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Biomedical subjects

M Cremer

Publications and source records attributed to M Cremer.

At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

[Medico-surgical attitude in the treatment of cancer of the bile ducts].

In order to evaluate the operative possibilities in patients with obstructive carcinoma of the biliary tract a precise diagnosis of local extent of the tumor and metastasis is essential (cholangiography, US, CTscan). The treatment is preferably surgical whether the tumor be resectable or not. However some patients who, for any reason, are not surgical candidates can be helped by new endoscopic intubation techniques. Medical and surgical consultation is essential to set the criteria for the best treatment modality in all patients with this disease, especially those who are not surgical candidates.

Adult↗
PubMedDate not supplied

[Treatment of adenocarcinoma of Vater's ampulla].

We reviewed the records of 51 patients. In two-thirds of the cases the main symptom was icterus; one third presented with pain. The whole group underwent a retrograde choledocho-pancreatography. An abnormal papilla was found in 80% of the cases. This finding proved to be of sufficient diagnostic importance without the necessity of an associated choledocho-pancreatography for diagnostic confirmation. Although in the majority of the cases the choledochus proved to be dilated, pancreatic duct enlargment was only noted in 50%. The only treatment in the very elderly patient was endoscopic sphincterotomy. Younger patients underwent a duodeno-pancreatectomy preceded by an endoscopic sphincterotomy. The morbidity and mortality associated with endoscopic opacification of the biliary and pancreatic ducts and sphincterotomy in this setting is much higher than for all other indications in general. For this reason we propose to perform a choledocho-pancreatography only when indispensable for diagnostic purposes (nl. papilla) or when endoscopic sphincterotomy is the chosen treatment modality.

Adenocarcinoma↗
PubMedDate not supplied

[Proximal duodenopancreatectomy in the treatment of tumors of the bilio-pancreatic junction].

Between 1978 and 1983, 32 patients underwent a proximal duodeno-pancreatectomy for malignant lesions of the ampullary region on head on the pancreas. Pre-operative diagnosis was made by endoscopic cholangio-pancreatography, echography, tomodensitometry and arteriography. 14 patients underwent a pre-operative endoscopic bile drainage procedure. The operative mortality was 6,2% and the morbidity 43%; the intensity of the icterus as well as the preoperative bile drainage procedure did not change these factors significantly. The pre-operative diagnostic procedures permitted a clear definition of the extent of the tumor and retrospective analysis demonstrated their prognostic significance with regard to long-term survival. 11 patients are still alive. The presence of histologically proven metastases reduce significantly the duration of survival. Surgical resection is the best treatment for malignant tumors of the ampullary region and the head of the pancreas without local or distant metastases.

Aged↗