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Biomedical subjects

K Draese

Publications and source records attributed to K Draese.

6 recordsLinked to original sources
PubMed1985

Stricter selection criteria improve the results of shunt surgery.

Between October, 1976 and December, 1982, 176 patients with full-blown liver cirrhosis were referred to us either with Acute oesophageal variceal bleeding, or after having had such a haemorrhage. Eight of these patients died of a haemorrhage that did not respond to conservative treatment, or of hepatic failure after emergency surgery. After receiving initial conservative treatment, 168 patients were classified in accordance with clinical, biochemical and haemodynamic selection criteria, particular importance being attached to the haemodynamic criteria. One-hundred-and-one of these patients in whom a shunt operation was not justifiable, were treated conservatively by means of repeated sclerotherapy. In the cases of acute bleeding, a balloon tamponade was performed in 3, an emergency shunt procedure in 1 and palliative dissection surgery in 4. Twenty-three patients in a non-bleeding state were treated conservatively without sclerotherapy. Shunt surgery was performed in 44 patients; out of the 42 patients shown by our selection criteria to be suitable for shunt surgery, only 1 patient died, 5 days after the operation, of cardiac failure with underlying toxic cardiomyopathy. In view of the low early mortality rate in selectively operated patients, a major argument against the use of the shunt for the treatment of portal hypertension is no longer valid, and it should again be considered whether the surgical procedure might not provide better long-term results than does conservative sclerotherapy alone.

Gastrointestinal Hemorrhage↗
PubMed1980

[Pharmacological effects on the motor activity of Oddi's sphincter. Postoperative electromanometric measurements of the bile ducts].

Besides the high diagnostical value of the electromanometric measurement, this method is especially useful for the registration of pharmacological effects upon the sphincter of Oddi. In this study the influence of hymecromon on sphincter function was tested in 138 patients. Hymecromon induced a significant decrease of pressure by prolonging the opening time (p < 0.001). In clinical experiments it could be shown that the increase of pressure induced by morphine in the common bile duct could be equalized by hymecromon within a short time. Depending significantly on the dosage (p < 0.01) there were identical results on the intravenous or intraductal application of hymecromon. An increase of activity of the liver-specific enzymes could not be seen after hymecromon treatment.

Ampulla of Vater↗
PubMed1976

[Catheterization of the umbilical vein, diagnostic and therapeutic relevance (author's transl)].

Catheterization of the umbilical vein does allow direct access to the portal system, thus yielding information about the pathophysiology of the hepatic and splanchnic vessel system. Mesurement of the portal vein pressure in conditions of portal hypertension can be performed in the portal vein. A special, three-compartment ballon catheter is available for mesurement of intrahepatic wedge pressure. Angiography of the umbilical vein allows earlier diagnosis of metastases within the liver than other diagnostic procedures. Intraportal application of cytostatic drugs using a long term indwelling umbilical vein catheter is feasible as well. Own experiences are as yet rather limited. Three patients have been treated up to now this way; evaluation of the therapeutic results is not yet possible, because of the short duration of therapy and because of the low number of patients. The technique of umbilical vein catheterization does not seem to present any problems. Complications are rare and did not occur in our series.

Angiography↗