Evaluation of clinical safety and beneficial effects of a fish oil containing lipid emulsion (Lipoplus, MLF541): data from a prospective, randomized, multicenter trial.

Objective: To prove safety and effectiveness of a lipid emulsion enriched with n-3 fatty acids from fish oil (Lipoplus) within the setting of parenteral nutrition of patients after major abdominal surgery and to determine whether there are effects on outcome parameters.

Design: Prospective, randomized, double-blind, multicenter trial.

Setting: University and surgical teaching hospitals.

[Laparoscopic treatment of small bowel obstruction with intussusception, volvulus and appendicitis caused by an inflammatory Meckel's diverticulum].

Indications and contraindications for diagnostic laparoscopy in cases of intestinal obstructions are discussed in connection with a 16-year-old patient's case report with small bowel obstruction including intussusception, volvulus and appendicitis caused by an inflammatory Meckel's diverticulum. The use of diagnostic laparoscopy in cases of intestinal obstructions is controversial. In the described case we performed completely laparoscopically the derevolving and desusception of the volvulus and intussusception, the appendectomy and resection of the diverticulum.

Effect of caseload on the short-term outcome of colon surgery: results of a multicenter study.

This prospective multicenter study investigated the effect of hospital caseload on early postoperative outcome of surgery for carcinoma of the colon in 75 German hospitals and included 2293 patients. The hospitals were divided into those with a caseload of 1-30 (group A), 31-60 (group B), and more than 60 (group C) operations. Increasing caseload was associated only with fewer general postoperative complications.

[Value and technique of laparoscopic choledochus revision in choledocholithiasis].

Despite a large scale indication to ERCP, 5% of unsuspected stones are shown by principally intraoperative cholangiography in our patients. Praeoperative diagnostic makes it possible to select the individual optimal therapy for each patient, the possibility of saving the Papilla vateri gives the large scale indication to laparoscopic common bile duct exploration. Also suspected stones gets a one-time cure therapy by complete laparoscopic operation.

[Minimal invasive lumbar sympathectomy--technique and outcome, retroperitoneoscopic approach]].

Peripheral vascular obliteration of the leg provides an indication for a retroperitoneoscopic lumbal sympathectomy initially using a balloon dilator to create a transitional retroperitoneal cavity. After introducing carbon dioxide and two 5-mm instruments, we perform the resection and extirpation of the lumbal sympathetic nerve from L 2 to L 4. No complications occurred in 29 patients except conversion to open surgery in two cases because of gas loss into the peritoneum after causing peritoneal lesions.

Laparoscopic proximal gastric vagotomy--neuralgic points of technique.

Laparoscopic proximal gastric vagotomy is a valuable therapeutic tool in the management of patients suffering from recurrent duodenal ulcer disease, the therapeutic principle being the effective reduction of gastric acid output without gastrotomy or gastric resection. The method is based on the well-documented conventional technique, which has been evaluated for over 15 years. The division of all vagal fibres to the gastric fundus and body is essential for complete vagotomy in order to ensure a sufficient reduction in gastric acid.

Laparoscopic cholecystectomy in a young girl.

Laparoscopic cholecystectomy is now a widely used procedure in adults. However, reports on this procedure in infants and young children are rare. This paper reports a successful laparoscopic cholecystectomy in a young girl.

Strategy and technique of laparoscopic common bile duct exploration.

The laparoscopic approach to common bile duct exploration enables the complete clearance of stones from the bile duct without damage to structures of physiological importance such as the ampulla of Vater. Despite preoperative endoscopic retrograde cannulation of the biliary tree (ERCP) in patients with suspected stones, routine intraoperative cholangiography reveals a further 6% with unsuspected common bile duct stones. Both the preoperative suspected stone and the stone found on intraoperative cholangiography can be adequately managed by the laparoscopic method.

[Laparoscopic operations of the bile duct].

Laparoscopic common bile duct exploration offers the possibility of complete minimal invasive therapy of biliary stone disease with respect to the anatomical structures of the papilla Vateri. In spite of generously indicated preoperative ERC, we found in 23 of 376 laparoscopic cholecystectomies unsuspected common bile duct stones by intraoperative in principle cholangiography. 8 patients with known common bile duct stones got a complete laparoscopic therapy.

[Reservoir capacity of esophagojejunostomy following gastrectomy determined by the radioisotope method].

The substitute reservoir emptying was determined quantitatively in 16 patients with total gastrectomy by means of the radio-isotope method. The continuity was restored in 15 patients by an entero-anastomosis in modification according to Graham and in one patient by esophagoduodenostomy. The investigation was carried out in 11 patients with total gastrectomy in upright position and in 4 patients in lying position.

[Current surgical management of reflux disease].

This disease has not been fully clarified yet. In our opinion, surgery should only be performed in cases of stage IV because of ulcers, irreversible scar formation, metaplasia of the epithelium, endobrachyoesophagus, stenoses or malignant degeneration. 11 patients suffering from severe reflux oesophagitis (stage IV) underwent a combination of supraselective vagotomy (to lower gastric acidity) fundoplication according to Nissen and intraoperative dilatation of the stenosis or stricture.

[Amino acid resorption and protein metabolism following total gastrectomy in the rat].

The investigations were carried out in rats by means of the amino acid 15N-glycinee 6 to 12 weeks after the gastrectomy. 10 rats were operated by Graham and 9 by Longmire, Gütgemann. 12 rats as a control group were not operated.

[Preoperative phase of colonic surgery (author's transl)].

The existing possibilities to prepare colon and rectum for surgery are discussed, optimal nutrition just before operation is particularly stressed. The efficiency of oral and parenteral antimicrobial prophylaxis ist pointed out. Apart from contra-indications, orthograde lavage of the bowel is the method of choice.

[Current state and perspectives of the use of the 15N-tracer technic in gastroenterologic studies].

The importance of 15N as tracer in medical research is increasing. Since 1965 many results were obtained in cooperation of surgeons (Surgical clinic of Karl-Marx-University; Bezirkskrankenhaus St. Georg, Leipzig) and coworkers of Central Institute of Isotope and Radiation research.

[Malabsorption from the surgical viewpoint].

Malabsorption following surgical procedures on the GI-tract happens only in rare cases, such as blindloop-syndrome, short gut-syndrome, internal fistulae and dumping syndrome after partial gastric resection. Pathophysiological background and therapeutical possibilities as well as parenteral nutrition are discussed in detail.

[The human utilization of orally administered 15N-glycine].

In 7 convalescent patients we studied utilisation of a single dose of 15N-labelled glycine. In intervals we estimated total-N, urea-N, NH3-N and their 15N-abundances (urine). The following results were obtained.

[Absorption of amino acids in patients after partial gastrectomy (B II) and truncal vagotomy with pyloroplasty or antrectomy (author's transl)].

After surgery for gastric or duodenal ulcer the resorption of amino acids is changed due to alteration of morphology and function of stomach, bile system, pancreas and small bowel. We used the stable isotope labelled amino acid 15N-glycine in patients after partial gastrectomy (B II), truncal vagotomy with pylorplasty as well as antrectomy and in healthy persons. It could be shown that in contrast to the control group the absorption of the amino acid in the surgical group took place more rapid and more intensive.

[Perforated gastric and duodenal ulcer (635 cases) (author's transl)].

Perforation could be observed in 10.14% of all patients with gastroduodenal ulcer admitted to our clinic from 1946 to 1976. 23.

[A balanced synthetic diet (Berlamin) in colonic surgery (author's transl)].

In preparation for surgery of the colon and rectum 50 patients were fed an oral balanced synthetic diet. Additionally, antibiotics were administered. With the exception of 4 patients the bowel was completely free from faeces.