[Endoscopy of esophageal cancer (author's transl)].

The late stages of symptomatic esophageal carcinoma rarely present diagnostic difficulties. Nevertheless, the tumor must be bioptically analyzed and defined to decide on proper treatment. Our future aim is to diagnose esophageal carcinoma at an early stage.

Pancreatic oncofetal antigen in pancreatic juices. Partial chemical characterization and diagnostic application of a pancreatic cancer-associated antigen.

Antisera were raised in rabbits to an antigenic structure present in fetal pancreas tissue, pancreatic tumor tissue, and pancreatic juices and in sera obtained from pancreatic cancer patients. The first chemical data indicate that this pancreatic oncofetal antigen is distinct from CEA, NCA, and NCA2 and is not glycolipid in nature. Immunoelectrophoretic analyses demonstrate that pancreatic oncofetal antigen is a protein or a glycoprotein, which displays microheterogeneity.

Alternating treatment of common bile duct stones with a modified glyceryl-1-monooctanoate preparation and a bile acid-EDTA solution by nasobiliary tube.

Twenty patients with bile duct stones were treated via an indwelling nasobiliary tube with a modified Capmul 8210 preparation (GMOC) and alternating with a bile salt-EDTA (BA-EDTA) solution for an average of 12 days. In vitro the dissolution capacity of GMOC and BA-EDTA for cholesterol stones was higher than that of Capmul 8210. The nasobiliary tube was tolerated well for a maximum of 84 days; this renders us independent of the T-tube.

[Longterm controls after endoscopic papillotomy [EPT] (author's transl)].

In 117 patients who have undergone endoscopic papillotomy (EPT) long term controls have been done. 51 were controlled in the hospital and 66 did answer a questionnaire. The mean time interval to the EPT was mean = 21.

Ultrasonic tomography by means of an ultrasonic fiberendoscope.

The diagnositc value of ultrasonic tomography of the upper abdominal organs is sometimes limited by bones and gas. Endoscopic ultrasonography (EUST) combines the advantages of the direct visualization of the upper GI tube and the ultrasonic imaging of adjacent organs. The ultrasonic probe consists of a 5 MHz array that generates a good resolution at the acustical focus, the endoscope is a conventional Olympus gastroscope type GFB3.

Experiences with the long standing nasobiliary tube in biliary diseases.

Specially designed longstanding nasobiliary tubes allow to reflect upon some well established therapeutic rules. The safe, decompressing effect of the tube leads to prompt relief of obstructive suppurative cholangitis. Therefore emergency of laparotomy can be avoided in high risk patients.

Descending sphincterotomy of the papilla of Vater through a choledochoduodenostomy under endoscopic view. Another variant of endoscopic papillotomy (EPT).

Endoscopic papillotomy required deep cannulation of the papilla of Vater. But retrograde placing of the papillotome in the distal common bile duct is not always possible. Occasionally conditions permitting a descending antegrade cannilation of the papilla are found.

Enteropancreatic circulation of trypsin in man.

Following the intraduodenal installation of purified 125I-labeled human trypsin up to about 4--6% of the label was measured after 15--30 min in blood plasma and found to separate in a dextran-gel filtration system similar to purified human trypsin (-125I) after incubation with human serum. About 1% of the installed trypsin-(-125I)-dose was found already after 20 min in 100 ml of aspirated pancreatic secretion and later on also in the duodenal content. The results support the concept of the existence of an enteropancreatic circulation of trypsin also in man and explain in part the low to non-detectable levels of immunoreactive serum trypsin observed in patients with exocrine pancreatic insufficiency.

[Therapeutic endoscopy in the gastrointestinal tract].

In selected chapters of the therapeutic endoscopy we tried to represent secure knowledge, actual tendencies and partly future prognoses. Hereby completeness cannot be expected. However, it became clear that numerous physical principles became useful for the therapy with the endoscope.

[A comparison of percutaneous transhepatic cholangiography and endoscopic retrograde cholangiopancreatography (author's transl)].

Results of percutaneous transhepatic cholangiography (PTC) with the Chiba needle were compared with those obtained by endoscopic retrograde cholangiopancreatography (ERCP). PTC was used in 102 cases, most often after ERCP had been inconclusive or had failed. Overall success rate of PTC was 79%.

[Crohn's disease: course and prognosis in 169 patients (author's transl)].

The most common initial symptoms in 169 patients with Crohn's disease, followed from 1956 to 1973, were diffuse abdominal pain, diarrhoea without any blood admixture, loss of weight, and fever. At the onset of the disease 84% of patients were aged 10-39 years. The most important complications (in descending order of frequency) were fistulae and abscesses, ileus, anaemia, and malabsorption.

Descending sphincterotomy of the papilla of Vater through the T-drain under endoscopic view. Variants of endoscopic papillotomy (EPT).

An indwelling T-drain is a valuable access to the common bile duct if the conventional EPT fails in the case of choledocholithiasis. It is often easier to cannulate the duodenal papilla from the common bile duct than from the duodenum. A papillotome of the Erlangen type introduced through the T-drain into the papilla spontaneously has the correct cutting direction.

Gas sterilization of fiber endoscopes.

Excitants of disease can be transmitted by endoscopes from one patient to another. Owing to their complicated construction and the heat-sensitive material fiber glass endoscopes are difficult to disinfect or sterilize. Of the known procedures of sterilization only gas sterilization with ethylene oxide can be used.

Santorini's Duct--an insignificant variant from normal or an important overflow valve?

In a retrospective examination 250 consecutive pancreatograms obtained by ERCP were controlled on the existence of a D. Snatorini. Starting from the genetic development of the pancreatic ducts the question is investigated whether a second open pancreatic duct is responsible for a better drainage of the pancreas.

[Tolerance of carbenoxolone sodium in elderly patients (author's transl)].

Eighteen elderly patients (average age 72.3 years) suffering from cardiac failure and from chronic gastric ulcers received carbenoxolone sodium, the risk of surgery being considered too high. The effects of this medical treatment were followed up closely.

[Retrograde endoscopic diagnosis and therapy in diseases of the bile papillae and the bile ducts (author's transl)].

Duodenoscopy with retrograde cholangiopancreatography including associated methods (cytology, manometry, endoscopic sphincterotomy, etc.) allows, with little risk, a more precise differentiation of jaundice. Considering the therapeutic consequences, the effort seems relatively small.