Therapeutic small-volume resuscitation preserves pancreatic microcirculation in acute experimental pancreatitis of graded severity in rats.

Background: Microcirculatory disorders play a major part in the pathogenesis of acute pancreatitis. Improvement of microcirculation is hypothesized to open a therapeutic window. The aim of this study was to evaluate the effects of small-volume resuscitation in acute pancreatitis.

Effect of platelet-activating factor antagonist WEB 2086 on microcirculatory disorders in acute experimental pancreatitis of graded severity.

Objectives: Platelet-activating factor (PAF) is an important mediator of inflammation and postulated to be involved in the pathogenesis of acute pancreatitis. In this study, we evaluated the therapeutic effect of PAF antagonist WEB 2086 in acute experimental pancreatitis of graded severity in rats.

Methods: According to a block design, 64 animals were randomly allocated to 8 groups.

Resection vs drainage in treatment of chronic pancreatitis: long-term results of a randomized trial.

Background & Aims: Tailored organ-sparing procedures have been shown to alleviate pain and are potentially superior in terms of preservation of endocrine and exocrine function as compared with standard resection (Whipple) for chronic pancreatitis with inflammatory pancreatic head tumor. Long-term results comparing these 2 procedures have not been published so far. The aim of this study was to report on long-term results of a randomized trial comparing a classical resective procedure (pylorus-preserving Whipple) with an extended drainage procedure (Frey) for chronic pancreatitis.

The pylorus: take it or leave it? Systematic review and meta-analysis of pylorus-preserving versus standard whipple pancreaticoduodenectomy for pancreatic or periampullary cancer.

Background: Our objective was to determine the relative effects of pylorus-preserving pancreaticoduodenectomy (PPPD) and standard Whipple pancreaticoduodenectomy (SWPD) in patients with pancreatic or periampullary cancer.

Methods: We searched seven bibliographic databases, conference proceedings, and reference lists of articles and textbooks, and we contacted experts in the field of hepatobiliary surgery. We included published and unpublished randomized controlled trials.

Long-term follow-up of a randomized trial comparing the beger and frey procedures for patients suffering from chronic pancreatitis.

Objective: To report on the long-term follow-up of a randomized clinical trial comparing pancreatic head resection according to Beger and limited pancreatic head excision combined with longitudinal pancreatico-jejunostomy according to Frey for surgical treatment of chronic pancreatitis.

Summary Background Data: Resection and drainage are the 2 basic surgical principles in surgical treatment of chronic pancreatitis. They are combined to various degrees by the classic duodenum preserving pancreatic head resection (Beger) and limited pancreatic head excision combined with longitudinal pancreatico-jejunostomy (Frey).

Microcirculatory function and tissue damage is improved after therapeutic injection of bovine hemoglobin in severe acute rodent pancreatitis.

Objectives: Stasis of the pancreatic microcirculation initiates and aggravates acute pancreatitis. Bovine hemoglobin has been shown to improve microcirculation in acute pancreatitis if prophylactically infused 15 minutes after initiation of acute pancreatitis. The purpose of this study was to evaluate the therapeutic effectiveness of bovine hemoglobin on pancreatic microcirculation and tissue damage later in the course of experimental acute rodent pancreatitis.

Systemic intravenous infusion of bovine hemoglobin significantly reduces microcirculatory dysfunction in experimentally induced pancreatitis in the rat.

Objective: To evaluate the effectiveness of bovine hemoglobin on pancreatic microcirculation and outcome in experimental acute rodent pancreatitis.

Summary Background Data: Stasis of the pancreatic microcirculation initiates and aggravates acute pancreatitis. Hydroxyethyl-starch (HES) has been shown to improve pancreatic microcirculation.

[Effect of pneumoperitoneum on ultrastructure of parietal peritoneum in experimentally induced peritonitis in the rat].

Aim of this study was to analyse the effect of gastric perforation induced peritonitis and a pneumoperitoneum (PP) on the ultrastructure of the parietal peritoneum. After randomisation rats allocated to groups I and II were subjected to standardized gastrotomy simulating gastric perforation. After a 12-h-interval a PP was induced in groups I and III.

[Growth factor a/b-FGF and PDGF have no effect on development of inflammatory tumor in chronic pancreatitis].

Extensive fibrosis combined with the development of pseudocysts, calcifications and concomittant loss of acinar cells are the characteristic features in the pathogenesis of chronic pancreatitis. In some patients an inflammatory mass is generated which is most frequently located in the pancreatic head. The inflammatory pancreatic head tumor has been postulated to be the pace maker of the course of the disease.

[Prognostic value of gastric tonometry in peritonitis due to intestinal perforation and laparoscopic versus conventional management in the swine model].

After a 12 hour period of experimental peritonitis induced by gastric perforation mortality was significantly higher in the laparoscopically treated group of pigs when compared to the open procedure. In both groups the treatment was simple oversowing of the defect plus peritoneal lavage. Septic shock associated with peritonitis and subsequent "multi organ failure syndrome" could accurately be predicted with gastric tonometry.

Systemic endotoxin and gastric mucosal pH are the best parameters to predict lethal outcome in a porcine model of abdominal sepsis according to multivariate analysis.

This study was devised to identify sepsis-relevant parameters that early and reliably predict a lethal outcome in intra-abdominal sepsis. In 18 Duroc pigs, peritonitis was induced through standardized gastrotomy. Twelve hours later the defect was oversewn and the abdominal cavity lavaged thoroughly.

Pathogenesis and the natural course of chronic pancreatitis.

This article gives an overview about current thinking in pathogenesis and natural course /therapy in chronic pancreatitis. Alcohol consumption is still the most relevant factor in the development of chronic pancreatitis, a disease with enormous personal and social impact, shortening life expectancy up to 10-20 yrs. Pathogenesis of chronic pancreatitis has to be considered for different symptoms.

Effect of prenatal glucocorticoids and postnatal nitric oxide inhalation on survival of newborn rats with nitrofen-induced congenital diaphragmatic hernia.

Background/purpose: Pulmonary hypertension and pulmonary hypoplasia account for the high mortality rate associated with congenital diaphragmatic hernia (CDH). In animal models of CDH, postnatal nitric oxide (NO) inhalation resulted in significantly better survival rates and antenatal glucocorticoid administration in improved lung compliance. The objective of this study was to evaluate the combined effect of prenatal glucocorticoid administration and postnatal NO inhalation on the survival rate of newborn rats with nitrofen-induced CDH.

Attenuation of sepsis-related immunoparalysis by continuous veno-venous hemofiltration in experimental porcine pancreatitis.

Objectives: In light of evidence suggesting that hemofiltration favorably influences septic diseases by removing sepsis mediators, the impact of different modalities of continuous veno-venous hemofiltration (CVVH) on outcome and immunologic derangements in porcine pancreatogenic sepsis was evaluated.

Design: Randomized, controlled intervention trial.

Subjects: Forty-eight minipigs of either sex.

Strictureplasty for large bowel stenosis in Crohn's disease: quality of life after surgical therapy.

The aim of surgical therapy in Crohn's disease is to improve quality of life. Surgery does not provide cure with radical resection of inflamed bowel. Therefore strictureplasty has become a useful bowel-preserving surgical technique in the treatment of small-bowel stenosis.

Quality of life after surgical therapy of small bowel stenosis in Crohn's disease.

Background: Improvement in quality of life is one of the important determinants in the treatment of Crohn's disease. Since there is no cure with radical resection of inflamed bowel, strictureplasty has become a useful surgical technique in the treatment of small bowel obstruction. The scope of this study was to define the results of strictureplasty and resection in terms of quality of life, surgical recurrence and postoperative complications.

Orthotopic liver transplantation for complicated HELLP syndrome. Case report and review of the literature.

A case of hepatic complication in a pregnant woman suffering from HELLP syndrome resulting in the need for transplantation is reported, and an algorithm for those instances is suggested. According to the literature, this is the 5th report of hepatic complications in HELLP syndrome necessitating liver transplantation. Since all but one of the transplanted patients survived (as opposed to a high mortality in non-transplanted patients), it is concluded, that a timely decision for transplantation is a safe option in this high risk group.

Modifications of the duodenum-preserving pancreatic head resection.

Surgery for chronic pancreatitis has gained wide acceptance because of excellent results regarding pain alleviation and control of complications arising from adjacent organs. After the introduction of the duodenum preserving pancreatic head resection by Beger almost three decades ago, many modifications have been proposed, evaluated and compared. This article reviews the variety of operations, the reported results and potential advantages.

Bradykinin B2-receptor antagonism attenuates fatal cardiocirculatory breakdown induced by severe experimental pancreatitis.

Objectives: To investigate the impact of the long-acting bradykinin B2 receptor antagonist HOE 140 (Icatibant) on survival time in a model of severe porcine pancreatitis.

Design: Randomized, controlled intervention trial.

Subjects: Thirty domestic pigs of either gender anesthetized by intravenous application of piritramide, midazolam, and pancuronium and mechanically ventilated.

[Current diagnosis and therapy of soft tissue sarcomas in the adult].

Soft tissue sarcomas embrace a wide variety of rare tumours. This often means excision without wide margins, and the unexpected malignancy leads to diversity of postoperative treatment. As a rule all lesions of a soft tissue tumour should be biopsied if persisting for more than 6 weeks.