Biography:

In the past Gordon L. Telford has collaborated on articles with Andreas M. Stadelmann and Robert H. Hollis. One of their most recent publications is Case reportPancreaticogastrostomy:Clinical experience with a direct pancreatic-duct-to-gastric-mucosa anastomosis. Which was published in journal The American Journal of Surgery.

More information about Gordon L. Telford research including statistics on their citations can be found on their Copernicus Academic profile page.

Gordon L. Telford's Articles: (9)

Case reportPancreaticogastrostomy:Clinical experience with a direct pancreatic-duct-to-gastric-mucosa anastomosis

AbstractThe propensity for leakage and disruption at the site of the pancreaticojejunostomy is a major reason for morbidity and death after pancreaticoduodenal resection. Because it is less prone to leakage and disruption, pancreaticogastrostomy has been reintroduced as a possible alternative to pancreaticojejunostomy. Of four patients in whom the pancreas was simply implanted into the stomach and five patients in whom a direct pancreatic-duct-to-gastric-mucosa anastomosis was constructed, there was no morbidity or death related to the pancreatic anastomosis. Because of evidence that a direct pancreatic-duct-to-gastric-mucosa anastomosis has an increased incidence of patency and because it was successful in a clinical setting, it is recommended.

Case reportPancreaticogastrostomy:Clinical experience with a direct pancreatic-duct-to-gastric-mucosa anastomosis

AbstractThe propensity for leakage and disruption at the site of the pancreaticojejunostomy is a major reason for morbidity and death after pancreaticoduodenal resection. Because it is less prone to leakage and disruption, pancreaticogastrostomy has been reintroduced as a possible alternative to pancreaticojejunostomy. Of four patients in whom the pancreas was simply implanted into the stomach and five patients in whom a direct pancreatic-duct-to-gastric-mucosa anastomosis was constructed, there was no morbidity or death related to the pancreatic anastomosis. Because of evidence that a direct pancreatic-duct-to-gastric-mucosa anastomosis has an increased incidence of patency and because it was successful in a clinical setting, it is recommended.

Case reportPancreaticogastrostomy:Clinical experience with a direct pancreatic-duct-to-gastric-mucosa anastomosis

AbstractThe propensity for leakage and disruption at the site of the pancreaticojejunostomy is a major reason for morbidity and death after pancreaticoduodenal resection. Because it is less prone to leakage and disruption, pancreaticogastrostomy has been reintroduced as a possible alternative to pancreaticojejunostomy. Of four patients in whom the pancreas was simply implanted into the stomach and five patients in whom a direct pancreatic-duct-to-gastric-mucosa anastomosis was constructed, there was no morbidity or death related to the pancreatic anastomosis. Because of evidence that a direct pancreatic-duct-to-gastric-mucosa anastomosis has an increased incidence of patency and because it was successful in a clinical setting, it is recommended.

Case reportPancreaticogastrostomy:Clinical experience with a direct pancreatic-duct-to-gastric-mucosa anastomosis

AbstractThe propensity for leakage and disruption at the site of the pancreaticojejunostomy is a major reason for morbidity and death after pancreaticoduodenal resection. Because it is less prone to leakage and disruption, pancreaticogastrostomy has been reintroduced as a possible alternative to pancreaticojejunostomy. Of four patients in whom the pancreas was simply implanted into the stomach and five patients in whom a direct pancreatic-duct-to-gastric-mucosa anastomosis was constructed, there was no morbidity or death related to the pancreatic anastomosis. Because of evidence that a direct pancreatic-duct-to-gastric-mucosa anastomosis has an increased incidence of patency and because it was successful in a clinical setting, it is recommended.

Case reportPancreaticogastrostomy:Clinical experience with a direct pancreatic-duct-to-gastric-mucosa anastomosis

AbstractThe propensity for leakage and disruption at the site of the pancreaticojejunostomy is a major reason for morbidity and death after pancreaticoduodenal resection. Because it is less prone to leakage and disruption, pancreaticogastrostomy has been reintroduced as a possible alternative to pancreaticojejunostomy. Of four patients in whom the pancreas was simply implanted into the stomach and five patients in whom a direct pancreatic-duct-to-gastric-mucosa anastomosis was constructed, there was no morbidity or death related to the pancreatic anastomosis. Because of evidence that a direct pancreatic-duct-to-gastric-mucosa anastomosis has an increased incidence of patency and because it was successful in a clinical setting, it is recommended.

Effect of central sympathectomy on gastric and small intestinal myoelectric activity and plasma motilin concentrations in the dog*

AbstractUsing a canine model, we studied fed and fasting gastric and small intestinal myoelectric activity and plasma motilin concentrations before and after transection of the spinal cord between the second and third thoracic segments. In sham-operated dogs, migrating complexes returned to normal by the second day after operation. Immediately after spinal cord transection, migrating complexes cycled in jejunum and ileum but not in the stomach and duodenum. After 11 and 15 days, migrating complexes returned to the duodenum and stomach, respectively. Plasma motilin concentrations did not cycle in animals without duodenal migrating complexes but returned to a normal cyclical pattern when duodenal migrating complexes returned. Feeding interrupted migrating complexes after cord transection and sham operation. The data observed in animals after 15 days suggest that myoelectric activity in fasted dogs and conversion of the fasted to the fed state of myoelectric activity are not under the control of supraspinal, sympathetic pathways.

Regular ArticleDistribution of Muscarinic Receptor Subtypes in Rat Small Intestine☆

AbstractDespite its great promise, small intestinal transplantation in some patients is complicated by difficult postoperative management. The reasons for this are complex. In a rat model of small intestinal transplantation, frequencies of migrating myoelectric complexes during fasting are reduced in ileal isografts and muscarinic receptor density is decreased. We hypothesized that the distribution of muscarinic 1 receptors localized to enteric neurons is altered after small intestinal transplantation. Distal small intestine was orthotopically transplanted in Lewis-to-Lewis donor–recipient combinations. At 3 months, transplanted and normal ileum was obtained to prepare membrane fractions. [N-methyl-3H]Scopolamine served as ligand, while scopolamine methylbromide, pirenzepine, and methoctramine were used in competitive homologous and heterologous displacement experiments. Receptor subtype models were examined by nonlinear regression analysis. In normal and transplanted ileum, heterologous displacement was consistent with three site models (P< 0.05). In normals, the muscarinic 1 receptor subtype was most abundant, with a relative distribution of 69 to 78%. There was a relative distribution of 13 to 16% for muscarinic 3 receptor subtype. After transplantation, the muscarinic 1 subtype decreased to a mean of 45% but the muscarinic 3 subtype increased to a mean of 42%. Using pirenzepine, mean pKDvalues were not different between the two groups. It is concluded that the decrease in muscarinic 1 receptor subtype after transplantation could be related to neuronal cell loss or to downregulation of the expression of muscarinic 1 receptors. The results did not support defective posttranslational processing of receptor proteins.

Pathophysiology of Small Intestinal Motility

All abdominal procedures produce changes in small intestinal motility. These effects range in severity from postoperative ileus due to opening the abdomen and handling the intestine to substantial alterations in initiation and coordination of myoelectric activity produced by resection and denervation. Although most patients readily adapt to the changes that occur after surgical procedures, the changes in contractile activity that occur with more extensive procedures, such as intestinal transplantation, may not be tolerated as easily. It is, therefore, imperative that clinicians pursue a more thorough understanding of the effects of surgical procedures on small intestinal contractile activity.

Southern surgical association articleHospital Readmissions after Surgery: How Important Are Hospital and Specialty Factors?

BackgroundHospital readmission rates after surgery can represent an overall hospital effect or a combination of specialty and patient effects. We hypothesized that hospital readmission rates for procedures within specialties were more strongly correlated than rates across specialties within the same hospital.Study DesignFor general, orthopaedic, and vascular specialties at Veterans Affairs hospitals during 2008 to 2014, 30-day risk-adjusted readmission rates were estimated for 6 high-volume procedures and each specialty. Relationships were assessed using the Pearson correlation coefficient.ResultsAt 84 hospitals, 64,724 orthopaedic, 24,963 general, and 10,399 vascular inpatient procedures were performed; mean readmission rates were 6.3%, 13.6%, and 16.4%, respectively. There was no correlation between specialty-specific adjusted hospital readmission rates: general and orthopaedic (r = 0.21; p = 0.06), general and vascular (r = 0.15; p = 0.19), and vascular and orthopaedic surgery (r = 0.07; p = 0.55). Within specialties, we found modest correlations between knee and hip arthroplasty readmission rates (r = 0.39; p < 0.01) and colectomy and ventral hernia repair (r = 0.24; p = 0.03), but not between lower-extremity bypass and endovascular aortic repair (r = 0.13; p = 0.26). Overall, controlling for patient-level factors, 1.9% of the variation in readmissions was attributable to specialty-level factors; only 0.6% was attributable to hospital-level factors.ConclusionsHospital readmission rates for orthopaedic, vascular, and general surgery were not correlated between specialties; within each of the 3 specialties, modest correlations were found between 2 procedures within 2 of these specialties. These findings suggest that hospital surgical readmission rates are primarily explained by patient- and procedure-specific factors and less by broader specialty and/or hospital effects.

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