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J Králík

Publications and source records attributed to J Králík.

At least 19 recordsLinked to original sources
PubMed1997

[The role of the portosystemic shunt in modern treatment of portal hypertension].

The authors discuss the importance of portosystemic anastomoses in contemporary treatment of portal hypertension, in particular in relation to TIPS. As a basis they use their own experience with 28 portosystemic anastomoses during the last five years and conclude that a correctly indicated anastomosis has certain advantages over TIPS. The basic requirements for indication of surgical peripheral portosystemic anastomoses are: 1. stage Child A (or onset of B), 2. posthaemorrhagic conditions, 3. satisfactory general condition, 4. stabilized liver disease and planned surgery.

Humans↗
PubMed1997

[Monitoring of selected biochemical markers of tissue ischemia, particularly of the digestive tract, in experiments and clinical practice].

The increase of organ transposition ill tile reconstruction of digestive tract, particularly transposition of the stomach and colon, is essential ill gullet surgery. The transposition is always accompanied by certain bigger or less degree of ischemia. In this study the authors followed the biochemical markers of tissue ischaemia, capable to lay down both pre- and postoperative vitality of the tucked organ an the anastomosis. Disclosing of the initial and later stadium of intestine ischemia is tile aim. Monitoring of the lactate in the serum is very useful. Its using was proved in the rich experimental group and it was certified in clinical practice.

Acidosis↗
PubMed1994

[An instrument for hepatic artery compression in palliative treatment of liver metastases using repeated ischemia. A model and experimental study].

Method of interrupted ischaemization of the liver afflicted with metastases from colorectal cancer is not definitively evaluated yet. Using the literary reports the authors proposed (in cooperation with MEDIN) a instrument for compression of the liver artery, economically easy available. The reability of this instrument was tested in model conditions and his safety to the tested artery was proved on the experimental animal.

Animals↗
PubMed1994

[Solitary liver metastasis of malignant schwannoma of the stomach treated with hemihepatectomy].

The cause of large solitary hepatic metastasis is mostly the colorectal cancer, rarely also the cancer of breast, kidney, gynecologic organs, the melanoblastoma and the nonepithelial tumors of the stomach. These metastases, when they are proved as solitary, especially with long interval after removing the primary tumor, are well indicated for liver resection till hemihepatectomy. The authors treated successfully a large metastasis of malignant schwannoma, eight years after resection of the stomach with the primary tumor. Morphologic characteristics and biologic activity of primary tumors of this kind are discussed.

Aged↗
PubMed1994

[Esophagectomy without thoracotomy in advanced esophageal achalasia].

Patients with advanced achalasia, accompanied by severe complications can be seen only rarely today. In these patients, resection of the esophagus has to be considered. The modern technique of extirpation of the whole thoracic esophagus without thoracotomy is a sparing intervention capable to solve the problem of dysphagia as well as the complications of advanced achalasia. The authors describe their favourable experience with this technique in three patients. The evidence for such radical treatment appears from the clinical picture and the microscopical findings in the resected specimens.

Adult↗
PubMed1993

[Retrosternal esophagocoloplasty as current means of surgery for esophageal carcinoma].

The authors present an account of their experience with retrosternal oesophagocoloplasty as a palliative by pas in inoperable carcinoma of the oesophagus. They differentiate secondary and primary indications. So far they used this operation in 27 patients. The total lethality is 33%, the mean survival period is 8 months. Some patients with the unilateral paresis of the left recurrent nerve have laryngoesophageal dysfunction with the danger of aspiration during swallowing. The shape, position and function of the paretic vocal cord can be favourable influenced by the administration of hydrophile gel into the vocal cord by the endoscopic route.

Adult↗
PubMed1993

Some reflections about portosystemic shunt in portal hypertension.

The authors report on the group of 85 patients with portal hypertension in whom a portosystemic shunt was established for uncontrolled bleeding from varices--in the period from 1968 to 1993. A total lethality was 9.4%, in planned operations 5.9%, in acute interventions 22%. Some aspects of shunt-operation are discussed (prehepatic portal hypertension, acute shunt, shunt preceding liver transplantation). It is concluded that the portosystemic shunt still plays a role in the therapy of complicated portal hypertension, although only as a selective intervention.

Adolescent↗
PubMed1993

Oesophagus carcinoma amino acids control.

Serum amino acids level examination of the oesophagus carcinoma patients admitted to I Surgical Clinic of Teaching Hospital in Olomouc from 1/1/1990 to 31/7/1991 were carried out by the authors. The standard values were found with the group of patients with resectionable tumor or with a tumor in non-advanced stage on the one hand and on the other hand there were some lower values with the patients with a tumor in an advanced stage. In this way two groups of the sick were examined--the first one with benign oesophagus stenosis accompanied by nutritional disorder, the second with resectionable lung carcinoma without nutritional disorder. Serum amino acids level examination is therefore considered to be rather an indicator of the important factor of a possible surgical treatment of a tumor.

Amino Acids, Essential↗
PubMed1993

Function anatomy of vascular stem of the transposed stomach.

In morphological study on the dead bodies the authors have followed with coloured injections of stomach arteries of pyloroanthral region under "physiological" pressure the vascular supply of mobilized stomach applied for the substitution of chest gullet. They found that the right gastroepiploic artery is much more important compared with right gastric artery, and further, that the gastric tube formed from the great curvature is much better supplied than the whole stomach. These conclusions correspond with clinical experiences with esophagogastroplastics.

Adult↗
PubMed1993

[A pancreatic pseudocyst in the liver].

A large cystic formation in the liver of 43-years old woman was identified as pancreatic pseudocyst, using histologic examination during laparotomy. The pancreas was found quite normal without any relation to the pseudocyst. Therefore it seems to be acceptable such a pathogenetic reflection, that the pseudocyst developed as a result of pathologic changes in heterotopic pancreatic tissue (embryonic malformation). The pseudocyst was partly resected and the large cavity in the liver was drained into the small intestine using Roux loop. After 8 months uncomplicated follow-up of the patient, the CT picture of her liver was nearly normal.

Adult↗
PubMed1993

[Experimental verification of the hepatic perfusion index for monitoring direct liver perfusion by portal blood].

The reliability of HPI measurement was studied in animal experiment. The portal vein of experimental dogs was narrowed by application of a metallic coil. The induced portal hypertension with important hepatofugal collaterals appeared to be a suitable model for the study of changes in HPI. A decrease in the index was statistically significant and corresponded to the hemodynamical efficiency of collateral circulation. The original experiment verified the reliability of HPI for an assessment of direct perfusion of the liver by portal blood.

Animals↗
PubMed1992

Long-term prognosis of prehepatic portal hypertension.

The study is a report of the long-term follow-up of 53 patients with prehepatic portal hypertension, their life and work conditions. The average time of the follow-up was 25 years. It was concluded, that the long-term prognosis is derived from the development of the disease, its recognition, the used therapy and from the function of the patient's liver. From the battery of therapeutic modalities a very good experience has been achieved with the endoscopic treatment of bleeding varices. The portosystemic shunt is a pathophysiologically well justified but selective procedure, which is indicated in about 20% of bleeding patients. The long-term prognosis of the disease was found good in 75% of patients.

Follow-Up Studies↗
PubMed1992

[Post-traumatic hemobilia and successful direct treatment of the arteriobiliary fistula].

Traumatic hemobilia is a rare complication of deep and central liver injuries. Repeated and massive bleeding requires an active therapy. For diagnosis of the arterial-biliary fistula, most advantageous is a transcutaneous selective arteriography which can be used also for therapeutic embolization. Of surgical techniques, ligature of the art.hepatica comm. or propria and direct closure of the fistula in the liver parenchyma are recommended. The authors report on such a successful direct intervention in a 9-year-old girl.

Bile Ducts, Intrahepatic↗
PubMed1992

[Rational therapy of prehepatic portal hypertension].

Prehepatic portal hypertension is mostly caused by an inflammatory closure (thrombosis) of the portal vein in the perinatal period. This form of portal hypertension is characterized by the following considerable facts: patients' liver is not damaged and a divergent collateral circulation (hepatofugal and hepatopetal) is formed. Due to the latter, portal circulation may improve spontaneously and no clinical signs of the disease are manifested. Most patients, however bleed rependedly from the cardioesophageal varices with various frequency and various severity. A direct surgical intervention had been successful in about 50% of cases. At present, it is almost replaced by endoscopic sclerotization giving compatible results. The pathogenetically based surgical method is the portosystemic shut that is necessary in 20% of patients, mostly as a secondary intervention. Pathophysiological sequelae of the shunt are less severe than in cirrhotic patients due to intact liver of patients with PPH and to favorable possibility of recirculation of portal blood via the hepatic artery. An appropriate therapeutical strategy accounts for favorable long-term prognosis of patients with prehepatic portal hypertension.

Humans↗
PubMed1992

[Liver resection using a suction knife in an experiment and in clinical practice].

The authors describe their experience with liver resection by means of an suction knife. In animal experiments, the optimal value of under-pressure for an effective and non-destructive function the knife was tested and the healing process in the vicinity of the cut surface was followed. This simple device was developed that allows evaluation of the results of liver resection (segmentectomy to hemihepatectomy) in clinical practice. The method was applied in ten out of twenty patients in which liver resection was performed in the last fourteen months. The inexpensive device functioned to the authors full satisfaction.

Adult↗
PubMed1992

[Changes in portal circulation in experimental prehepatic portal hypertension].

In a long-term experiment on dogs the lumen of the portal vein was reduced to one fifth by insertion of a metal spiral. The thus created disorder of the portal circulation was succeeded by the development of abundant hepatofugal collaterals and the development of mild portal overpressure without clinical manifestations. The altered portal circulation was followed up by dynamic hepatobiliary scintigraphy for a period up to 12 months. It was revealed that the curve of isotope movement through the liver was altered in a way suggesting slower perfusion of the liver by portal blood. This observation resembles those in patients with prehapatic portal hypertension and their confirmation. The investigation is documented by morphological, X-ray and isotope methods.

Animals↗
PubMed1991

[Resection therapy of advanced achalasia].

Achalasia of the esophagus is combination of dysfunction of the lower esophageal sphincter and disorder of the peristaltic movement of the esophageal body. Both components influence one another in a negative way, but the first usually prevails. That is why satisfactory and long-term results can be obtained in most of patients with non-advanced achalasia by Heller's myotomy. In a small group of patients with disease of megaesophagus-type (disorder of the motility of the esophageal body prevails) and in patients in which their disease reach for various reasons the stage of advanced (decompensated) achalasia, the resection-surgery is etiopatogeneticly justified. At the Ist and IInd surgical clinic in Olomouc 331 patients with achalasia have been operated so far. 29 patients treated by resection of a shorter or longer portion of the aboral esophagus, in 2 patients the whole thoracic esophagus was extirpated without thoracotomy. Resection was in principle indicated as secondary treatment. To substitute the esophagus the stomach in various operative modifications was used in two thirds of the patients, in the remaining patients interposition by a segment of the small or large intestine was carried out.

Esophageal Achalasia↗