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Biomedical subjects

F Kümmerle

Publications and source records attributed to F Kümmerle.

At least 73 records · Page 4Linked to original sources
PubMed1980

[Preoperative percutaneous transhepatic drainage of the biliary system (PTCD) in malignant obstructive jaundice (author's transl)].

Percutaneous transhepatic intubation and drainage of the biliary system were performed in 23 patients, 19 cases preoperatively because of malignant obstructive jaundice. With 12 days the bilirubin serum level went to normal values, and the patients general condition and liver function showed marked improvement. By preoperative PTCD the mortality of palliative procedures in pancreatic carcinoma decreased. Complications occurred in five cases and were easy to manage. Clinical aspects such as indication, optimal period of drainage, and value of other techniques in bile drainage are discussed.

Adult↗
PubMed1980

[Progress in the localization of insulinomas].

Preoperative percutaneous transhepatic portal vein catheterization with selective blood sampling from the pancreatic veins and insulin radioimmunoassay is a very successful new procedure for localization of insulinomas. A careful peroperative inspection and bidigital palpation of the whole pancreas helps to avoid the problems of undetected insulinoma.

Adenoma, Islet Cell↗
PubMed1979

[Modern methods in localization of pheochromocytomas (author's transl)].

In six patients with adrenal pheochromocytoma the tumors were localized by ultrasonography, phlebography of the adrenal glands and by estimation of plasma catecholamines selectively obtained from the vena cava and the adrenal gland veins. All tumors were localized by selective catecholamine estimation, five by ultrasonography, and four by phlebography. The smallest pheochromocytoma of 1.5 g weight was only localized by selective catecholamine estimation but not by ultrasonography or phlebography. This tumor, however, had been visualized by computed tomography. To avoid diagnostic errors by selective catecholamine estimation, it is important to withdraw blood from the adrenal gland veins prior to the injection of any radiographic contrast media, since this may result in an extremely enhanced secretion of catecholamines from the adrenal medulla.

Adrenal Gland Neoplasms↗
PubMed1979

[The diagnosis of phaeochromocytoma: sensitivity of vanillylmandelic acid and urinary catecholamine determination and the Katecult test (author's transl)].

Tumour weight was compared with maximal vanillylmandelic acid and catecholamine excretion in 24-hour urine in 21 patients with phaeochromocytoma. The tumour weight correlated both with vanillylmandelic acid (r = 0.805, P less than 0.001) as well as urinary catecholamine levels (r = 0.725, P less than 0.001). Normal vanillylmandelic acid excretion was found in seven patients; urinary catecholamine levels were abnormal in all patients. The Katecult test was additionally performed in ten patients, with nine positive results.

Adrenal Gland Neoplasms↗
PubMed1979

[Primary hyperparathyroidism (author's transl)].

Experience gained from 100 patients with surgically and histologically proven primary hyperparathyroidism over a period of 14 years led to simplification of diagnostic procedures and development of a surgical scheme. Over the years patients with discrete disease symptoms or with asymptomatic disease were observed more frequently. This can be seen as the result of earlier diagnosis due to increasing spread of laboratory autoanalysers and the resulting routine calcium determination. Development of surgical intervention is characterised by omitting preoperative diagnostic procedures to determine localisation, a schematised operation, and more reliance on macroscopic criteria rather than on quick sections during surgery.

Adolescent↗
PubMed1979

[Surgery of tumors of the endocrine pancreas. Result of a survey made in the Federal Republic of Germany].

Within a ten-year scan (1967-1976) 207 insulinomas, 50 gastrinomas, 8 Verner-Morrison tumours, 5 glucagonomas and 12 endocrine pancreatic tumours with associated MEA syndrome (multiple endocrine adenomatosis) were treated surgically at various university hospitals (information obtained by questionnaire). Half of the insulinomas were treated by enucleation, one third by resection of the tail of the pancreas. Total gastrectomy was the procedure of choice in 80% of patients with gastrinoma, but sometimes pancreatic resection to remove the tumour was added. An new therapeutic concept of using histamine-H2 receptor antagonists for treating patients with Zollinger-Ellison syndrome is discussed. In the eight patients with a Verner-Morrison syndrome removal of the tumour or distal pancreatic resection was the procedure of choice.

Adenoma, Islet Cell↗
PubMed1979

[Indication of delayed surgery in the postacute phase of hemorrhagic necrotizing pancreatitis].

In acute hemorrhagic-necrotizing pancreatitis partial necrosis with good response to conservative therapy can be differentiated from extensive necrosis with no response to conservative therapy. In case of surviving the acute phase sequester and abscess are often to be seen in the "postacute phase", after 10-14 days. The indications for the "delayed operation" in this postacute phase are development of a palpable mass together with clinical deterioration and other complications. The surgical procedure consists of digital removal of necrotic tissue (sequestrotomy), abscess incision and resection. Since 1971 84 of 93 patients with a postacute pancreatitis were operated, two third survived.

Acute Disease↗
PubMed1979

[Cancer of Vater's ampulla].

From 1964 to 1977 a total of 50 patients were operated on for carcinoma of the ampulla of Vater, the second most frequent tumor of the periampullar region. The cardinal symptom was jaundice. The diagnostic procedures of high value were roentgenographic examination of the upper gastrointestinal tract with the use of barium, also hypotonic duodenography, sonography, and percutaneous transhepatic cholangiography (ERCP, angiography). Curative treatment was possible by duodenopancreatectomy, with a resection rate of 74%. The 5-year survival rate was 27% with a postoperative death rate of 13.5%.

Ampulla of Vater↗
PubMed1979

[Geriatric surgery of the upper GI-tract (author's transl)].

The results of surgery of the upper gastrointestinal tract in elderly patients achieved at the Department of Surgery of the University of Mainz are represented. New pathophysiological concepts in peptic ulcer surgery, improved preoperative procedures like endoscopic retrograde cholangiography (ERC) and percutaneous transhepatic cholangiography (PTC) in diseases of the biliary tree are important contributions to the indications and operative tactics. The rules of cancer surgery are also true in geriatric surgery. Diagnostic and therapeutic procedures should be restricted according to the particular limits set up by age.

Abdomen↗
PubMed1978

[Surgery of endocrine pancreatic tumors. Results of a survey in the German Federal Republic].

Within a ten-year scan (1967-1976) 207 insulinomas, 50 gastrinomas, 8 Verner-Morrison tumours, 5 glucagonomas and 12 endocrine pancreatic tumours with associated MEA syndrome (multiple endocrine adenomatosis) were treated surgically at various university hospitals (information obtained by questionnaire). Half of the insulinomas were treated by enucleation, one third by resection of the tail of the pancreas. Total gastrectomy was the procedure of choice in 80% of patients with gastrinoma, but sometimes pancreatic resection to remove the tumour was added. An new therapeutic concept of using histamine-H2 receptor antagonists for treating patients with Zollinger-Ellison syndrome is discussed. In the eight patients with a Verner-Morrison syndrome removal of the tumour or distal pancreatic resection was the procedure of choice.

Adenoma, Islet Cell↗
PubMed1978

[Gastrointestinal complications of acute pancreatitis (author's transl)].

Gastrointestinal complications, such as ileus, bleeding, stenosis and fistula formation, were retrospectively analysed on 180 patients with acute pancreatitis. Paralytic ileus occurred in only a quarter of patients with acute oedematous pancreatitis and only one had bleeding from a gastric ulcer. Complications occurred in the early but also postacute stage in patients with the haemorrhagic-necrotizing form. Even with early and delayed operation and adequate treatment of most complications, renewed gastrointestinal complications were not uncommon and required re-operations.

Acute Disease↗