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870809X400985
更新日期:2009-05-01 00:00:00
abstract:INTRODUCTION:Admission for overnight or longer hospital stay from a day-case unit is an unwelcome event. This audit was designed to identify the incidence of unplanned admissions and also to detect the potential factors for such overstays. PATIENTS AND METHODS:Details of plastic surgical day-case patients were obtaine...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588405X60560
更新日期:2005-11-01 00:00:00
abstract::Endoscopic transthoracic sympathectomy (ETS) has recently become established as a successful treatment for severe palmar and axillary hyperhidrosis. In this unit the indications for ETS have been broadened to include patients with Raynaud's syndrome and critical upper limb ischaemia and this paper is primarily concern...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract:INTRODUCTION:There has been regular dialogue regarding the importance of developing clinical networks to compensate for the steady decline in general paediatric surgery performed by adult surgeons. Despite this dialogue, there are no contemporary published data to quantify the issue. This report documents patterns in d...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2019.0178
更新日期:2020-04-01 00:00:00
abstract::A series of 21 patients (18 female) whose intractable constipation was treated by colectomy between 1976 and 1985 is reported. There was no mortality attributable to surgery in this series. Total colectomy with ileorectal anastomosis was the preferred operation, but it produced a satisfactory result in only 12 patient...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1987-03-01 00:00:00
abstract:INTRODUCTION:Recent studies have shown that women who recall childhood abuse are at increased risk of emotional problems following a breast cancer diagnosis. How services should respond is unclear given the risk of compounding the emotional trauma of cancer with questioning about abuse. Our aim was to present the resea...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588414X13946184901407
更新日期:2014-07-01 00:00:00
abstract:INTRODUCTION:The equivalence of breast-conserving surgery followed by postoperative radiotherapy against mastectomy is now firmly established in patients with early breast cancer. The results of surgery in large-breasted women can be poor, with radiation-induced fibrosis, chronic pain and poor cosmesis contributing to ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588413X13511609958091
更新日期:2013-04-01 00:00:00
abstract::Spontaneous cervical lymphocoeles are extremely rare. Their surgical management can pose many challenges with the lack of clear surgical planes potentiating risks. We present the case of a patient with an extensive right-sided cervical lymphocoele. Surgical excision would have involved extensive surgery with risk to ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588412X13171221500826
更新日期:2012-03-01 00:00:00
abstract::In the Royal Navy, after surgery, the time that servicemen spend away from work and the level of duty to which they return are decisions made by the surgeon, not the general practitioner. In a prospective study, we have thus been able to assess the acceptability of return to full duty at decreasing intervals after hig...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00
abstract::First reported two decades ago, isolated incisional recurrence of hepatocellular carcinoma is an extremely rare clinical entity. We present two cases of recurrence: one recurring over 10 years after initial resection, and the second presenting with a port site recurrence 3.5 years following laparoscopic radiofrequency...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2017.0097
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVES:To determine the effects of cuts in surgical beds and operating lists upon the waiting list. To evaluate the effects of the Waiting List Initiative upon the total number of patients on the waiting list, the number of patients waiting for more than one year, and the ratio of patients with low priority, non-li...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:INTRODUCTION:Nicorandil is a commonly prescribed antianginal medication that has been found to be associated with painful anal ulceration. The incidence of this complication is unknown. We have used the best data available to us to make an estimate of this figure in a health district with a remarkably stable populatio...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588412X13171221501573
更新日期:2012-04-01 00:00:00
abstract::The most important development in determining successful organ transplantation has been the improved understanding of the immune response and the interactions between antigens, antibody, immune complexes, complement component, lymphocytes and macrophages. The initiation and termination of an immune response, whether c...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,评审
doi:
更新日期:1983-05-01 00:00:00
abstract:INTRODUCTION:Carpal tunnel decompression is the most commonly performed surgical procedure within a hand unit. Although very effective, the complications following the procedure can be significant. In an attempt to identify the causes of such complications, we assessed whether seniority of the surgeon impacts on outcom...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588407X232035
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVES:To provide guidance about the risks which should be disclosed to patients and documented during the consent process. METHODS:The Delphi Consensus Technique was used to decide what constitutes mandatory risk disclosure for three index procedures. Documentation of risk on consent forms was audited and compare...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/1478708041118
更新日期:2004-11-01 00:00:00
abstract::Congenital cholesteatoma is a rare entity. It arises from aberrant epithelial remnants left at the time of closure of the neural groove, between the 3rd and 5th week of embryonic life. Otoscopy typically shows a pearly white mass, medial to the intact tympanic membrane, primarily in the anterosuperior quadrant, withou...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870807X160425
更新日期:2007-03-01 00:00:00
abstract::Sixty patients scheduled for vaginal surgery under lumbar epidural block were randomly allocated into two groups, one of which received ethamsylate intravenously prior to induction of anaesthesia. Ethamsylate did not reduce the blood loss at operation in these patients. The possible factors underlying this observation...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1983-03-01 00:00:00
abstract:INTRODUCTION:Minimally-invasive, video-assisted thyroidectomy (MIVAT) was developed to reduce scarring/trauma associated with cervical incisions used in open thyroidectomy. Results from various centres have been published internationally but none from the UK. This study reports the first results from the UK and compare...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,多中心研究,评审
doi:10.1308/003588410X12628812459977
更新日期:2010-07-01 00:00:00
abstract::A previously fit 37-year-old man developed superior mesenteric venous thrombosis after undergoing a laparoscopic Nissen fundoplication. Despite receiving thrombo-embolic prophylaxis on postoperative day 16, he presented with a gradual onset of vague, but severe, umbilical and epigastric pains. Laboratory tests, abdomi...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:2002-05-01 00:00:00
abstract::Neutropaenic patients are at particular risk of developing a pseudomonal fasciitis known as ecthyma gangraenosum. Despite the similarities with necrotising fasciitis, Fournier's gangrene has a very different aetiology and management. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract::Patients with extensive chronic Crohn's disease of the small bowel, who may have had repeated excisional surgery, sometimes develop intestinal obstruction due to the development of a stricture. Surgery is usually thought to be contraindicated since further resections would leave the patient with insufficient small int...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1982-07-01 00:00:00
abstract:INTRODUCTION:Extensor mechanism ruptures might be easily overlooked and misdiagnosed, and delayed diagnosis of quadriceps tendon rupture is frequent. However, the literature recommends early surgical repair within 72 h. PATIENTS AND METHODS:This paper describes a new simple clinical diagnostic test that directly evalu...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588407X179044
更新日期:2007-04-01 00:00:00
abstract::Thirty-seven patients who had had either a colonoscopy or a selective mesenteric angiogram while being investigated for severe or persistent gastrointestinal bleeding of obscure origin were reviewed. Failure to make a prompt diagnosis was partly responsible for the 16% hospital mortality in the series. Colonoscopy was...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract::The purpose of this article is to examine current orthopaedic training in the UK and objectively compare this with other English-speaking countries. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588409X359303
更新日期:2009-04-01 00:00:00
abstract::This is a report of a 2-year experience with the management of penetrating injury of the cervical trachea. There were 29 cases. The respiratory status of the patient on admission dominated the initial management: 12 patients required emergency intubation and were immediately taken to operation, while 17 patients were ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract::Scintigraphy was performed on 180 patients with suspected biliary tract disease using technetium-99m-labelled derivatives of iminodiacetic acid. Most of the patients were also evaluated by conventional techniques and the results were correlated with the findings at operation and with histological examination of tissue...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1981-09-01 00:00:00
abstract::Adult ingestion of caustic substances is an unusual but serious surgical problem, with injuries likely to be more extensive than those in the corresponding paediatric population. After initial stabilisation and airway management, clinicians are presented with a complex multisystemic problem, frequently requiring a mul...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588415X14181254789286
更新日期:2015-05-01 00:00:00
abstract:INTRODUCTION:Advanced (pT2/T3) incidental gallbladder cancer is often deemed unresectable after restaging. This study assesses the impact of the primary operation, tumour characteristics and timing of management on re-resection. METHODS:The records of 60 consecutive referrals for incidental gallbladder cancer in a sin...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588414X14055925060073
更新日期:2015-03-01 00:00:00
abstract::Complex perianal fistulas may at times be very difficult to treat. New vascularised tissue can reach the perineum from leg muscles and the omentum. A less well-known source is the labial fat tissue (modified Martius graft) which has a robust posterolateral pedicle and which can be useful as an adjunctive technique for...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1998-11-01 00:00:00