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[The primary gallbladder neoplasm].

From 1960 to 1975 in the Surgical Clinic of the Medical Academy Erfurt altogether 77 patients with a primary malignoma of the gall-bladder were observed. Symptomatology and findings are non-characteristic. 64 times a laparotomy was carried out, whereby in 51 cases the intervention had to be finished as test laparotomy. 13 times a cholecystectomy or a biliodigestive anastomosis was carried out. The average survival time of the patients with test laparotomy was 53 days. A survival time of more than one year could nertainty. Issuing from this the author adopts a definite attitude to carcinogenesis and the importance of lithiasis.

Alkaline Phosphatase

Laparoscopy in general surgery.

In the last seven years laparoscopy has become increasingly popular in North America. The procedure has been mainly embraced by the gynecologist. Other specialities have been relatively slow in recognizing its value. Laparoscopy has wide applications in general surgery. It is a useful tool in blunt abdominal trauma and often prevents laparotomy. In patients with acute abdominal conditions, when findings are atypical, uncertainty in diagnosis may be resolved by laparoscopy. In patients with malignant disease it permits assessment of the extent of the lesion and enables accurate selection of the mode of therapy. Numerous procedures per laparoscopy, including biopsies, division of adhesions, cholangiography and collection of samples for bacteriologic studies, may be carried out simultaneously. Complication associated with the procedure are few but may be severe. These can be avoided by careful adherence to proper technic.

Abdomen, Acute

Does bile promote extra-colonic cancer?

The incidence of biliary-tract cancer and of several other gastrointestinal tumours is increased when conditions favour conversion of bile acids to more active substances. This may indicate that bacterial degradation of bile salts is related to the pathogenesis of cancer in parts of the alimentary tract other than the large bowel.

Bile

[Ultrasound in tumor diagnostics. Possibilities and problems with regard to internal medicine as an example (author's transl)].

Ultrasound B-scan (real time and gray scale technique) has proved to be a noninvasive, low expensive and suitable method in internal tumor diagnostics. The most important fields are the diagnosis of pancreatic tumors, of malignant lymphomas, of tumors of the kidneys and the adrenal gland. Furthermore there is possible the diagnosis of tumors of the liver, the bile ducts, the spleen and the thyroid gland. The differentiation between solid and cystic tumors has shown to be a domain of ultrasonography. The limitations of the method are caused by the relatively bad (lateral) resolution of ultrasonography. Therefore tumors smaller than 1.5 cm cannot be diagnosed regularly. There is, moreover, no ultrasonic pattern typical of malignancy.

Adrenal Gland Neoplasms

[Malignant obstructive jaundice. Current status of surgical therapy].

424 patients with malignant jaundice were treated from 1964 to 1976. 152 carcinomas of the extrahepatic biliary tract and 272 carcinomas of the duodenopancreatic region were reported. Initial symptoms of cancer of this region are often vague, so that physicians must employ a high index of suspicion if earlier diagnosis is to be effected. Most of the carcinomas of pancreas and the biliary tract are unresectable because of the early dissemination. The dismal of the malignant tumors of the biliary tract is unchanged during the last 50 years but survival rates are better in carcinoma of the duodeno-pancreatic region.

Bile Duct Neoplasms