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  • 1
    Electronic Resource
    Electronic Resource
    The quantification in human gastric juice of duodenogastric reflux by sodium output and by bile-labelling using indocyanine green (1979)
    Springer
    Journal of molecular medicine 57 (1979), S. 815-824 
    Details
    ISSN: 1432-1440
    Keywords: duodeno-gastrischer Reflux ; Magensaft ; Galle-Markierung ; Duodenogastric reflux ; Gastric juice ; Bile labelling
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Ten minute samples of gastric juice were collected by naso-gastric aspiration during maximal histamine stimulation in 14 subjects (6 normal, 8 with duodenal ulceration). In eight of these studies, a simultaneous intravenous infusion of Indocyanine green (ICG) was used to label the bile. A single intravenous injection of Boots secretin was given during the maximal plateaux, and further samples collected. The volume, titratable acidity, electrolyte concentrations and ICG concentrations were measured. Changes in volume and in electrolyte concentrations after secretin were consistent with the hypothesis that secretin stimulated duodenogastric reflux, and that duodenogastric reflux was the major determinant of spontaneous variations in electrolyte concentrations in gastric aspirate. Duodenogastric reflux was calculated by a previously described formula based on the sodium content of the aspirate, and this was found to correlate well with the concentration of the ICG label in the aspirate.
    Notes: Zusammenfassung 10 min-Proben von Magensaft wurden mit Hilfe der nasogastrischen Aspiration während maximaler Histaminstimulation bei 14 Personen gesammelt (6 Normalpersonen, 8 Patienten mit Ulcus duodeni). Bei 8 dieser Untersuchungen wurde eine gleichzeitige Infusion mit Indocyanin Grün (ICG) verwendet, um die Galle zu markieren. Eine intravenöse Einzelinjektion von Boots-Sekretin wurde während der maximalen Plateausekretion gegeben und weitere Proben wurden gesammelt. Volumen, titrierbare Azidität, Elektrolyt- und I.C.G.-Konzentrationen wurden gemessen. Veränderungen im Volumen und in den Elektrolytkonzentrationen nach Sekretin stimmten mit der Hypothese überein, daß Sekretin den duodenogastrischen Reflux stimuliert und daß der duodeno-gastrische Reflux die Hauptdeterminante für spontane Variationen in den Elektrolytkonzentrationen im Magenaspirat ist. Der duodeno-gastrische Reflux wurde mit einer früher beschriebenen Formel berechnet, die auf dem Natriumgehalt des Aspirates basiert. Dies erwies sich als gut korreliert mit der Konzentration des ICG im Aspirat.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01477986
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  • 2
    Electronic Resource
    Electronic Resource
    Diagnosis and treatment of common bile duct stones (CBDS) (1998)
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 856-864 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Common bile duct stones — Gallbladder — Bile duct calculi — Laparoscopic cholecystectomy — Endoscopic retrograde cholangiopancreaticography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Common bile duct stones (CBDS) are a frequent problem (10–15%) in patients with symptomatic cholecystolithiasis. Over the last decade, new diagnostic and surgical techniques have expanded the options for their management. This report of the Consensus Development Conference is intended to summarize the current state of the art, including principal guidelines and an extensive review of the literature. Methods: An international panel of 12 experts met under the auspices of the European Association of Endoscopic Surgery (EAES) to investigate the diagnostic and therapeutic alternatives for gallstone disease. Prior to the conference, all the experts were asked to submit their arguments in the form of published results. All papers received were weighted according to their scientific quality and relevance. The preconsensus document compiled out of this correspondence was altered following a discussion of the external evidence made available by the panel members and presented at the public conference session. The personal experiences of the participants and other aspects of individualized therapy were also considered. Results: Our panel of experts agreed that the presence of common bile duct stones should be investigated in all patients with symptomatic cholecystolithiasis. Based on preoperative noninvasive diagnostics, either endoscopic retrograde cholangiopancreaticography (ERCP) or intraoperative cholangiography should be employed for detecting CBDS. Eight of the 12 panelists recommended treating any diagnosed CBDS. For patients with no other extenuating circumstances, several treatment options exist. Stones can be extracted during ERCP, or either before or (in exceptional cases) after laparoscopic or open surgery. Bile duct clearance should always be combined with cholecystectomy. Evidence for further special aspects of CBDS treatment is equivocal and drawn from nonrandomized trials only. Conclusions: The management of common bile duct stones is currently undergoing some major changes. Many diagnostic and therapeutic strategies need further study.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900729
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  • 3
    Electronic Resource
    Electronic Resource
    Percutaneous cholecystolithotomy (1989)
    Springer
    World journal of urology 7 (1989), S. 129-130 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Initial experience with percutaneous cholecystolithotomy is described. The procedure was carried out in 46 patients with successful access in 42 (91%). Results were encouraging with a high rate of removal of stones and a low complication rate. It is suggested that stone clinics should be capable of managing both biliary and renal calculi, and that the technology should be shared between the teams involved.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01637367
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  • 4
    Electronic Resource
    Electronic Resource
    The effect of a second-generation 3D endoscope on the laparoscopic precision of novices and experienced surgeons (1999)
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 1087-1092 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopic surgery — 3D laparoscope — 2D laparoscope — Performance — Assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Endoscopic surgeons rely on visual feedback to control their movements but lack stereopsis, an important depth cue. Previous three-dimensional (3D) systems alternated images on a two-dimensional (2D) screen, which was uncomfortable for surgeons. A second-generation 3D system provides continuous stereoscopic images on a monitor suspended at arm's length. We studied its effect on the laparoscopic precision of novices and experienced surgeons. Methods: Experienced laparoscopic surgeons (n= 12) and novices (n= 16) performed a total of 672 tasks in 2D, 3D, and under direct vision. Precision was assessed using the Imperial College Surgical Assessment Device (ICSAD), which generates objective scores of performance by analyzing the movements of surgical instruments. Results: We found that 2D endoscopic vision impaired performance by 35–100% when compared with direct vision, whereas 3D reduced this endoscopic handicap by 41–53% in novices and experienced surgeons (p 〈 0.03). No side effects were reported with the new 3D system. Even in 2D, novices performed better with an image at arm's length (p 〈 0.03). Conclusions: Second-generation 3D significantly improved the laparoscopic precision of novices and experienced surgeons, without the side effects reported from previous systems. This technology is expected to improve the ease and safety of laparoscopic surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649901179
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  • 5
    Electronic Resource
    Electronic Resource
    Duodenum-Preserving total pancreatectomy for chronic pancreatitis (1995)
    Springer
    Journal of hepato-biliary-pancreatic surgery 2 (1995), S. 45-51 
    Details
    ISSN: 1436-0691
    Keywords: total pancreatectomy ; duodenum-preservation ; chronic pancreatitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Preservation of the duodenum when performing total pancreatectomy lessens postoperative gastrointestinal disturbance. This paper describes the technique of duodenum-preserving total pancreatectomy where all pancreatic tissue within the C-loop is removed, and compares the out-come of patients who had a duodenum-preserving procedure with those who underwent a standard pancreatoduodenectomy. There was no operative mortality following duodenum-preserving total pancreatectomy, and all patients are alive at 46–125 months follow up. The major drawback of duodenum preservation has proven to be the development of a biliary stricture, in six patients. In carefully selected patients, duodenum-preserving total pancreatectomy has produced good long-term results.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02348287
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  • 6
    Electronic Resource
    Electronic Resource
    Amoxycillin/clavulanic acid (augmentin)-induced intrahepatic cholestasis (1989)
    Springer
    Digestive diseases and sciences 34 (1989), S. 1290-1293 
    Details
    ISSN: 1573-2568
    Keywords: amoxycillin ; clavulanic acid ; augmentin ; intrahepatic cholestasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A 75-year-old man developed a biopsy-proven, drug-induced intrahepatic cholestasis after use of amoxycillin trihydrate combined with the Β-lactam inhibitor potassium clavulanate (Augmentin). Cholestatic liver injury is an uncommonly recognized, probably immunologically based adverse reaction to therapy with penicillin and its derivatives.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01537281
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