Overview on compression anastomoses: biofragmentable anastomosis ring multicenter prospective trial of 1666 anastomoses.

This study represents a European prospective clinical multicenter trial and was undertaken to evaluate the applicability of the biofragmentable anastomosis ring (BAR) as a routine anastomotic tool in teaching hospitals. The trial results analyzed consisted of 1666 BAR anastomoses performed in 1360 patients from March 1989 to May 1996 in the upper (1042 anastomoses) and lower (624 anastomoses) gastrointestinal (GI) tract. Only patients selected for elective procedures and having previously undergone orthograde bowel cleansing were entered into the trial.

[Choledocholithiasis--therapeutic splitting].

Despite new developments like chemolitholysis and extracorporeal shock wave lithotripsy, conventional cholecystectomy was the "gold standard" in the treatment of gallstones. The range of indications and the operative strategy were well standardized, although the management of common bile duct stones in gallstone disease was still under debate. For high-risk and elder patients endoscopic retrograde cholangio-pancreatography (ERCP), papillotomy and stone extraction was established, in younger patients the best management was questionable.

Aggressive extracorporeal shock wave lithotripsy of gall bladder stones within wider treatment criteria: fragmentation rate and early results.

Two hundred and twenty patients with a total of 412 gall bladder stones of between 8 and 38 mm in size were treated with extracorporeal shock wave lithotripsy, using the overhead module Lithostrar Plus. Fifty six per cent of stones were solitary (mean (SD) diameter 23 (5) mm) and 9.5% of the patients had more than three stones.

[Prevention and treatment of postoperative fistulae--new indications for fibrin gluing].

The additional sealing of bronchial and gastrointestinal sutures and anastomoses, respectively, by means of fibrin sealant helped to significantly reduce the postoperative dehiscence rate; this rate amounted to 3.6% for additionally sealed bronchus stump occlusions and to 4.2% in gastrointestinal operations, whereby naturally in emergency abdominal operations the rate was higher (7.