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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

On the basis of examination and treatment of 364 elderly and senile patients with obstructive jaundice and cholangitis, the authors conclude that the frequency of these complications is high and that cholangitis takes an atypical course in patients over 60 years of age. They determine the significance of the respiratory insufficiency syndrome in manifestation of the severity of the disease. In view of the high risk of surgery at the peak of jaundice and cholangitis, the authors suggest the wide use of endoscopic papillosphincterotomy according to indications for correcting biliary hypertension. It proved to be one of the most effective methods in the treatment of jaundice and cholangitis, contributed to reduction of the number of surgical operations on cavities and to a 4.4-fold decrease of postoperative death rates among this contingent of patients.
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PMID:[Treatment of nontumorous obstructive jaundice and cholangitis in middle-aged and elderly patients]. 262 3

Experience in the treatment of 238 patients for nontumorous lesions of the biliary tract by choledochotomy is generalized. Choledochotomy was performed in obstructive jaundice during the operation, in cholangiolithiasis, suppurative cholangitis, strictures of the terminal part of the choledochus, and indurative pancreatitis which were attended by biliary hypertension. Diagnostic choledochotomy was undertaken only in 5.8% of patients. Twenty-two (9.2%) patients died after choledochotomy. The method of completing choledochotomy was chosen individually according to the character of the pathological changes in the bile ducts and the acuteness of the inflammatory process. Choledochotomy was completed by external drainage of the common bile duct in 116 patients, by complete suturing of the choledochus in 19, by creation of bile-draining anastomoses in 89, and by papillosphincterotomy in 14 patients. Terminal and lateral choledochoduodenoanastomosis was formed in 25 patients, with good immediate results. Mortality was highest after papillosphincterotomy and external drainage of the choledochus.
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PMID:[Indications for choledochotomy and methods for its performance]. 267 5

A 77-year-old woman was admitted with obstructive jaundice. US and CT demonstrated a solid mass 2.5cm in diameter in the hepatic hilum. Cholangiography revealed not only severe stenosis of the hilar hepatic duct but also involvement of the right-posterior-inferior-ventral branch and right caudal branch. Angiography showed almost normal appearance except cystic artery. Duodenal invasion was also detected by per oral duodenography. These findings forced to plan extended right hepatic lobectomy with caudate lobectomy and pancreatoduodenectomy for radicality. In spite of the aged and her complications such as DM, hypertension, scoliosis and bradyacusia, liver function was good and she was mentally very active for life. Therefore, planned operation was performed and the suitability of this operation was proved by histological examination. She underwent resection of the abdominal wall for recurrence 8 months after and now alive without the disease 27 months after the first operation. It is stressed that the most suitable operation should be selected conceiving the mode and severity of cancer extension which is revealed by precise preoperative examinations and extended operation may be indicated in even the elderly if various conditions are good.
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PMID:[A case of advanced gallbladder carcinoma of a 77-year-old female successfully resected with extended right hepatic lobectomy with caudate lobectomy and pancreatoduodenectomy]. 318 98

In a survey the present possibilities are outlined to get knowledge about diseases of inner organs with the help of enzyme determinations in the urine. Here it is remarkable that changes of the enzyme excretion appear not only in renal disease with acute renal failure, pyelonephritis, glomerulonephritis, renal infarction and nephroptosis but are also to be observed in primarily extrarenal diseases such as diabetes mellitus, hyperthyroidism, thesaurismoses, myocardial infarction, hypertension, acute pancreatitis, epidemic hepatitis, liver cirrhosis, obstructive jaundice and rheumatoid arthritis. The causes of the changes of enzyme excretions are various. Since enzymes of different origin and localisation behave themselves variably, the simultaneous determination of a brush border marker (e.g. alanine aminopeptidase), a lysosomal enzyme (e.g. beta-glucuronidase or N-acetyl glucosaminidase) and a low molecular enzyme (e.g. lysozyme) is of use for the recognition of renal alterations. By the control of activities of urinary enzymes it is possible to get without risk informations about pathobiochemical processes in the kidney which are not to be gained by means of other methods.
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PMID:[Urinary enzyme excretion in diseases of the internal organs]. 636 87

Data on the treatment of 228 patients with calculous cholecystitis complicated by obstructive jaundice are reported. Two-stage treatment was applied. In the first stage endoscopic and roentgenoendobiliary therapeutic interventions were undertaken to relieve jaundice and remove its causes. In the second stage a planned surgical operation was conducted after elimination of biliary hypertension, which consisted in cholecystectomy in the majority of patients. Such therapeutic tactics reduced mortality by half.
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PMID:[Method of treatment of patients with calculous cholecystitis complicated with mechanical jaundice]. 774 30

A 21-year-old man presenting with jaundice and hypertension was found to have an extraadrenal pheochromocytoma. Cholangiography demonstrated a cavity in the head of the pancreas that was in communication with both the pancreatic and common bile ducts. Hemorrhage from the cavity led to the patient's death and postmortem examination revealed focal infarction of the pancreatic head. This case adds hemobilia, obstructive jaundice, and focal pancreatic infarction to the list of bizarre remote manifestations of pheochromocytoma.
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PMID:Focal pancreatic infarction in pheochromocytoma. 832 94

The results of treatment of 295 patients with complicated chronic pancreatitis (CP) for period from 1996 to 2000 yr were presented. CP without the ducts dilatation was revealed in 37 patients, ductal hypertension--in 19, calcinose fibrous-degenerative CP--in 73, cystic form of CP--in 142, CP in combination with external pancreatic fistula--in 24. Frequency of the complications occurrence in various forms of CP--the obstructive jaundice and cholangitis--was analyzed. Complex approach to the choice of tactic of the operation performance was proposed, application of additional methods of sorptional and immune therapy, depending on the CP form, complicated by the obstructive jaundice and cholangitis, was substantiated.
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PMID:[Strategies of surgical treatment of chronic pancreatitis complicated by obstructive jaundice and cholangitis]. 1202 7

The case of a 67-year-old male patient affected by ingravescent obstructive jaundice, calcific choledocholithiasis and cardiopathic hypertension, is presented. On sonography, marked dilatation of intra- and extrahepatic bile ducts with a hyperechoic round neoformation was visualized. CT was performed to ascertain the nature of the lesion. However, it did not confirm the lithiasic nature of the stenosis. Sampling for ERCP was inadequate. Cholangiopancreatography was therefore necessary to establish a correct diagnosis and the subsequent therapeutic approach. Distal choledochal obstruction was evidenced, suspicious for lithiasis obstruction. A definitive diagnosis could not be established on exclusive imaging findings. Surgery was performed with the diagnosis of cholangiocarcinoma with lithiasis.
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PMID:Obstructive jaundice. 1651 74

Results of 1831 laparoscopic cholecystectomies (LCE) are analyzed. Symptoms of obstructive jaundice were at 170 (9.3%) patients. All these patients underwent endoscopic papillosphincterotomy before LCE for removal of bile hypertension. Conversion to open surgery was necessary in 44 (2.4%) cases. Intraoperative injuries of extrahepatic bile ducts occurred at 5 (0.27%), bleeding--at 10 (0.6%) patients. Postoperative complications were seen at 36 (2.0%) patients including intraabdominal bleeding (4), drainage bile less (8), subhepatic abscess (4), epigastric wound infection (16). There were 2 (0.1%) lethal outcomes. Accurate surgical technique and timely conversion to open surgery prevent complications of LCE.
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PMID:[The ways for reduction of complication rate after laparoscopic cholecystectomy at acute cholecystitis]. 1816 10

The aim of this study is to review the practice and outcomes at our institution of percutaneous transhepatic placement of metallic biliary stents for non-hepato-biliary/pancreatic (non-HBP) malignant obstructive jaundice. A retrospective review was performed of the records of all patients undergoing transhepatic stenting for non-HBP malignant obstructive jaundice over a 7-year period. A total of 25 patients were successfully stented and linear regression analysis of a variety of demographic, clinical and laboratory markers against survival was performed. Survival after stenting varied from 1 to 1354 days (median 58, mean 152). An initial bilirubin level less than 300 micromol/L (P=0.01) and a reduction of greater than 50% in bilirubin post stenting (P=0.02) were strong predictors of improved survival. Older patients survived longer than younger ones (P<0.01). There was a weak association of survival with an albumin>30 g/L (P=0.06), but no statistically significant correlation with creatinine or haemoglobin levels or active tumour treatment after stenting. There were few major complications from the procedures. Transhepatic metallic biliary stenting for non-HBP malignant biliary obstruction is a safe and effective procedure, and with careful patient selection, significant periods of survival and palliation of jaundice can be achieved.
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PMID:Outcomes in percutaneous stenting of non-hepato-biliary/pancreatic malignant jaundice. 1970 50


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