George L. Juler

A prospective, randomized clinical investigation ofcholecystoenterostomy and choledochoenterostomy

Summary A prospective, randomized clinical trial was conducted to assess the efficacy of bilioenteric bypass in noncalculous distal biliary obstruction. Thirty-one patients required bypass for either malignant obstruction or chronic pancreatitis and were randomized into two groups: cholecystoenterostomy or choledochoenterostomy with cholecystectomy [ 15, 16 ]. Nine bypasses failed after cholecystoenterostomy and two after choledochoenterostomy (p

Intramesenteric perforation of sigmoid diverticulitis with nonfatal venous intravasation

Complications from barium enema are rare (0.035 per cent). A patient with venous intravasation during barium enema complicated by pylephlebitis and portal vein obstruction is the tenth to be reported on, the fourth to survive. This accident was associated with colon disease in eight of the patients studied, five of whom had diverticular disease.

Evaluation of recurrent duodenal ulcer after vagotomy-pyloroplasty.

Seventy-five antrectomies were performed for recurrent duodenal ulcer after 1,515 vagotomy and drainage procedures. Eighty-four per cent of proved recurrences at reoperation were associated with positive acid secretory tests. Seventy-eight per cent of recurrences occurred in patients with intact vagal trunks. Incomplete vagotomy is implicated as the cause of recurrence.