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Biomedical subjects

W Wayand

Publications and source records attributed to W Wayand.

69 records · Page 4Linked to original sources
PubMed1982

[Measurement of the pancreatic blood supply before and after duct occlusion].

Blood flow measurements in the pancreas were performed in 12 pigs in situ, after the splenectomy, and then after the occlusion of the pancreatic duct by means of prolamin as well during a relaparotomy after 6 weeks. No change was pointed out immediately after the occlusion in face of the state following the splenectomy. The flow in the splenic artery was reduced significantly (p less than or equal to 0.0001) by 62% after 6 weeks.

Animals↗
PubMed1981

[Transcutaneous measurement of the central venous pressure (author's transl)].

The intrathoracic pressure rises when exhaling into a manometer to such an extent that finally the venous flow of blood to the right heart stops. It is supposed that this venous stop flow pressure (VSFP) is equal to the central venous pressure. In a clinical trial by two independent examiners in 97% of the cases a correlation within a range of 5 cm H2O was found (70 measurements). Thus the central venous pressure can be measured noninvasively with an ultrasound device.

Adult↗
PubMed1981

[Selective proximal vagotomy with intraoperative monitoring using Burge's test].

Only the test by Burge shows an effective evidence among the intraoperative control methods for testing the completeness of section during selective proximal vagotomy. The postoperative results are discussed in this study. 78 patients of 91 could be controlled endoscopically 3 to 60 months postoperatively. The result of the group with the Burge test (n = 38) does not differ essentially from the group without the Burge test (n = 40). However, the Burge test has a didactic importance certainly for surgeons in the training.

Electric Stimulation↗
PubMed1980

[Diagnosis of subphrenic abscess by sonography (author's transl)].

The diagnosis of a subphrenic abscess by sonography is based mainly on the experience of the examiner. A short description of the normal subphrenium is given. The diagnostic criteria for a subphrenic abscess and the differentialdiagnosis are discussed. In 19 cases of subphrenic abscess in question the diagnosis was missed in two cases, giving a success rate of 89.5%.

Ascites↗
PubMed1980

[Risk of surgical polypectomy in the colon (author's transl)].

Morbidity and lethality of 143 patients who had undergone surgical polypectomy in the colon were evaluated retrospectively; the transanal, transphincteral and transabdominal approaches have been used. Because of the size of the adenoma transabdominal surgery was done in 92 patients (54 colotomy, 10 segmental resections, 28 more extended resections of the colon). Colotomy alone had a complication rate of 23.7% and a lethality of 3.3%. On comparing results of colotomy and coloscopic polypectomy it can be stated, that the surgical approach is no alternative any more because of its high complication rate. Surgery is only indicated, when polyps are too big to be removed by the coloscopic approach.

Adenoma↗
PubMed1979

Healing of enterotomies with preexisting peritonitis. An experimental study in guinea pigs.

The question of whether the presence of peritonitis has any influence upon the process of healing and the load capacity of a standard enterotomy was studied in guinea pigs. Laparotomy was performed 4 h after induction of peritonitis by a standardized method. Fecal peritonitis could be confirmed clinically, histologically and bacteriogically in all cases. A standardized enterotomy was carried out. The animals were killed 3 or 5 days later, anastomoses inspected, and the intraluminal pressures for anastomotic rupture measured. Comparison with a control group showed: (1) there can be normal healing of an enterotomy even with coexisting peritonitis; (2) anastomotic breakdown takes place at the same pressure as in the control group (p less than 0.01), and (3) primary lethality is significantly higher in cases operated in the presence of peritonitis (33 vs. 20%).

Animals↗
PubMed1979

[Controlled clinical trial "blind" versus aimed fibrebronchoscopic suction in mechanically ventilated patients (author's transl)].

In patients treated with ventilation therapy only 60% of blind suction catheters reach the desired position. In ten patients the routinely performed blind suction was replaced by aimed bronchoscopic suction. Blood gas analyses before and after aimed and blind suction favoured the former. Also the arterioalveolar oxygen tension difference showed a good response to aimed suction. There is a broad spectrum of indications for fibreoptic bronchoscopy in every care unit dealing with mechanical ventilation.

Blood Gas Analysis↗
PubMed1976

[Corrective surgical procedures following partial gastrectomy for gastro-duodenal ulcer (authors transl)].

Corrective surgical procedures for postgastrectomy syndromes are well-established in abdominal surgery. The indications for early corrective intervention are clearly defined on the basis of the patients' postoperative course. Corrections at a later date should only be considered in presence of major symptoms which did not respond to conservative therapy and following careful morphological and functional assessment of the patient. An analysis of gastric acid secretion should be carried out before and after the operation. The aim of corrective interventions is the restitution, as far as possible, of physiological conditions: prevention of rapid gastric emptying and reduction of gastric hypersecretion. Through postoperative follow-up examination of the patients over many years is essential. The case history, operation technique and outcome is presented in this review of 92 patients treated at the First Department of Surgery, University of Vienna and the findings are discussed.

Adolescent↗
PubMed1976

[Primary malignant tumours of the small intestine (author's transl)].

In the years between 1936 and 1973 19 patients with malignant tumours of the small intestine were admitted to the 2nd Department of Surgery, University of Vienna. Analogous to the findings of large-scale investigations adenocarcinomas (7 cases) preponderate in the upper small intestine in our case material, while lymphosarcomas and carcinoids mainly occur in the ileum. A radical surgical procedure was possible in 11 cases. The adenocarcinomas have the most unfavourable prognosis, whilst survival times of up to 10 years were found with lymphosarcomas and carcinoid tumours.

Adenocarcinoma↗
PubMed1976

[Indications and technics for esophagoduodenostomy].

From 1961 to 1974 19 esophagoduodenostomies have been performed after total gastrectomy. One patient died postoperatively because of pulmonary embolism. The mean survival rate was 16,4 months. In far advanced gastric carcinomas an elongation and dilatation of the duodenum favours this kind of anastomosis. In low risk patients, in the aged and for palliative gastrectomy we suggest to prove the possibility for performing an esophagoduodenostomy.

Adenocarcinoma↗
PubMedDate not supplied

Selective use of ERCP in patients undergoing laparoscopic cholecystectomy.

With the advent of laparoscopic cholecystectomy (LCH) various strategies have been proposed for the management of common bile duct (CBD) stones. In a consecutive series of 1140 patients subjected to LCH, preoperative endoscopic retrograde cholangiopancreatography (ERCP) was attempted in 128 patients (11.2%) and successfully accomplished in 121 (94.5%). Based on the prediction of CBD stones by laboratory tests, ultrasonography, and intravenous cholangiography, prelaparoscopic ERCP was performed in 106 patients (9.3%). CBD stones were identified in 56 patients and benign papillary stenosis in 5 patients (57.5%). Of these 61 patients, 58 (95%) were treated by endoscopic sphincterotomy (ES) and stone extraction followed by LCH after a mean interval of 1.6 days. Three patients with failure of endoscopic ductal stone extraction required open CBD exploration. In 39 of the 106 patients (36.8%) ERCP was negative for ductal stones but revealed unexpected ampullary and pancreatic cancer in two cases. Six patients (of the 106) with preoperative ERCP cannulation failure (5.7%) were managed either by LCH and intraoperative cholangiography or by open CBD exploration. In 22 of the 1140 total patients (1.9%) ERCP was performed at various intervals after LCH. Retained CBD stones were found in eight patients, and ES and ductal clearance was achieved in all eight. There was no mortality among the entire surgical group who underwent perioperative ERCP/ES. Including two cases of ES-related pancreatitis, the overall morbidity was 5.5% (7 of 128). Perioperative ERCP/ES in conjunction with LCH is an attractive approach for patients with cholecystocholedocholithiasis, at least until laparoscopic ductal clearance becomes a standard procedure.

Adolescent↗
PubMedDate not supplied

Single-dose cefodizime as infection prophylaxis in abdominal surgery: a prospective multicenter study.

This prospective pilot study was performed to evaluate the efficacy, safety and tolerability of a single dose of cefodizime as infection prophylaxis in patients undergoing major abdominal surgery. One hundred forty-nine patients received 2g cefodizime, a third-generation cephalosporin, 30 min before abdominal surgery. The mean operation time was 116 +/- 66 min. Eighteen patients received metronidazole additionally. In 8/149 patients (5.4%) the final outcome was considered to be a treatment failure. 94.6% of the patients had no signs of infection. The long half-life of cefodizime allows a single-dose perioperative prophylaxis even in abdominal surgery lasting 3 to 4 h. Cefodizime can be regarded as a safe antibiotic prophylaxis with few side effects.

Abdomen↗
PubMedDate not supplied

Closure of the cystic duct during laparoscopic cholecystectomy with a new feedback-controlled bipolar sealing system in case of biliary obstruction--an experimental study in pigs.

BACKGROUND/AIMS: The excellent results of new devices like the new bipolar feedback-controlled sealing system (LigaSure) for closure of blood vessels encouraged surgeons to use these instruments for other structures like bile ducts. The aim of this study was to evaluate the feasibility of closure of cystic duct in case of biliary obstruction. METHODOLOGY: Ten domestic pigs underwent laparoscopic cholecystectomy sealing the cystic duct with LigaSure. The common bile duct was closed with an endoclip to create a biliary hypertension. On the 12th postoperative day blood samples were taken for liver enzymes. At autopsy on day 15 the pigs were investigated for bile leaks or biliary peritonitis. The cystic duct was resected for histological examination. RESULTS: Seven pigs survived, one pig died during introduction of anesthesia, one on the 1st and one on the 2nd postoperative day without any findings at the autopsy. One pig out of 7 had a bile leak; the other 6 were without any sign of leakage. Histologically 3 pigs had a regular coagulation zone at the cystic duct, 3 had a total necrosis, one a partial necrosis of the mucosa only. CONCLUSIONS: Though there was only one insufficiency, the feedback-controlled bipolar vessel sealer cannot be recommended for biliary surgery with regard to the high rate of necrosis stated in our experiment.

Animals↗
PubMedDate not supplied

Value of diagnostic laparoscopy in abdominal malignancies.

Diagnostic laparoscopy was performed in 72 patients for diagnosis of suspected cancer or staging of intraabdominal malignancies. In 66 of 72 patients (91.7%) a diagnosis was possible laparoscopically and in 53 patients (73.6%) a laparotomy was avoided. In 19 of 72 patients (26.4%) laparoscopy changed staging of preoperative non-invasive test and helped to plan proper surgical management. Laparoscopy has proved to be an effective diagnostic tool in abdominal malignancies and should help to avoid unnecessary laparotomies in case of incurable disease. It should be used complementary to non-invasive imaging methods and the addition of laparoscopic ultrasonography will improve the accuracy of examination.

Abdominal Neoplasms↗