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Biomedical subjects

G Kautz

Publications and source records attributed to G Kautz.

29 records · Page 2Linked to original sources
PubMed1980

[The Caroli syndrome].

Caroli's disease is characterized by congenital pseudocystic dilatation of the biliary tree. Inflammation and stone formation lead to clinical manifestation in the second decade. ERC and computed tomography are main diagnostic procedures. In cases, where the alterations are limited partial hepatectomy has been recommended. If dilatations are diffuse, the aim of surgical treatment is the performance of a choledochojejunostomy to realize drainage and prevent recurrent ascending cholangitis.

Adult↗
PubMed1979

[Surgical or endoscopic papillotomy? (author's transl)].

Endoscopic papillotomy has become a competitive method to the surgical technique. Endoscopy took over many cases formerly treated surgically. The indications to either procedure are defined. The alterations of papilla and peripapillary region of choledochus are treated by endoscopy. The surgical method is indicated in gallbladder diseases, in further accessory operations and in failing of endoscopic proceeding. The complication rate of endoscopic papillotomy is 6.7 p.c. and about 20 p.c. under the rate of the surgical method. The relation of mortality rate is given with 1.5 p.c.: 3.8 p.c. in favour of endoscopy. Indications, advantages, disadvantages and complications of both methods are discussed, using the own case material of 211 surgical and 714 endoscopic papillotomies.

Aged↗
PubMed1979

[Relaparotomy or endoscopic surgery in complications after bile duct surgery].

The number of cases in bile duct surgery has continuously increased since second world war. Correcting operation is necessary in 5 to 7% after cholecystectomy. Since 1973 more and more the endoscopic treatment takes place of surgery. Typical complications can be divided into two groups belonging to their manifestation. Early complications are due to an insufficient intraoperative diagnosis or injuries of bile tract. Late complications comprehend successive development of duct stenosis and cholangitis. The therapeutic possibilities of endoscopic papillotomy are directed only to the papilla and near-by sections of the choledochus, while surgical treatment is due to the more difficult performance of iatrogenic lesions. The indications to each method are shown and discussed by 138 surgical and 714 endoscopic treatments.

Biliary Tract Diseases↗
PubMed1979

Gastric stump carcinoma -- carcinogenic factors and possible preventive measures.

Cancer in the resected stomach has a very poor prognosis unless it is detected at the "early gastric cancer" stage. The development of gastric stump carcinoma is probably dependent on the procedure chosen for primary surgery (resection). Local irritation accompanying the execution of anastomosis is also discussed as a possible cause of malignant transformation. Surgical precautions should include the choice of methods avoiding reflux, and the use of resorbable suture material for performing an exact and well-matched anastomosis. Periodic postoperative control is essential; in addition to radiological methods, endoscopy and biopsy are indicated for adequate identification of local abnormalities and mucosal changes. Patients whose high risk was stated in previous examinations, must be re-examined at shorter intervals. Identification of changes at the early cancer stage requires close cooperation of surgeon and pathologist.

Duodenum↗
PubMed1978

[Treatment of complications after endoscopic papillotomy (author's transl)].

In 717 endoscopic papillotomies there were 52 complications in 48 patients, requiring 15 emergency operations with 11 deaths. Surgical intervention was undertaken in six patients for cholangitis after obstruction by stone, in four for retroperitoneal perforation, in two each for bleeding or jamming of the dormia basket, and in one for pancreatitis. Cause of death was very poor general condition or age over 80 years in four; retroduodenal abscess in four; haemorrhagic pancreatitis in two, and cholangiogenic sepsis in one.

Aged↗
PubMed1978

Endoscopic retrograde cholangiography (ERC) in surgical emergencies.

Twelve patients, presenting with an acute abdomen of suspected biliary tract origin, had endoscopic retrograde cholangiography performed. Eight patients had either traumatic, spontaneous, or postoperative biliary tract fistulas with five leading to the peritoneal cavity, one to the colon, one to the bronchial tree, and one to the liver parenchyma from a ruptured gall-bladder. Each was confirmed by endoscopic retrograde cholangiography. Four patients with jaundice, following traumatic rupture of the liver, had a pathological communication between the intrahepatic biliary tracts and the hepatic vascular system. It is concluded that ERC is a reliable method for obtaining precise localization of biliary tract problems in surgical emergencies both pre- and post-operatively.

Adolescent↗
PubMed1977

[Therapeutic endoscopic retrograde cholangiography (author's transl)].

Endoscopic papillotomy is a further development of endoscopic cholangiography. This therapeutic procedure was successful in 516 (94.7%) of 545 cases. Choledocholithiasis (405 cases) and papillary stenosis (97) were the main indications for the procedure. Of 405 patients with choledocholithiasis, 376 (93%) are now free of stones. There were 38 (7.4%) complications and 5 (1%) of these had a lethal outcome with (11) (2%) requiring emergency laparotomy. Cholangitis was the most serious complication. It is becoming increasingly evident that the endoscopic papillotomy is replacing reoperation in many cases of choledocholithiasis.

Cholangiography↗