[54 consecutive duodenopancreatectomies without fatality].

Over a five-year period (1.1.89-31.

[Atony of the gallbladder as a risk factor for acalculous cholecystitis. What is the effect of intensive care?].

The incidence of acute acalculous cholecystitis (AAC) is increasing and associated mortality is high. Biliary stasis and sludge formation are probably important factors in the pathogenesis of this disease. No data concerning the dynamics of these changes in the early phase of intensive care therapy are available.

[Laparoscopic cholecystectomy in morbid obesity. Indications or contraindications?].

In early reports on the experience with laparoscopic cholecystectomy severe obesity was considered a contraindication for this procedure. The prospectively documented data of 370 consecutive patients undergoing laparoscopic cholecystectomy were analysed to investigate, whether this point of view is still justified. 35 of these 370 patients were classified as being severely obese (body-mass-index greater than 33 kg/m2).

Immunohistochemical studies on specificity and affinity of the BB5-antibody against human parathyroid tissue.

Localisation of parathyroid tissue in hyperparathyroidism may be difficult with standard methods. Immunoscintigraphy, using radiolabeled antibodies against epitopes of human parathyroid cells, could be a promising alternative. Therefore, we studied the necessary preconditions, whether the so-called BB5-antibody, directed against parathyroid cell membranes possesses sufficient specificity and affinity to be employed in immunoscintigraphy.

Surgical treatment of carcinoid tumors of the small bowel, appendix, colon and rectum.

Carcinoid tumors occur most frequently in the gastrointestinal tract. Most of these tumors are clinically silent and the diagnosis is not made before surgery. The surgical treatment depends on the localization and the size of the tumor.

[Palliative therapy of complex hilar biliary obstructions using self-expanding metal stents].

Implantation of self-expandable metal stents was planned for 21 patients (12 women, 9 men; mean age 64.7 +/- 11.6 [38-80] years) with malignant obstructive jaundice due to complex hilar biliary obstruction (Bismuth II: n = 5, Bismuth III: n = 13, Bismuth IV: n = 1, state after hepaticojejunostomy: n = 2).

[Laparoscopic adrenalectomy].

Between June and September 1993, laparoscopic adrenalectomy was indicated in five patients (three women, two men; aged 25-50 years). Three had a phaeochromocytoma, two had an adenoma (Conn's syndrome). Four of the five tumours were localized to the right adrenal gland, one to the left.

Expression and distribution of VLA receptors in the pancreas: an immunohistochemical study.

Very late activation (VLA) receptors mediate cell adhesion to extracellular matrix, mainly by acting as adhesion receptors to fibronectin, collagen, and laminin as well as to other cells. These interactions not only regulate normal cell-extracellular matrix contact, but also are thought to be involved in metastasis and invasive tumor growth. Using immunohistochemistry [the alkaline phosphatase-anti-alkaline phosphatase (APAAP) technique] we compared the expression and distribution of VLA receptors in normal pancreatic tissue, chronic pancreatitis, and ductal pancreatic adenocarcinoma.

Preoperative localization of gastrointestinal endocrine tumors using somatostatin-receptor scintigraphy.

Objective: The purpose of this study was to determine the value of somatostatin-receptor scintigraphy (SRS) in the preoperative localization of gastrointestinal endocrine tumors. The authors report their preliminary experiences with this new technique as compared to conventional imaging studies like computed tomography (CT) and ultrasonography (US).

Summary Background Data: Most endocrine tumors possess high-affinity somatostatin-receptors.

[Broad use of laparoscopic cholecystectomy in the teaching clinic. Experiences and results of 300 operations].

Laparoscopic cholecystectomy (LC) was integrated early in surgical training according to the concept "observe, assist and then operate under the assistance of an experienced surgeon". 300 LC's were performed by 27 different surgeons (8 board certified surgeons, 19 residents in the year 2-6 of training). 60.

[Diagnostic and therapeutic procedures in splenic and hepatic artery aneurysms].

The diagnosis and therapy of splenic and hepatic artery aneurysms is besides clinical findings based on ultrasound and selective arteriography. Surgical treatment depends on the exact localization of the aneurysm. Because of postsplenectomy sepsis preservation of spleen should be reached.

[Colon diverticulitis: imaging diagnosis with ultrasound--a prospective study].

In a prospective study, we investigated the value of high resolution sonography for the imaging diagnosis of colonic diverticulitis. A total of 161 patients with abdominal complaints on account of which acute diverticulitis entered into differential diagnosis were included in the study. 74 of these finally had proven colonic diverticulitis (prevalence, 46%).

[Standardized surgical concept for the diagnosis and therapy of Zollinger-Ellison syndrome].

Between 1987 and 1991, 16 patients (13 females, three males; mean age 52.4 [33-73] years) with Zollinger-Ellison syndrome (ZES) were treated according to a standardized surgical concept. The diagnostic work-up consisted of measuring serum gastrin levels, pre-operative localization by ultrasound and abdominal computed tomography, as well as extensive staging by laparotomy.

Partial hepatectomy affects pancreatic size and function in rats.

The effect of partial hepatectomy (62 +/- 2% of liver mass) or sham laparotomy on the pancreas was studied in rats. Pancreatic contents of DNA, protein, and digestive enzymes were measured 14 days postoperatively. Pancreatic acini were prepared to study exocrine pancreatic function after hormonal stimulation.

[Parathyroid gland cancer. Problems in diagnosis and therapy].

Parathyroid carcinoma occurs in 0.1 to 5% as the cause of primary hyperparathyroidism (HPT). It is difficult to determine the true incidence, because parathyroid carcinoma is diagnosed too often due to unreliable histologic criteria.

Ultrasonography in blunt abdominal trauma: influence of the investigators' experience.

The validity of routine ultrasonography (US) in the evaluation of patients with blunt abdominal trauma (BAT) was investigated in a prospective study. From April 1989 to April 1990, 140 patients with suspected BAT were included in this study. Ultrasonography was performed by 17 surgeons using a standardized technique.

Gastric argyrophil (enterochromaffin-like), gastrin, and somatostatin cells after proximal selective vagotomy in man.

The number, size, and volume density of endocrine cells was determined in biopsies obtained endoscopically in patients after proximal selective vagotomy (PSV; N = 31), antrectomy (N = 9), untreated duodenal ulcer (DU) disease (N = 11), and in controls (N = 15). Serum gastrin was significantly elevated after PSV (mean 60 pg/ml) compared to DU patients (29 pg/ml), controls (26 pg/ml), and after antrectomy (11 pg/ml). Volume density of fundic argyrophil (largely enterochromaffin-like) cells after PSV (0.

Perioperative nonspecific histamine release: a new classification by aetiological mechanisms and evaluation of their clinical relevance.

As a consequence of the performance of a randomized controlled clinical trial on perioperative histamine release and cardiovascular and respiratory disturbances, several types of increases in plasma histamine had to be distinguished instead of only two which existed at the beginning of the study: drug-induced allergic and pseudoallergic reactions. First of all, the new classification by aetiology (clinical epidemiology) was derived from a meta-analysis (secondary analysis) of the most recent literature. According to that histamine release in the perioperative period has several, different causes and is involved in several, different disease manifestations.

[What is the cost of laparoscopic cholecystectomy?].

After laparoscopic cholecystectomy (LC) has replaced open cholecystectomy (OC) to a large extent as standard method in the operative treatment of cholecystolithiasis the question of costs and economics raises. To evaluate this question the data of 50 patients who underwent elective LC were analysed in a retrospective study and compared with the data of 50 patients who were cholecystectomized using the open technique. The median of in-hospital stay was 6 (3-15) days for LC and 10 (3-33) days for OC.