RESUMO
Ninety-eight consecutive patients with ampullary and periampullary carcinoma diagnosed between 1983-1993 were studied retrospectively. Among these patients, 66 had a carcinoma of the head of the pancreas, 10 a carcinoma of the papilla of Vater, 8 a carcinoma of the duodenum, and 14 a carcinoma of the distal common bile duct. Resectability rate ranged from 12% to 90% according to the tumor location and histologic type. Palliative procedures such as laparotomy, biopsy and bilio-digestive bypasses were performed in 27 patients. Curative resections were performed in 24 cases: 20 pancreatoduodenectomies, 2 total pancreatectomies, 1 duodenectomy, 1 common bile duct resection. The results of the surgical treatment as well as mortality and morbidity rates were compared with those of different and larger series.
Assuntos
Ampola Hepatopancreática/cirurgia , Neoplasias do Ducto Colédoco/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ampola Hepatopancreática/patologia , Neoplasias do Ducto Colédoco/mortalidade , Neoplasias do Ducto Colédoco/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
In the last 5 years 25 patients (11 men, 14 women) with carcinoma of the extrahepatic biliary duct were studied. The most frequent localization of the carcinoma was the hepatic hilum. D.C.P. according to Whipple was possible only in one patient, while in 20 patients a palliative approach with external and internal biliary derivations was the choice. In the remaining 4 patients an explorative laparotomy with biopsy was performed. It is concluded that palliative resection allows for a better quality of life.
Assuntos
Adenocarcinoma/diagnóstico , Neoplasias dos Ductos Biliares/diagnóstico , Ductos Biliares Extra-Hepáticos , Adenocarcinoma/mortalidade , Adenocarcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias dos Ductos Biliares/mortalidade , Neoplasias dos Ductos Biliares/cirurgia , Ductos Biliares Extra-Hepáticos/cirurgia , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Cuidados PaliativosRESUMO
The Authors report their experience of biliary endoscopic endoprosthesis placement in 42 patients for palliative treatment of carcinoma of the pancreatic head. The morbidity, the mortality and the duration of hospitalization are considerably less than with surgical biliodigestive anastomosis. The mean survival is almost the same in both cases.
Assuntos
Neoplasias Pancreáticas/cirurgia , Próteses e Implantes , Adulto , Idoso , Idoso de 80 Anos ou mais , Endoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos , Próteses e Implantes/efeitos adversosAssuntos
Adenocarcinoma Papilar/etiologia , Pólipos do Colo/complicações , Neoplasias Duodenais/etiologia , Adenocarcinoma Papilar/patologia , Adulto , Ampola Hepatopancreática/patologia , Pólipos do Colo/genética , Pólipos do Colo/patologia , Neoplasias Duodenais/patologia , Humanos , Masculino , Neoplasias Primárias Múltiplas/patologiaRESUMO
Three cases of arteriovenous fistulae observed in recent years at the University of Rome's 3rd Surgical Clinic, and of different site, entity are aetiology, are presented. The recent international literature is reviewed and the more outstanding clinical and therapeutical features of this form are discussed.
Assuntos
Angiomatose/cirurgia , Fístula Arteriovenosa/cirurgia , Malformações Arteriovenosas/cirurgia , Adolescente , Adulto , Artéria Braquial , Artéria Femoral , Veia Femoral , Antebraço/irrigação sanguínea , Mãos/irrigação sanguínea , Humanos , Artéria Ilíaca , Masculino , Pessoa de Meia-Idade , Coxa da Perna/irrigação sanguíneaRESUMO
Endoscopic surgery of the gastrointestinal tract has become in the last years one of the most important procedures in the treatment of some digestive diseases. In view of the positive results obtained by means of the diagnostic coloscopy, an extension of this modern method for therapeutic purposes has been considered appropriate. At the Digestive Endoscopy Centre of the 3rd Surgical Clinic of University of Rome, 1337 coloscopies have been carried out, of which, 1236 were routine, 86 urgent and 15 intraoperative cases. Operative coloscopy was carried out in 310 routine and 16 urgent cases. From a technical point of view, operative endoscopy in the colon is particularly difficult and requires considerable experience. It is our opinion that this method can give useful and interesting contributions to the diagnosis and therapy of some lesions of the large intestine, provided suitable surgical conditions are available with all the necessary equipment. Following these criteria, it is possible to avoid complications such as haemorrhage and intestinal perforation. Our experience in this field is undoubtedly positive, since there has not been any complication but it is necessary to perform operative coloscopy under fluoroscopic control. With regard to coloscopic polypectomy it is the opinion of the authors that this procedure has a therapeutic value in benign polyps and when superficial cancerization has not invaded the muscularis mucosae in the head of the polyp.
