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  • 1
    Electronic Resource
    Electronic Resource
    Computed tomography of carcinoma in the pancreatic head (1981)
    Springer
    Abdominal imaging 6 (1981), S. 343-347 
    Details
    ISSN: 1432-0509
    Keywords: Computed tomography ; Pancreas ; Head of pancreas ; Pancreatic neoplasms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Computed tomographic findings in patients with localized and extensive pancreatic head cancer were studied. Widening of the pancreatic duct existed in both groups; mass shadow was hardly detected in localized and rather easily detected in extensive cancer; duodenal invasion and obliteration of fat planes were found only in extensive type; enlargement of the pancreas was a confusing factor of tumor detection in localized type; atrophy of the pancreatic body and tail was a most favorable indirect sign in extensive cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01890283
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  • 2
    Electronic Resource
    Electronic Resource
    CT demonstration of annular pancreas: Case report (1983)
    Springer
    Abdominal imaging 8 (1983), S. 143-144 
    Details
    ISSN: 1432-0509
    Keywords: Pancreas ; Annular pancreas ; CT diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A patient with annular pancreas is described. CT succeeded in visualization of a peninsular protrusion of the parenchyma from the pancreatic head. In the diagnosis of annular pancreas, CT provided unequivocal evidence before operation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01948107
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  • 3
    Electronic Resource
    Electronic Resource
    Increased biliary cholesterol secretion in alloxan diabetic mice (1984)
    Springer
    Surgery today 14 (1984), S. 174-183 
    Details
    ISSN: 1436-2813
    Keywords: alloxan diabetic mice ; biliary cholesterol secretion ; lithogenic index ; dietary cholesterol ; bile acid metabolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Plasma and liver cholesterol levels and biliary cholesterol, phospholipid and bile acid concentrations were examined in normal and alloxan diabetic mice fed ordinary and 0.5 per cent cholesterol diets. The plasma and liver cholesterol levels markedly increased in the diabetic mice, and the cholesterol diet further increased the liver cholesterol level but not that in the plasma. The gallbladder bile weight increased in the diabetic mice, but not after the cholesterol diet. The biliary lipid concentrations markedly increased in the diabetic mice, and the increases of the cholesterol and phospholipids exceeded that of the bile acids, resulting in increases of the cholesterol molar concentration ratio (mole percent) and the lithogenic index. The cholesterol diet increased the biliary cholesterol concentration and slightly the phospholipid, but not the bile acids. Therefore, the cholesterol mole percent and the lithogenic index increased. Among the biliary bile acid composition, cholic and deoxycholic acids increased and β-muricholic acid decreased in the diabetic mice, whereas the cholesterol diet feeding decreased cholic acid and increased chenodeoxycholic and α-muricholic acids. These data suggest that the mechanism of the increase of biliary cholesterol secretion in diabetic mice is different from that after cholesterol diet.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02469813
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Better control of esophageal variceal bleeding by sclerotherapy followed by surgery (1990)
    Springer
    Surgery today 20 (1990), S. 260-268 
    Details
    ISSN: 1436-2813
    Keywords: acute variceal bleeding ; endoscopic sclerotherapy ; back-up surgical treatment ; distal splenorenal shunt
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This paper reports the clinical results of a retrospective study comparing endoscopic injection sclerotherapy (EIS) and back-up surgical treatment after EIS in the management of acute variceal bleeding. The 74 patients included in the study were divided into 2 groups. Group I consisted of 41 patients who received EIS over a mean period of 2.2 sessions and Group II consisted of 33 patients who underwent EIS and subsequent surgical intervention, in the form of 19 distal splenorenal shunts and 14 nonshunting procedures. The overall percentage of patients in whom initial control of variceal bleeding was achieved was 91.8 per cent. Four of the Group II patients were saved by emergency nonshunting operations. Rebleeding was experienced by 4 (28.6 per cent) of the 14 patients who underwent nonshunting surgery but by only 1 (5.3 per cent) of the 19 patients who underwent selective shunt surgery. The cumulative survival in Group II was significantly superior to that in Group I with 2 year survival being achieved in 66.7 per cent of the Group II patients but in only 23 per cent of Group I patients. Thus, the combination of initial EIS and back-up surgical intervention may be more benefical than sclerotherapy alone for patients with acute variceal bleeding, while, the distal splenorenal shunt may be a more suitable surgical technique for patients having previously EIS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02470659
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  • 5
    Electronic Resource
    Electronic Resource
    Lymphoepithelial cyst of the pancreas with sebaceous differentiation (2000)
    Springer
    Journal of gastroenterology 35 (2000), S. 396-401 
    Details
    ISSN: 1435-5922
    Keywords: Key words: pancreatic true cyst ; lymphoepithelial cyst ; sebaceous gland
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: We recently encountered a patient with a lymphoepithelial cyst of the pancreas with sebaceous differentiation. We sought to compare the characteristics of this patient with those previously reported in order to foster a keener understanding of this rare clinical entity. After reviewing the present patient's case in detail, we conducted a comprehensive review of the English-language literature and analyzed the clinical characteristics of reported cases of lymphoepithelial cysts. Our patient was an asymptomatic 60-year-old man who presented with an incidental finding of a cystic lesion in the tail of the pancreas documented by computed tomography. The cyst was enucleated, and was found to contain keratinized material. It was lined by squamous epithelium with small sebaceous glands, and surrounded by lymphoid tissue with germinal centers. Of 33 reported cases, only 6 (18%) contained sebaceous glands. In all patients who underwent operation, the cysts were easily resected, and the outcome was favorable. Lymphoepithelial cyst of the pancreas is rare, and may be difficult to differentiate from cystic neoplasms preoperatively. Therefore resection is indicated. The diagnosis, however, can be confirmed by careful histologic review, and the prognosis is excellent.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005350050367
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  • 6
    Electronic Resource
    Electronic Resource
    Surgical management of acute hemorrhagic postbulbar duodenal ulcer after a previous major surgical procedure (1985)
    Springer
    Surgery today 15 (1985), S. 348-354 
    Details
    ISSN: 1436-2813
    Keywords: acute ulcer ; postbulber duodenal ulcer ; hemorrhagic ulcer ; gastrectomy ; vagotomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The choice of operation for acute hemorrhagic postbulbar duodenal ulcer after an operation is discussed. Distal partial gastrectomy was performed in six patients. The ulcer was treated by resection, suture, or removal by mucoclasis. Hemostasis was attained in five patients. In another, multiple ulcers were observed in the descending portion of the duodenum and gastrectomy failed to control hemorrhage, resulting in death. Rebleeding was observed in two, one from a newly formed ulcer in the upper part of the papilla of Vater after gastrectomy with truncal vagotomy and which was halted by suture of the ulcer and another was from a newly formed ulcer in the remnant stomach after gastrectomy and which was halted by selective vagotomy and ligation of the left gastric artery. It is recommendable to perform a subtotal gastrectomy and vagotomy combined with removal of the ulcer by mucoclasis or ulcer suture. In some cases, pancreatoduodenectomy may have to be done.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02469929
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  • 7
    Electronic Resource
    Electronic Resource
    Hepatobiliary and gastrointestinal imaging after pancreaticoduodenectomy —A comparative study on Billroth I and Billroth II reconstructions (1990)
    Springer
    Surgery today 20 (1990), S. 294-299 
    Details
    ISSN: 1436-2813
    Keywords: pancreaticoduodenectomy ; Imanaga's reconstruction ; Child's reconstruction ; proximal jejunal loop ; dual scintigraphy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study was conducted to compare the passage of bile and food through the remnant alimentary tract between 2 and 6 months following pancreaticoduodenectomy in patients undergoing Billroth I (Imanaga) and Billroth II (Child) reconstructions, using dual scintigraphy. In the patients who underwent Child's operation (n=14), hepatobiliary scintigraphy showed a prominent stasis of bile tracer in the proximal jejunal loop and a significant time delay before the bile and food became mixed at the upper jejunum. On the other hand, in the patients who underwent Imanaga's operation (n=9) no bile stasis in the proximal jejunal loop was found and the time taken before the two agents became mixed was similar to that of healthy controls (n=7). The time taken for the two agents to mix at the upper jejunum was 65.8±7.9 min in the patients after Child's operation, 17.3±2.5 min in those after Imanaga's operation, and 18.5±2.8 min in the healthy controls, respectively. Continuous stasis of bile in the proximal loop and severe postcibal asynchronism in patients who undergo Child's operation can therefore cause reflux cholangitis and absorptive disturbances in the long postoperative term. The results of this study suggest that Imanaga's reconstruction is a more physiological procedure than Child's reconstruction following pancreaticoduodenectomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02470664
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  • 8
    Electronic Resource
    Electronic Resource
    Modified segmental gastrectomy combined with vagotomy for a gastric ulcer near the gastro-esophageal junction (1991)
    Springer
    Surgery today 21 (1991), S. 125-127 
    Details
    ISSN: 1436-2813
    Keywords: gastric ulcer ; segmental gastrectomy ; vagotomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To avoid proximal gastrectomy which destroys the gastroesophageal closing mechanism, modified segmental gastrectomy with vagotomy was performed on 3 patients with gastric ulcers located in the stomach near the gastro-esophageal junction. These were all patients in whom a proximal gastrectomy would usually have been performed. The proximal line of resection did not encroach upon the mucosal rosette being within 1 cm of it following the margin of the ulcer. In each patient, the modified segmental resection of the upper stomach consisted of the surgical removal of a continuous strip of tissue including the ulcer and ulcer-bearing area along the wall followed by an end to end gastro-gastrostomy. In the 10 years following surgery, there have been no signs of reflux esophagitis, stricture, or recurrent ulcers in any of the 3 patients. This modified segmental gastrectomy with vagotomy is therefore recommended for gastric ulcers located near the gastro-esophageal junction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02470878
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  • 9
    Electronic Resource
    Electronic Resource
    Progesterone inhibits the contractile motility of the guinea pig gallbladder (1987)
    Springer
    Surgery today 17 (1987), S. 388-394 
    Details
    ISSN: 1436-2813
    Keywords: carbachol ; histamine ; cholecystokinin-octapeptide ; calcium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied the effects of progesterone on the contractile motility of the guinea pig gallbladderin vitro. Carbachol (10−6 M) induced contractions were reduced by the pretreatment with progesterone (10−8–10−6 M) in a dose-dependent manner. Concentration-response curves for carbachol, histamine and CCK-OP showed inhibition by progesterone (5×10−7 M). These results suggest that progesterone has a direct inhibitory effect on gallbladder smooth muscle. Contractile responses to potassium (10–60 mM) or calcium (0.4–3.2 mM), which were thought to activate the contractile machinery by increasing the influx of extracellular calcium, were not affected by the pretreatment of progesterone. The direct inhibitory effects of progesterone on gallbladder smooth muscle might be explained by the inhibition of calcium release from the intracellular storage sites.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02470639
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  • 10
    Electronic Resource
    Electronic Resource
    Follow up studies on various reconstruction methods of the biliary tract including our new method (Roux Y-duodenojejunal anastomosis) (1988)
    Springer
    Surgery today 18 (1988), S. 179-186 
    Details
    ISSN: 1436-2813
    Keywords: Roux Y ; jejunal interposition ; reflux cholangitis ; biliary diversion ; simultaneous scintigraphy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Thirty six patients with benign diseases of the biliary tract (14 patients with congenital choledochal dilatation, 15 patients with postoperative stricture and 7 patients with others) were divided into three groups: 21 patients who underwent a Roux Y (RY), 7 patients who underwent a jejunal interposition (IP) and 8 patients who underwent a side to side anastomosis between the jejunal limb of the Roux Y and the duodenum (RY-DJ). The RY-DJ was designed to decompress the Roux Y jejunal limb and to allow an inflow of bile into the duodenum. Significant complications, including cholangitis, infection, or abdominal pain, developed in 10 of the patients with RY (48 per cent), 7 of the patients with IP (100 per cent) and 1 of the patients with RY-DJ (13 per cent). None had a postoperative peptic ulcer. Simultaneous scintigraphy showed the time required for the two agents,99mTc-IDA and111In-DTPA, to mix at the upper jejunum, which revealed that the time taken by the patients with RY-DJ was similar to that of the patients with IP and to that of healthy controls. The time was markedly longer in the patients with RY, presumably due to a prominent stasis of the bile tracer in the Roux Y jejunal limb. Our new method (RY-DJ) for reconstruction of the extrahepatic biliary tract is more physiological and has less postoperative complications than other conventional methods.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02471428
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