[Usefulness of continuous duodenal catheterization and drainage in the postoperative period after papillosphincteroplastic operations]. / Utilità del sondaggio duodenale continuato nel decorso post-operatorio degli interventi di papillosfinteroplastica.

The Authors claim the continuous emptying of the duodenum after papillosphincteroplastic useful in preventing APP. In order to prove it they present 27 running cases of sphicteroplastic so treated in which the postoperative amylasemy did not exceed the normal values.

[Postoperative acute pancreatitis (PAP). Direct personal experience]. / Pancreatite acuta post-operatoria (PAP). Nostra esperienza diretta.

Eight different cases of APP observed after intervents made near the pancreas (partial gastrectomy for ulcer, papillosphincteroplasty, DCP) are presented. The clinical stage, the therapeutic attempts, the results are studied. The clinical stage, the therapeutic attempts, the results are studied. In order to value the role of the pancreatic trauma in causing the APP the Authors have checked in addition 14 cases in which a direct action on the pancreas was present. In these cases noticeable amylasemic increases have not been observed except one cases of APP after DCP. Hypothesizing the role of a duodenal hyperpressure in causing the reflux of duodenal juice into the Wirsung then in causing an APP, the Authors report the results obtained after the introduction of a catheter into the duodenum in order to make it empty untily the renewal of peristalsis, during the papillosphincteroplasty and partial gastrectomy for ulcer. The Authors suggest that the duodenal emptying could be a method to prevent the APP. The prevention by the usually adopted drugs as aprotininum and glucagonum was ineffective, as well as other surgical techniques. High mortality: 5 cases on 8.

[Study of postoperative amylasemia. Its diagnostic value in postoperative acute pancreatitis (PAP)]. / Lo studio della amilasemia post-operatoria. Suo valore diagnostico nella pancreatite acuta post-operatoria (P.A.P.).

A study of the postoperative amylasemia levels on 375 different intervents is presented. Three different behaviours have been observed: 1) in 44 cases there has been a rapid increase of the amylasemia gone on for less than 4 days without any clinical sign of pancreatitis; 2) in 6 cases the increase, sometimes less marked than the previous cases, developed and continued for longer time, showing oscillations with a slow return to the normality. At the same time there was a slow recovery in the general conditions; the cause of that has been interpreted as a pancreatic affection; 3) in 8 cases the amylasemia increase developed for many days with large and long oscillation and clinical signs of APP. The opinion of Authors is that the APP is characterised by amylasemia increases presenting large oscillations life times exceeding 4 days, and that they are joined with clinical signs of pancreatitis (pain, sickness, hypotension, ec.). The study of the amylasemia plotting is considered to be a rather good method to emphasize a pancreatic disease.