[Ultrasonographic study on the contractility of the gallbladder in gastrectomized patients with gastric cancer].

The contractility of the gallbladder (GB) in 24 total-or subtotal-gastrectomized patients for gastric cancer was investigated with ultrasonography. The resting area of the GB and a fat meal-induced GB contractility were studied in 12 patients at early postoperative (about 3 weeks) and in 12 patients at late postoperative (more than 6 months) stage. The scanning condition was set at every 5-10 min for 60 min after the ingestion of the meal. The values obtained were compared with those obtained from 12 control subjects free from liver or biliary tract diseases. The results obtained were summarized as follows: 1) In the control subjects, more than 50% contraction of the GB was seen at 30 min after the test meal. The GB continued to contract slowly till the end of the observation (60 min). 2) The resting area of the GB from both early and late postoperative patients was significantly larger than that found in the control subjects. 3) The contraction ratio of the GB from the early postoperative patients was significantly smaller than that from the control subjects whilst the ratio from the late postoperative patients was comparable to that from the control subjects.

[Timing of surgical intervention in ulcerative colitis].

Ulcerative colitis is a borderline disease between medicine and surgery and ultimate evaluation of medical or surgical therapy remains to be settled. Except for the absolute indication for operation (toxic dilatation, perforation, bleeding and etc.), it is not always easy to consider surgery for this disease because so many factors influence its clinical course. Nevertheless, a prudent decision regarding surgery seems mandatory for a reasonable surgical therapy with a low mortality and high curability that enables an earlier rehabilitation and more complete social activity. The total number of primary operative cases of ulcerative colitis in our clinic over a period of March 1954 through the end of December 1983 was 30. A comparison of our experience up to the end of 1965 and since then has shown an operative mortality of 2/14 in the first and 1/16 in the second period, and that all these 3 deaths were through an emergency operation but not through 29 cases of elective surgery. It is emphasized that one of the most important factors influencing outcome of operation is whether or not it is undertaken as an urgent surgery during a hard time of the disease that has failed to respond to intensive medical treatment.