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  • 1
    ISSN: 1432-0509
    Keywords: Biliary tract, obstruction ; Gallstone, diagnosis ; ERCP, interventional techniques
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Therapeutic applications of endoscopic retrograde cholangiopancreatography (ERCP) have increased dramatically, and endoscopic sphincterotomy (ES) is the cornerstone of these techniques. Indications include treatment of retained biliary duct stones, papillary stenosis, benign and malignant strictures, and acute cholangitis and pancreatitis. We reviewed our recent experience to assess the spectrum of procedures done and their results. Medical records and radiographic examinations in 60 consecutive patients undergoing therapeutic ERCP were studied. Patients were placed into one of three treatment groups; Group 1, ES alone (N=21); Group 2, ES plus stone retrieval (N=15); and Group 3, ES plus stent placement (N=24). In Group 1, all of eight patients with ductal stones had spontaneous passage. In 11 patients with papillary stenosis, nine had relief of symptoms following ES. Two patients with pancreatitis improved after ES. In Group 2, all 15 patients with ductal stones had successful retrieval. In Group 3, patients were treated for biliary stricture alone (4), retained stones (7), pancreatitis (5), neoplasms (6) and papillary stenosis (2). In these 24 patient, 21 (88%) were treated successfully or had palliation of their symptoms. In our series, a wide variety of therapeutic applications of ERCP was used to manage simple and complex biliary disease. ES alone or in combination with other techniques was done in all patients. Overall, 55 (92%) of 60 interventional procedures were successful as defined by removal of stones and relief or palliation of symptoms.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Abdominal imaging 19 (1994), S. 349-354 
    ISSN: 1432-0509
    Keywords: Defecography, technique ; Anorectal disorders, management
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the medical records and defecograms in 55 consecutive patients to determine the impact of results of defecography on clinical management. Main indication for defecography was constipation, present in 40 (73%) of 55 patients. In the remaining 15 patients, indications included obstructed defecation (5), incontinence (5), and miscellaneous symptoms (5). Defecography evaluated pelvic floor motion by assessing changes in the anorectal angle (ARA) and anorectal junction (ARJ) during various maneuvers, extent of evacuation, and structural abnormalities. Patients were grouped based on results of defecography as being normal (26) or abnormal (29). Comparison of measurements of the ARA and ARJ with various maneuvers showed no significant differences between the two groups. Clinical impact was determined by analyzing therapy done following defecography and subsequent patient response. In the normal group, 15 patients were managed medically, seven surgically, and four lost to follow-up. Clinical improvement occurred in 13 (59%) of 22 patients, with similar results between medical (60%) and surgical (57%) therapy. In the abnormal group, 16 had medical management, seven surgical therapy, and six lost to follow-up. Clinical improvement occurred in 13 (57%) of 23 patients but surgical therapy showed more improvement. In conclusion, most standard measurements of the ARA and ARJ were of no value in determining abnormality. Results of defecography did not alter selection of medical or surgical therapy, and had little impact on patient response to therapy.
    Type of Medium: Electronic Resource
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