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K Rückert

Publications and source records attributed to K Rückert.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Intraoperative sonography of the bile ducts].

The experience with intraoperative ultrasonography (IOUS) during biliary surgery demonstrates positive and negative aspects. An evaluation of the method is possible by two prospective studies from the literature. The IOUS of the bile ducts is not a substitute for intraoperative cholangiography. Imaging of the papilla is possible in 30% only and examination of the drainage into the duodenum is impossible. The predictive value of a positive IOUS test is higher in comparison with cholangiography.

Bile Duct Neoplasms↗
PubMed1987

[Surgery in chronic pancreatitis. II. Late results following non-resection operations].

Between 1966 and 1985, 994 patients with chronic pancreatitis were treated at a University Surgical Department, 346 by drainage or diversion procedure, 339 by resection and 309 conservatively. The most frequent non-resecting procedures were: pancreatic pseudocyst drainage in 146, biliary-digestive tract anastomosis in 80, gastro-enterostomy in 15, biliary-tract revision in 58 and pancreatic duct drainage in 7 patients. More than half the patients had previously been operated on at least once. Overall postoperative death rate was 6.6%. Of those operated on up to 1983, whose subsequent course was analysed retrospectively, 16% had died (mean observation period 4.6 years). As many as 29% of patients had further bouts of pancreatitis. Weight remained steady or increased in 82%, the number of those with diabetes increased by 6%. All but 12% remained free of pain postoperatively or had only minor and occasional symptoms. Alcohol abuse decreased markedly. If alcohol consumption remained moderate (less than 50 g daily), late mortality rate was definitely decreased. Drainage or diversion procedures and pancreas resection are not competitive but complementary methods in chronic pancreatitis. Imaging techniques have helped the trend towards more conservative management.

Adolescent↗
PubMed1987

[Surgery of chronic pancreatitis. I. Late results after resection management].

From 1966 to 1985, 994 patients were treated for chronic pancreatitis. In 339 (34%), a resection of the pancreas was carried out. There were 166 left resections as compared to 175 right resections (Whipple, total duodenopancreatectomy). Almost half of the patients had already been operated on beforehand. The surgical lethality after partial duodenopancreatectomy could be lowered from 15% to 1.6%. After left resection, it continued without change to be 4% to 7%. Total duodenopancreatectomy and subtotal left resection were no longer carried out. 31% of the 246 patients followed up in a retrospective study died in the later course (mean period of follow-up observation: 6.5 years). Less than 10% of the patients died of complications due to pancreatitis. Three quarters of the patients maintained constant weight or gained weight. In half of the patients, there was a manifest diabetes mellitus postoperatively. 76% were free of pain postoperatively or had only slight symptoms. The late results are essentially determined by the readiness of the patients to adopt a disciplined style of life with reduction of alcohol consumption. This must be considered in the establishment of the indication for pancreatectomy in chronic pancreatitis.

Adolescent↗
PubMed1987

Ductal adenocarcinoma of the head of the pancreas: incidence of tumor involvement beyond the Whipple resection line. Histological and immunocytochemical analysis of 37 total pancreatectomy specimens.

Intrapancreatic tumor spread of ductal adenocarcinoma of head of pancreas was examined histologically in 37 total pancreatectomy specimens. Five to 10 tissue blocks were prepared from grossly tumor-free tissue of each pancreas and coded by anatomic location. Step sections from each block were analyzed for carcinoma in situ lesions, invasive carcinoma, and benign ductal lesions. Immunocytochemical staining with monoclonal antibodies (MAb) against carcinoembryonic antigen (CEA) and nonspecific cross-reacting antigen 95 (NCA 95) were used to help in discriminating carcinoma in situ from papillary duct hyperplasia. In 3 of 37 pancreatectomy specimens (8%) tumor was found to spread in continuity from the primary carcinoma into the body and tail. In two of these three cases with tumor beyond the usual Whipple resection line, the tumor was present as a "carcinoma in situ" lesion along the main pancreatic duct. Since discontinuous tumor growth was not observed, multicentricity of duct type adenocarcinoma seems to occur less frequently than was previously reported.

Adult↗
PubMed1986

[Technical aspects of the use of ultrasound diagnosis in surgical interventions].

The following are the specifications for intraoperative sonography equipment: Small, easy-to-manipulate 7-10 mHz probes which can be gas-sterilised. The sound head contact surface should be 2 X 3 X 1 to 2 cm. Three probes of different shape. Transmission cable 2-3 m in length. Gas-sterilisable ultrasound unit, cable and plug. Large screen monitor. Control panel which can be encased with a plastic foil according to sterility requirements. 8 step gray scale. Integrated image storage. Documentation possibility using videotape and/or photographic unit. For intraoperative sonography the body parts to be examined are sonographed at a distance of 1-2 cm using a precursor water gap. Interpretation of sonographic images can be performed only in connection with the palpation findings of the surgeon.

Bile Duct Diseases↗
PubMed1986

[Intraoperative ultrasound study in surgery].

Report on intraoperative sonography in 257 patients (89 with pancreatic and 67 with liver disease, 24 with vascular surgery and 24 with bile duct disease). Intraoperative sonography was helpful for the detection of tumors not evident by inspection and palpation. In vascular surgery it proved to be an excellent means for quality control. The main problems encountered concerned the evaluation of the bile ducts and of haemodynamically insignificant vessel wall lesions.

Bile Duct Diseases↗
PubMed1986

Role of surgical treatment in pancreatic carcinoma.

From 1964 through 1984, we treated 810 patients for carcinoma of the pancreas. In 129 patients PDE was possible (16%). Up to 1977, we had performed Whipple's procedures, while from 1978 through 1982 total pancreatectomy was our principal procedure. Since 1983, partial PDE again has been the procedure of choice for the potentially curative treatment of pancreatic cancer. Comparing the results of both methods (60 partial/64 total), we did not find any advantages of total pancreatectomy. Operative mortality increased after total PDE and survival time related to tumor stage did not extend. The 2-year survival rate for partial PDE was 26 and for total PDE 14%. Regarding the patients with unresectable cancer of the pancreas, the rate of those not undergoing surgery rose to 25% due to better preoperative staging by modern imaging techniques, while the rate of exploratory laparotomies was reduced to 5%. Since the preoperative use of PTCD, the mortality rate of our palliative procedures dropped to 12%. The biliodigestive anastomosis of choice is the hepaticojejunostomy. Gastroenterostomy is not routinely added (6% only).

Female↗
PubMed1985

[Cystadenoma and cystadenocarcinoma of the pancreas. Clinical aspects, therapy and prognosis].

Cystadenoma and cystadenocarcinoma are relatively rare forms among tumors of the pancreas (10% and 1%, respectively). Imaging methods have increased the numbers diagnosed. Between 1964 and 1984 nine cystadenomas and ten cystadenocarcinomas have been observed. Correct diagnosis is often delayed until there is a palpable upper abdominal mass. Histologically there are three different forms: benign, serous cystadenoma (multicystic, with clear fluid); mucoid cystadenoma (sticky, glass-like; single cavity; potentially malignant); and cystadenocarcinoma. Treatment of choice is complete tumour resection. The prognosis is definitely better for cystadenoma than ductal adenocarcinoma.

Adult↗
PubMed1985

[Ultrasonics and lavage in polytraumatized patients with blunt abdominal trauma].

The reliability of sonography and peritoneal lavage in assessing the need for immediate surgical intervention in blunt abdominal trauma was examined in a controlled prospective and retrospective study. Whereas no false results occurred using peritoneal lavage, false negative findings in sonography were 9.8% and false positive findings 3.9%. A significant difference was also found on retrospective evaluation of all cases with diagnostic peritoneal lavage (2.2% false results) and ultrasound investigations (14.9% false results). This demonstrates that sonography cannot fully replace peritoneal lavage as a diagnostic method in blunt abdominal trauma.

Abdominal Injuries↗
PubMed1985

Localization of small islet-cell tumors. Preoperative and intraoperative ultrasound, computed tomography, arteriography, digital subtraction angiography, and pancreatic venous sampling.

A total of 42 islet-cell tumors were examined between 1972 and 1984. Problems of localization were only encountered in 31 tumors less than 2 cm in diameter. Of 31 small tumors, 27 were correctly localized using a combined diagnostic approach: ultrasound was successful in 12/20 tumors, CT in 9/21, angiography in 20/31, intraarterial digital subtraction angiography in 1/2, and pancreatic venous sampling in 13/16. The smallest tumor found by ultrasound and CT was 7 mm in diameter. Intraoperative ultrasound demonstrated all 9 insulinomas examined. Currently, the most useful techniques for localizing small islet-cell tumors are ultrasound, CT, and angiography. CT is particularly useful for tumor staging. Improvement of non-invasive diagnostic techniques will obviate the need for transhepatic blood sampling.

Adenoma, Islet Cell↗
PubMed1985

[Sonographically monitored intraoperative fine-needle aspiration cytology in pancreatic diseases].

Intraoperative fine needle aspiration cytology of the suspected pancreatic region was carried out in 14 patients with a preoperatively confirmed tumour of the pancreas. Sonographic assessment revealed a malignoma in six cases and chronic pancreatitis in eight cases. All sonographic findings were confirmed by puncture cytology; there was no false negative or false positive diagnosis. Fine needle aspiration cytology monitored via sonography can help to further reduce the incidence of false negative findings in intraoperative cytology and can exercise a decisive influence on surgical procedure by intraoperative sonography-monitored staging.

Biopsy, Needle↗
PubMed1985

[Intraoperative sonography in surgical diseases of the liver].

Intraoperative ultrasonography was performed in 24 patients with single or multiple liver metastases of colorectal cancer, in 4 patients with a hepatocellular carcinoma, in 2 patients with an hepatic abscess and in one patient with a focal nodular hyperplasia and one with a liver hemangioma. In 9 of 32 patients with inflammatory or malignant liver disease the tumors were not palpable or visible. These hepatic lesions were localized by intraoperative ultrasound. In 5 cases preoperative unknown hepatic tumors were diagnosed by intraoperative sonography.

Carcinoma, Hepatocellular↗