Abstract:
BACKGROUND:Bile duct anastomoses are still associated with a high failure rate. Although following iatrogenic bile duct transection only a positive selected group of patients get a primary end-to-end reconstruction, long-term results demonstrate an incidence of postoperative strictures up to 78%. Also in orthotopic liver transplantation biliary tract complications remain a significant cause of morbidity with an incidence of up to 49%. Since these complications can also be seen under optimal circumstances, the methodically based disadvantages of the conventional hand suturing like perforating needle injury of the choledochal wall with intraluminal suture material, the suboptimal approximation of the mucosal edges and an inhibited blood flow in the choledochal stumps caused by a suture related tissue strangulation may also responsible. Thus there is a search for alternative anastomosis techniques. METHOD:To test extramucous placed titanium clips for biliary reconstruction after complete division of the bile duct we performed an end-to-end-anastomosis in 9 pigs. Therefore we used the VCS (Vascular Closure Staples)-instruments (Auto Suture). RESULTS:The application of the VCS-clips (medium size) permitted the technical realization of a tension free, everted anastomosis with an exact approximation of the mucosal edges. One of the animals died from aero embolism intraoperatively. All the others showed a complication-free postoperative period without any signs of anastomotic leakage or stenosis (follow-up: 6 months). At histological examination there were smooth and intact mucosal surfaces in all pigs and--especially important for the development of strictures--only a very mild fibrosis and inflammation. CONCLUSIONS:The potential advantage of the VCS-clip-technique is the non-penetrating tissue approximation with optimal contact of the mucosal layers that does not compromise the blood flow in the choledochal stumps. Before clinical use can be recommended further studies are required.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Birth M,Gerberding J,Markert U,Wohlschläger C,Brugmans F,Bruch HPdoi
10.1055/s-2000-10077subject
Has Abstractpub_date
2000-01-01 00:00:00pages
990-6issue
12eissn
0044-409Xissn
1438-9592journal_volume
125pub_type
杂志文章abstract::The transplantation of marginal organs or those meeting the so-called extended donor criteria (EDC) is today a significant option to alleviate the low availability or organs and to increase the number of transplantation which in turn is -accompanied by a lower mortality among wait-ing-list patients. However such an ex...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1098880
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:To review the endogenous alterations generating critical illness in bowel obstruction. DATA SOURCES:Own experimental and clinical investigations and relevant articles published in international literature. DATA SYNTHESIS AND CONCLUSIONS:Large bowel obstruction is mostly confined to the colon. Passive dilata...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1998-01-01 00:00:00
abstract::From 1973 to June 1982, 218 patients older than 70 years (148 women, 70 men) suffering from acute bowel obstruction were seen at our Dept. The mortality rate came up to 33%. Main causes of the ileus were incarcerated hernias and colonic obstruction (25% each). In case of an incarcerated hernia the authors emphasize ea...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::Interruption of the inferior vena cava by an umbrella-filter, clip or Green-field-filter has been performed in more than 400 patients during the past 14 years. Overall hospital mortality was 1% by clip application and 7% by Mobin-Uddin-umbrella. The indication for this method is limited to those patients suffering fro...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Regular follow-up programs after radical resections of rectal carcinoma have been introduced in numerous hospitals. The main goal of a regular follow-up program is the early diagnosis of tumor recurrence in the asymptomatic stage to allow further radical resection. We evaluated the efficiency (quote of further resecti...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::Patient data management in anaesthesia and intensive care should include besides medical data of individual patients economically important parameters, e.g. working time or cost of material. Integration of this data management system in the hospital information network enables case-oriented analyses for costs in relat...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1996-01-01 00:00:00
abstract::Data on surgical lung cancer cases were extracted from the German Federal Statistics on Diagnosis-related groups (DRG) and a possible association between hospital volume and surgical mortality was explored. All treatment cases documented between 2005 and 2015 with the main diagnosis of lung cancer (International Class...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/a-0806-8021
更新日期:2019-02-01 00:00:00
abstract::There are various ways and means of performing the callus distraction procedures used more and more frequently in the clinic today. The interplay of numerous factors affects the macroscopical and microscopical morphological appearance and thus the quality of the bone regenerate. The radiological appearance during and ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1994-01-01 00:00:00
abstract::From 1966 to 1975 1169 patients underwent a partial gastrectomy (Billroth-II). 944 patients (80%) were followed up by their surgeons in a so call "gastric after-care". On the average these patients were pstoperatively out of work for 58 days. This time depends on postoperative complications, disturbed gastric function...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::In a prospective study, the results following PTA of 30 short stenoses > 70% in 17 infrainguinal arterial bypass grafts were examined. The stenoses were detected after a mean follow-up of 7.2 months by Duplex-ultrasound. The initial success rate after PTA was 100%. After an average time of 4.6 months recurrent graft s...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::Presented is a new technique in preoperative conditioning of the pedicled TRAM-flap employing an interventional-radiologic procedure, selective embolization of the deep inferior epigastric artery (DIEA). During a four year period in 40 patients with a mean age of 48.4 (31-66) years breast reconstruction was performed ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:PURPOSE OF THE STUDY:The current study presents a new technique and results of minimal invasive screw osteosynthesis in the treatment of Bennett's fractures and discusses its advantages and disadvantages. OPERATIVE TECHNIQUE:The Bennett's fragment has to be of sufficient size (at least one quarter of the articular sur...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2003-40628
更新日期:2003-06-01 00:00:00
abstract::Normal ranges, which were set up for quality control, serve to define an acceptable qualitative niveau of treatment. To establish such criteria, it is important to consider group-specific characteristics during investigations. Results of clinical trials are the basics to determine the normal range of parameters of qua...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::The analysis of the genetic causes of tumor development led to the identification of many genes affected in these diseases, which play a role in the control of cell proliferation and apoptosis. However, these studies also suggested that not all alterations are equal with regard to their effect on tumor growth, and the...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:The pancreatic anastomosis may be the Achilles heel in pancreatic surgery. When a postoperative pancreatic fistula develops, be it mild or severe, in some cases life-threatening, POPF-associated complications can occur. OBJECTIVES:Possibilities for the prophylaxis, diagnosis and therapy of POPF and POPF-ass...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0043-119896
更新日期:2018-06-01 00:00:00
abstract::Penetrating injuries of the lower thoracic wall and anterior abdominal wall cause difficulties in the decision for laparotomy. For gunshot wounds laparotomy without further investigations is in most cases justified, but in other penetrating traumata one should use every diagnostic modality to prevent unacceptably high...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::After operation of uncomplicated forms of appendicitis in children postoperative complications characterised by sudden vehement stomach-ache, quickly increasing tension of the abdominal wall, rise of temperature, pulse and white blood cells as well as vomitus, mostly on the fifth post-operative day could be observed. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::56 conservatively treated fractures of the patella with small dislocation are analysed. In comparison with plaster cast immobilisation early functional treatment yields the best results. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::From 1971 through 1996, 16 patients were operated on for atypical aortic coarctation. Three of them (two women, 18 and 27 years old, one boy, 13 years old) had typical signs of neurofibromatosis type I (NF1). All had renovascular hypertension due to suprarenal and/or interrenal aortic stenosis. Two had additional bila...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1997-01-01 00:00:00
abstract::In order to prove the hypothesis--short anamnesis; short survival time--the duration of the anamnesis and the period of survival of 230 patients with carcinoma of the colon were statistically mathematically and graphically investigated. No relationship in accordance with a rule was found between the duration of anamne...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::Changes of the blood flow in the different layers and regions were determined with radioactively labelled microspheres after proximal vagotomy. Under normal conditions and vagal stimulation a significant reduction of the flow in corpus and antrum up to 74% can be observed at least over the time of 3 weeks. This decrea...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract:AIM:Evaluation of the diagnostic and therapeutic management of peripheral steal syndrome after placement of an autologous arteriovenous (av-) fistula and presentation of treatment results after its surgical correction. METHODS:During a time period from 1994 to 1999, 1 253 av-fistulas for hemodialysis were placed in ou...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2002-33705
更新日期:2002-08-01 00:00:00
abstract::Together with the classical conservative treatment or the rarely necessary surgical thrombectomy in patients with acute deep vein thrombosis, catheter-directed thrombolysis is becoming more and more popular. This review provides a critical view on the evidence for catheter-directed thrombolysis providing a "Contra" po...
journal_title:Zentralblatt fur Chirurgie
pub_type: 评论,杂志文章
doi:10.1055/s-0034-1368632
更新日期:2014-10-01 00:00:00
abstract::The combined lesion of the anterior cruciate ligament (ACL) with simultaneous or secondary meniscal tears has severe consequences for the knee joint. By a synopsis of the literature and own experimental investigations in sheep it can be shown that in ACL deficient knees secondary meniscal lesions occur, what finally e...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-01 00:00:00
abstract::About 50% of relaparotomies in the early postoperative period are caused by peritonitis, the lethality ranges from 32 to 88% (average 56%). The most frequent reasons for the development of peritonitis following abdominal surgery are presented as well as the possible way to early diagnosis of this complication. In view...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::Currently, there is no structured training plan to become a transplant surgeon in Germany. Similar to the Anglo-Saxonian educational system we have implemented a 3-year fellowship in transplant and hepatic-, pancreatic-, biliary (HPB) surgery. The educational curriculum is based on the guidelines of the European Board...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0032-1328738
更新日期:2014-06-01 00:00:00
abstract::Heavily injured patients, patients who underwent operations on pelvis, hips, abdomen or malignoma surgery, as well as gynaecology patients suffering from malignoma or previous deep femoral vein thrombosis in connection with pregnancy or obesity are at risk to suffer from pulmonary embolism with potentially lethal cour...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::Diagnosing posttraumatic haemobilia is difficult since the symptoms are neither specific nor early or easy to detect. At present the mortality rate comes up to 20%. Clinical signs and diagnostic procedures are described in detail. Selective ligation of the liver arteries or partial resection of the involved lobes of t...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract:INTRODUCTION:An adequate approach to surgically induced sepsis needs an early and targeted antibiotic therapy in addition to focus sanitation. The PCR-based LightCycler Septifast test can detect 90 % of the sepsis-associated microoganisms (e. g., Gram-positive, Gram-negative bacteria, fungi) within only a few hours. P...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0028-1098776
更新日期:2009-06-01 00:00:00
abstract:UNLABELLED:In 35 patients with diabetic gangrene, amputation above the ankle (n = 18) or below the ankle (n = 17) was planned by nonspecialised general surgical departments or practicing surgeons. Prior to the operation, these patients presented to a specialised diabetic foot clinic; their clinical courses were analyse...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00