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  • Esophageal involvement  (1)
  • Ileus  (1)
  • Key words: Laparoscopic ultrasound—Intraoperative cholangiogram—Digital fluorocholangiogram—Laparoscopic cholecystectomy—Choledocholithiasis  (1)
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Material
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  • 1
    Electronic Resource
    Electronic Resource
    A comparison of laparoscopic ultrasound with digital fluorocholangiography for detecting choledocholithiasis during laparoscopic cholecystectomy (1998)
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 929-932 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopic ultrasound—Intraoperative cholangiogram—Digital fluorocholangiogram—Laparoscopic cholecystectomy—Choledocholithiasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Laparoscopic ultrasound is an alternative to operative cholangiogram for evaluation of the common bile duct (CBD) during laparoscopic cholecystectomy. It is a safe, fast, and reliable method for detecting choledocholithiasis. Methods: We prospectively evaluated the sensitivity and specificity of laparoscopic ultrasound (LUS) and digital fluorocholangiogram (DFCG) in a three-phase study of 360 consecutive patients. Results: In phase I, 140 patients undergoing laparoscopic cholecystectomy had LUS performed first, followed by DFCG. Thirteen patients had CBD calculi identified on LUS. Four patients with confirmed (two cases) or presumed (two cases) CBD calculi on DFCG were not identified on LUS. Thus, the specificity of LUS was 100%, whereas the sensitivity was 76.5%. DFCG had four false positives, for a sensitivity of 100% with a specificity of 96.7%. LUS was performed, on average, in 6.6 min, whereas DFCG required 10.9 min to perform. In phase II, the infusion of saline through a cystic duct catheter was performed in instances where the distal CBD could not be well seen. This maneuver distended the intrapancreatic portion of the CBD, allowing better visualization. Nine stones were identified on LUS in 78 patients, increasing the sensitivity to 100%. One false positive DCFG was encountered, resulting in a sensitivity of 100% and a specificity of 98.6%. In phase III, we performed routine LUS and used DFCG only in select cases. The sensitivity and specificity for LUS were 95.7% and 100%, respectively, whereas DFCG had a sensitivity of 95.2% and a specificity of 100%. One patient in phase III has returned 11 months post-op with a CBD stone. This was initially missed on LUS, DFCG, and postoperative ERCP. The sensitivity and specificity in all 360 patients were 90% and 100% for LUS and 98.1% and 98.1% for DFCG, respectively. A total of five CBD stones were missed by LUS, four early in the study (phase I). One missed on LUS in phase III was also missed by DFCG and ERCP. Conclusions: LUS is a reliable alternative to DFCG during laparoscopic cholecystectomy (LC). With experience, it is as sensitive as DFCG and more specific. It is more rapidly performed than cholangiography.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900749
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    185. Notfallcoloskopie als Entscheidungshilfe für die Operationsindikation (1986)
    Springer
    Langenbeck's archives of surgery 369 (1986), S. 743-743 
    Details
    ISSN: 1435-2451
    Keywords: Colonoscopy ; Acute intestinal bleeding ; Ileus ; Acute pseudo-obstruction ; Coloskopie ; Akute untere Intestinalblutung ; Ileus ; Akute Pseudoobstruktion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In 5 Jahren wurden von 1565 Coloskopien 30 (1,9%) notfallmäßig durchgeführt. Bei 7 von 13 Patienten mit akuter Intestinalblutung war eine Lokalisation ohne Segmentzuordnung im Colon möglich. Bei 13 von 17 Patienten mit klinischen und radiologischen Zeichen eines Dickdarmileus ergab sich durch den endoskopischen Ausschluß eines mechanischen Hindernisses die Diagnose einer akuten Pseudoobstruktion. 12 dieser meist polymorbiden Patienten konnten durch die gleichzeitige endoskopische Dekompression risikoarm und erfolgreich therapiert werden. Bei strenger Indikationsstellung war die Notfallcoloskopie eine Hilfe sowohl für die OP-Indikaton wie für den OP-Zeitpunkt und das intraoperative Vorgehen.
    Notes: Summary In 5 years, 30 of 1565 colonoscopies (1.9%) were performed as emergency procedures. In 7 of 13 patients with acute intestinal bleeding, localization to the colon without determination of the segment was possible. In 13 of 17 patients with clinical and radiological signs of colonic ileus, the diagnosis of acute pseudo-obstruction was established endoscopically by ruling out mechanical obstruction. Of these morbidly ill patients, 12 could be safely treated by endoscopic decompression with success. With a strict indication for surgery emergency colonoscopy was a great aid to determining both the indication for and the time of operation, as well as the intra-operative procedure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01274503
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Long-term manometry of tubular esophagus in progressive systemic sclerosis (1994)
    Springer
    Journal of molecular medicine 72 (1994), S. 343-349 
    Details
    ISSN: 1432-1440
    Keywords: Long-term manometry ; Progressive systemic sclerosis ; Esophageal involvement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Long-term manometry of the tubular esophagus was performed in 20 consecutive patients (18 females, 2 males; median age 56.5 years) with progressive systemic sclerosis (PSS) and a control group of 20 healthy subjects (18 females, 2 males; median age 56.5 years). The measurements were performed via a data logger of 1 MByte memory capacity with the help of two pressure sensors placed 8 and 18 cm above the lower esophageal sphincter. Esophageal contractions were analyzed with respect to pressure amplitudes in the esophagus distal and proximal, quotient of pressure amplitudes distal/proximal, number of contraction waves in a 24-h period, and kind of spreading (propulsive, simultaneous). In the PSS group there was a significant decrease in pressure amplitudes in the distal sensor (median 31.5 versus 39.5 mbar in controls, P 〈 0.02), in the quotient of pressure amplitudes distal/proximal (median 0.885 versus 1.25 in controls, P 〈 0.001), in the number of waves in 24 h (median 939.5 versus 1656 in controls, P 〈 0.01), and in the occurrence of propulsive waves (median 34% versus 57% in controls, P 〈 0.01). Fifteen patients (75%) had hypomotility disorders as compared to the control group, in which the lower limit of normal values was defined by the 5th percentile of descriptive analysis. These first data of long-term manometry in patients with PSS indicate that long-term manometry may be an effective method for identifying esophageal involvement in PSS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00252825
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    Paper (German National Licenses)
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