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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 5 (1991), S. 51-56 
    ISSN: 1432-2218
    Keywords: Cholelithiasis ; Cholecystotomy ; Interventional technique ; Minimally invasive surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary This instrument set for a single puncture technique of laparoscopic cholecystotomy was developed in 100 phantom tests with pig gallbladders and was later evaluated in 12 animal experiments. No complications were observed. After clinical development, treatment on an outpatient basis under local anaesthesia seems possible. For the patient this would mean avoiding general anaesthesia, shorter hospitalization, pain reduction and good cosmetic results, while reducing expenditure for the public health authorities at the same time. To avoid recurrent stones, diet and low-dose drug therapy should be considered. Because the procedure is minimally invasive, repetition of the laparoscopic procedure seems justified if stones recur.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 366 (1985), S. 607-607 
    ISSN: 1435-2451
    Keywords: Indication for operation ; Complications ; Rate of marginal ulcers ; Indikationsstellung ; Komplikationen ; Rezidivrate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In der Chirurgischen Uni-Klinik Göttingen wurden von 1976–1983 40 Patienten mit einem Ulcus pepticum jejuni diagnostiziert. Eine transthorakale Vagotomie wurde 12mal durchgeführt. Die Indikationsstellung richtete sich nach der Größe des Restmagens, der Magenentleerung, der Anamnese und dem Ausschluß endokriner Ursachen. Postoperative Komplikationen traten in 4 Fällen auf (Pleuraerguß, Dystelektase). 1 Patient verstarb an einer Oesophagusvaricenblutung. 3 Patienten wiesen Rezidive auf, 2 Nachresektionen waren erforderlich. Die transthorakale Vagotomie ist im Vergleich zur Nachresektion risikoärmer. Die Rezidivrate beträgt etwa 10%. Präoperative Diagnostik zum Ausschluß endokriner Störungen ist erforderlich.
    Notes: Summary At the Department of Surgery of the University of Göttingen, 40 patients were diagnosed from 1976–1983 as having a jejunal peptic ulcer. In 12 patients transthoracic vagotomy was performed, depending on the size of the remaining stomach, undisturbed passage, anamnesis, and exclusion of endocrine disorders. Postoperative complications were seen in 4 patients (pleural exudate, dystelectasis), and 1 patient died of gastrointestinal bleeding (liver cirrhosis). Marginal ulcers were seen in 3 patients; two re-resections were necessary. Transthoracic vagotomy showed a smaller rate of complications in comparison with re-resection. Marginal ulcers amounted to up to 10%. Preoperative exclusion of endocrine disorders in necessary.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1435-2451
    Keywords: Cholecystotomy ; Minimally invasive surgery ; Laparoscopy ; Interventional technique
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Als Ergänzung von konservativen und interventionellen Verfahren zur Entfernung von Gallensteinen unter Erhaltung einer funktionsfähigen Gallenblase wurde die laparoskopische Cholezystotomie von einem Zugang aus entwickelt. Dazu wurden 120 Phantomversuche an Schweinegallenblasen durchgeführt. In 20 Tierexperimenten mit Schweinen wurden keine wesentlichen Komplikationen beobachtet. Als Vorteile des Verfahrens im Vergleich zu einigen konkurrierenden Methoden sind sofortige Steinfreiheit, Entfernung auch kalkhaltiger Steine and definitiver Verschluß der Gallenblase zu nennen. Ein ambulanter Eingriff in Lokalanäs-thesie erscheint nach Einführung in die Kliniksroutine möglich. Die wesentliche Indikation dürften Patienten mit hohem Operationsrisiko darstellen. Die Cholezystotomie ist als Alternative zur perkutanen Litholyse und zur ESWL anzusehen.
    Notes: Summary The laparoscopic cholecystotomy was developed to remove calculi while preserving a functioning gallbladder. 120 phantom tests on pig's gallbladders were performed. No major complications were observed in 20 animal experiments with pigs. Compared with competing conservative and interventional methods the laparoscopic cholecystotomy provides immediate removal of stones and a definite closure of the gallbladder by a clip. Calcified stones are no contraindication for the procedure. After introduction into the clinical routine, an outpatient treatment in local anaesthesia seems to be possible. Patients with a high operative risk should be treated by this method. The laparoscopic cholecystotomy represents an alternative to the percutaneous transhepatic litholysis and the ESWL.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 366 (1985), S. 429-433 
    ISSN: 1435-2451
    Keywords: Tube caecostomy ; Healing ; Complications ; Selbstheilende Coecalfistel ; Heilungsverlauf ; Komplikationen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 83 Patienten wurde nach distalen Dickdarmresektionen eine Entlastung des Dickdarmes mit einer selbstheilenden Caecalfistel nach Stelzner vorgenommen. Neben 26 tiefen anterioren Resektionen wurden 54 anteriore Resektionen und 3 linksseitige Hemicolektomien entlastet. 10,8% der Fisteln mußten operativ verschlossen werden. Anastomoseninsuffizienzen traten in 3,8% der Fälle klinisch in Erscheinung. Die selbstheilende Coecalfistel erweist sich als wirksames Verfahren zur Anastomosenentlastung und zeigt eine geringere Eigenkomplikationsrate als die protektive Kolostomie. Kolostomie.
    Notes: Summary A retrospective study of 83 patients who underwent caecal fistula as described by Stelzner during the five-year period between 1979 to 1984 was carried out. 26 fistulas were performed after low anterior resection, 54 after anterior resection and 3 after left hemicolectomy. In 10.8% the operative closure of the fistula was necessary. An anastomotic insufficency could be recognized clinically in 3.8%. The overall complication rate was 21.7%. The caecal fistula seems to be an effective procedure with a lower complication rate than the temporary colostomy.
    Type of Medium: Electronic Resource
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