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H J Halbfass

Publications and source records attributed to H J Halbfass.

At least 19 recordsLinked to original sources
PubMed1995

[How safe is short-term inpatient treatment after laparoscopic cholecystectomy].

In 534 patients after laparoscopic cholecystectomy an earliest discharge was intended. The median day of discharge was day 3 postoperatively. The limitations to discharge were; normal physical findings, temperature back to normal and sonographic findings, which did not exceed the usual fluid accumulation in the gallbladder bed. Under strict application of these limitations no postoperative complication was missed. Due to outpatient pre-examination and operation on the day of admission the total length of stay could be limited to 2 days median. Also in this subgroup of 178 patients the chosen procedure was save.

APACHE↗
PubMed1991

Immunoscintigraphy using different methods of applying a 99mTc labeled monoclonal anti-CEA-antibody in the staging of patients with liver metastases before partial hepatectomy.

It was the aim of this study to determine the value of portal-venous (p.v.), intra-arterial (i.a.) or intravenous (i.v.) IS in the detection of liver metastases. Immediately after angiography and i.a. CT (20 patients) or p.v. CT (6 patients), 0.7-1.2 GBq of the 99mTc labeled anti-CEA MoAb were injected via the i.a. catheter, and in 10 patients i.v. Planar scanning was performed. Using IS in the detection of liver metastases a total sensitivity of 61% was established. However, IS was still found to be the decisive method of excluding extrahepatic tumor deposits.

Adult↗
PubMed1985

Mesocaval and distal splenorenal shunts: effect on hepatic function, hepatic hemodynamics, and portal systemic encephalopathy.

The effect of the mesocaval interposition shunt (n = 12) and the distal splenorenal shunt (n = 9) on the wedged hepatic venous pressure, the estimated hepatic blood flow, quantitative hepatic function, and the rate of portal systemic encephalopathy was evaluated in 21 patients who had bled from esophageal varices. After mesocaval shunt the wedged hepatic venous pressure was significantly reduced by 42% (from 26 +/- 3 mm Hg to 15 +/- 5 mm Hg, P less than 0.001) compared to 16% only (from 25 +/- 3 mm Hg to 21 +/- 2 mm Hg, P less than 0.005) after distal splenorenal shunt. The estimated hepatic blood flow also decreased significantly after mesocaval shunt by 61% (from 1.45 +/- 0.46 l/min to 0.56 +/- 0.25 l/min, P less than 0.001) compared to 29% (from 1.29 +/- 0.32 l/min to 0.91 +/- 0.39 l/min, P less than 0.05) after distal splenorenal shunt. Despite significantly different influences of both types of shunt operations on wedged hepatic venous pressure and estimated hepatic blood flow (P less than 0.001), postoperative changes of hepatic function were comparable in both groups of patients. The galactose elimination capacity, the initial plasma disappearance rate of Bromsulphalein, and the plasma ratio of valine, leucine, and isoleucine to phenylalanine and tyrosine were reduced by 13%, 26%, and 29%, respectively, after mesocaval shunt, compared to 12%, 25%, and 17% after distal splenorenal shunt. Only two patients of the mesocaval shunt group with the largest decrease in estimated hepatic blood flow developed portal systemic encephalopathy postoperatively, and the distal splenorenal shunt patients with their minor hemodynamic sequelae remained free of portal systemic encephalopathy.

Adult↗
PubMed1984

[Treatment of renal artery stenosis following kidney transplantation].

Stenoses of the renal artery occurred in 4.6% of 415 transplanted kidneys between 1969 and 1983. Most of them were caused by traumatic intima-lesions and were localised postanastomotically. The best therapeutic procedure seems to be the transperitoneal approach with widening venous patch plasty or venous bypass. The percutaneous transluminal catheter dilatation may be successful in suitable cases.

Angioplasty, Balloon↗
PubMed1984

[Late results of mesocaval and distal splenorenal shunts].

Shunt operations were carried out in 63 patients. Child A and B patients received alternatingly a distal splenorenal or mesocaval shunt, Child C and emergency patients exclusively mesocaval shunts. The postoperative mortality in the emergency group was 29%, in the elective group with mesocaval shunts 13% and with distal splenorenal shunts 17%. After 3 years the cumulative survival rates were similar in all patient groups and amounted to 54-64%. Episodes of acute encephalopathy in the late phase were observed only after mesocaval shunts (7%).

Humans↗
PubMed1982

[The blunt abdominal trauma (author's transl)].

Up to 1970 the number of patients suffering from blunt abdominal trauma showed a substantial increase. In more than 50% of all cases there are additional injuries. The most important factor influencing the prognosis of these patients is the early and correct indication for operation and the avoidance of unnecessary laparotomies. As a primary aim in diagnosis one should consider the recognition of an intraperitoneal bleeding without risk for the patient. Peritoneal lavage as an invasive method with low complication rates has proved good. First reports also show good results using the sonography of the abdomen. The recognition of the injured organ allows a carefully directed operation. Concerning the prognosis it is of minor importance. The diagnosis in patients with blunt abdominal trauma at the university clinic of Freiburg consists of: sonography, followed in positive cases by laparotomy or angiography and laparotomy. In cases with questionable results a lavage is done.

Abdominal Injuries↗
PubMed1982

[Results of continuous permanent irrigation in diffuse purulent peritonitis].

In a prospective study continuous peritoneal lavage was carried out in 30 patients with diffuse purulent or fecal peritonitis using a volume of 20-50 1/24 h during 5-7 days. Bacteria were recognised in the effusate until day 5. Protein losses per 24 hours amounted to 4,1-46 g. A mean value of 14,5 +/- 14 g was determined. The fractional protein clearance of IgG had increased compared to other proteins. A mortality of 26,7% was obtained. Death causes were the consequences of septic shock. In none of the investigated cases remaining empyemas in the peritoneal cavity could be shown. There was no support for the establishment of lavage tracks.

Adolescent↗
PubMed1981

[Ultrasonic diagnosis of blunt abdominal injuries].

In 190 patients with blunt abdominal trauma a sonogramm was made after admission. In 25 cases blood and fluid had accumulated in the abdominal cavity. In 24 cases diagnosis was correct. In patients who had organ lesions without fluid in the abdominal cavity the injured organ could be determined in 22 out of 25 cases. The danger of late liver and spleen ruptures existed in patients with organ hematomas. False positive results regarding fluid accumulation in the peritoneal cavity were found in 3 out of 165 patients.

Abdominal Injuries↗
PubMed1980

[Increased success rate of renal transplantation by HLA-DR-typing: a retrospective analysis of the South-German co-operative study group for renal transplantation (author's transl)].

Retrospective HLA-DR-typing and the influence of HLA-DR antigen on transplantation prognosis was studied in 90 kidney donor-recipient pairs. It was clearly demonstrated that HLA-DR compatible donor kidney provides a significantly better transplant prognosis than if there is HLA-DR incompatibility. Donor kidneys with only one identical HLA-DR antigen gave a six-month survival rate of 80%. Only HLA-AB identical cadaver kidneys ("full house identity") give similar survival times. Because of relatively lower polymorphism of the HLA-DR alloantigen system, HLA-DR identical donor organs are discovered more frequently than when HLA-AB antigens are taken into consideration. HLA-DR identical donor kidneys (identical for both HLA-DR antigens) have an even better transplant prognosis than "full house identical" kidneys, since the survival rate in the former is 87% after six months.

HLA Antigens↗
PubMed1979

[Topography and surgico-tactical principles of the mesocaval shunt].

The mesocaval shunt has special advantages. It can be applied also in patient with worse condition (Child B and C). The technically simple performance according to the original method of Drapanas is recommended provided that anatomical variants at the surgical trunk of the vena mesenterica superior are known. The anatomical situation should be investigated preoperatively by direct (umbilical vein catheter) or indirect mesentericography. The access via umbilical vein offers in addition the possibility of coronary vein embolisation in emergency patients.

Blood Vessel Prosthesis↗
PubMed1978

[In vivo determination of local tissue pO2 in renal cortex in kidney transplantation].

From measurement of local tissue PO2 in human kidney grafts after restoration of renal circulation, a correlation between initial microcirculation and kidney function can be drawn. PO2-histograms of kidney grafts with sufficient function are normal, whereas PO2-histograms of kidneys with delayed onset of function (congruent to 3 weeks) show distinct disturbances of microcirculation. These preliminary results suggest that measuring local tissue PO2 in transplanted kidneys may be of value for the prognosis of the graft.

Humans↗
PubMed1978

[Artificial embolization before septic amputation].

By artificial embolization before extensive septic amputation arrosion bleedings that are otherwise noncontrollable can be prevented. Resorbable gelatine (Gelforam) is suitable for embolization. For safety one can leave a balloon catheter above the embolized vessel segment for several days.

Accidents, Traffic↗