[A new catheter for enteroclysis: Torino 1. Results in 398 cases]. / Nuovo set per enteroclisi: Torino 1. Risultati in 398 casi.

The authors report on the use a new barium enema catheter employed in 398 patients from January, 1990 through June, 1991. Its innovative characteristics and several possible uses are compared with those of conventional equipment. Particularly, the advantages offered by the various possible placement sites of the catheter--i.e., the II duodenal portion and beyond the ligament of Treitx--are discussed, together with its different uses according to clinical symptoms: its best location is beyond the ligament of Treitz in subocclusions, versus in the II duodenal portion if tumors or other duodenal conditions are suspected. The new catheter exhibited 100% accuracy; the average exposure time for radioscopy during its positioning was 3 minutes. A selected group of 149 patients was examined for complications, which were few (8%), of poor importance, short and completely curable.

[Percutaneous treatment of bile duct lithiasis. Personal experience in the first 150 cases]. / Trattamento percutaneo della litiasi dei dotti biliari. Esperienza personale nei primi 150 casi.

Since 1983 we have percutaneously treated 150 cases of bile duct lithiasis in which previous endoscopic maneuvers had been incomplete or unfeasible. Complete resolution of lithiasis was obtained in 139 of 150 patients. In 6 cases only partial success was obtained but symptoms subsided. In 2 cases the treatment failed and the patients underwent surgery. Minor complications were observed in 12.6% of patients and resolved either spontaneously or by percutaneous maneuvers. Mortality rate was 2%. After a follow-up period of 6-12 months, 9 patients had a recurrence, completely resolved with further percutaneous treatment. These cases never required surgery. We obtained the best results in patients with stones residual after cholecystectomy or a iatrogenic stricture of the biliary tree. We obtained good results in massive lithiasis with combined endoscopic, surgical and radiological procedures. Morbidity and mortality rates were lower than in surgical series and similar to the endoscopic ones. The short hospitalization, the low cost and the possibility of treatment on an outpatient basis should promote the spreading of percutaneous techniques in the treatment of bile duct lithiasis.

Percutaneous transhepatic sphincterotomy--a report on 3 cases.

The technique of percutaneous transhepatic sphincterotomy is described. This procedure was employed in 3 patients with common bile duct (CBD) stones in whom a previous attempted endoscopic procedure had failed for anatomical reasons (a Billroth II gastric resection or a partial gastric resection with Braun anastomosis). Complete immediate success was obtained in all 3 patients. Furthermore, no major complications occurred during transhepatic treatment. The authors suggest that PTS be employed electively in patients with diseases of the biliary tree in whom the endoscopic approach fails.