Search PubMed⌕ Search

Biomedical subjects

T Junginger

Publications and source records attributed to T Junginger.

At least 271 records · Page 15Linked to original sources
PubMed1990

[Long-term results following surgical treatment of islet cell adenoma].

To evaluate the long term results after operation of islet cell adenomas we analyzed our own patient material from 1.1.1967 to 30.11.1988. During this time we operated 43 patients with islet cell tumors. 36 patients had benign adenomas. After a medium time of 6.7 years we analyzed the outcome of 33 patients. Only one out of 29 patients with a solitary adenoma had a recurrence of the disease. Two patients after pancreas resection had diabetes mellitus. In contrast to this only one out of four patients with multiple adenomas was free of symptoms. One patient had diabetes mellitus. In two patients five operations were necessary up to now, nevertheless one of the patients had persistent hypoglycaemic symptoms. These results show that the most important factor in therapy of patients with islet cell tumors is the recognition and complete removal of multiple adenomas.

Adenoma, Islet Cell↗
PubMed1990

[Hematobilia--a rare complication after traumatic liver rupture].

Hematobilia is a rare complication after traumatic liver injury and has a high mortality. Clinical signs are hyperbilirubinemia and increase of bile acids in serum by rarely increased liver enzymes. Pathophysiologically there is a connection between bile duct system and liver veins. To determine the diagnosis giving rise to the clinical signs, after abdominal ultrasonography and computed tomography the ERCP seems to be the most suitable method. The treatment of hematobilia is not necessarily operative; a successful conservative therapy is also possible.

Adult↗
PubMed1990

[Resorbable staple sutures for partial stomach and duodenal stump closure. Animal experiment studies].

In two groups of pigs, 10 in each, partial gastrectomies with gastroduodenostomy (Billroth I) respectively gastrojejunostomy (Roux-en-Y) were performed. Absorbable lactomer (Polysorb, Auto-Suture) staple lines--a copolymer of glycolic acid/lactic acid-, used for the closure of the lesser curvature of the stomach and the duodenal stump, were safe. No suture dehiscence was observed. Macroscopic examination showed no major inflammatory adhesions around the staples. Microscopically inflammatory reactions around the staples in the gastrointestinal wall were found. Our results yielded no contraindication for clinical tests of absorbable sutures in gastrointestinal surgery.

Anastomosis, Roux-en-Y↗
PubMed1990

Electromagnetically generated extracorporeal shockwaves for fragmentation of extra-and intrahepatic bile duct stones: indications, success and problems during a 15 months clinical experience.

Electromagnetically generated extracorporeal shock waves (without waterbath) were applied after intravenous premedication with 10-15 mg diazepam and 100 mg tramadol in the treatment of 33 patients (aged 32 to 91 years) with multiple intrahepatic stones (n = 4) or huge common bile duct stones (n = 29, 18-30 mm in diameter), which could not be removed by conventional endoscopy. Stone disintegration was achieved in 70% of common bile duct stones and in all intrahepatic concrements after 800-7500 discharges, which were applied during one (n = 21), two (n = 6) or three sessions (n = 6). Apart from mild fleabite-like petechiae at the side of shock wave transmission no other side effects were observed for a total of 51 procedures. We believe electromagnetically generated shock waves are safe, easy to apply, and relatively effective in the therapy of common bile duct and intrahepatic stones.

Adult↗
PubMed1990

[Surgical, endoscopic or radiologic interventional therapy in bile duct cancer].

The therapy of bile duct cancer is in some cases under controversial discussion. A retrospective comparison between patients who underwent surgery or endoscopic treatment is difficult because of patient selection. It seems that there is no difference in the two groups with regard to 30 days mortality. A prospective or randomized study about this point of discussion is not available. Some retrospective studies show that patients with non-operative treatment had more late complications than had operated patients. Because of tumor extension resection is only possible in a few patients. Operation and endoscopic treatment are therefore not contradictory methods.

Adenocarcinoma↗
PubMed1990

[Preoperative localization in organic hyperinsulinism--useful or superfluous].

In our own patient material (n = 43) the percutane sonography had a sensitivity of 61.9%, the CT 73.3%, the angiography 66.6% and the PTP 76.9%. Intraoperatively 95.2% of all insulinomas were palpable and the intraoperative sonography (IOS) had a sensitivity of 81.2%. In Germany all clinics except for one recommended a sonography and a CT and 83.8% an angiography prior to the first operation. A preoperative localization diagnostic is therefore not absolutely necessary, but may however be helpful in single cases.

Diagnostic Imaging↗
PubMed1990

[Value of preoperative diagnosis in assessing tumor extension of ductal pancreatic carcinoma].

The value of preoperative diagnostics in evaluating the extension of pancreatic carcinoma can be important in some cases for planning its therapy. In ca. 90% of our own patient material only the combination of angiography and computed tomography allowed a correct decision regarding tumor invasion of the vessels. Retrospectively metastases of the liver were seen in 80% and prospectively in 66.7% (sonography), respectively 58.3% (computed tomography) with a specificity of 86.9% respectively 91.3%. These results support our procedure of performing preoperative diagnostics in order to evaluate local operability and resectability only in patients with bad physical condition.

Angiography↗
PubMed1990

[Surgical therapy of insulinoma].

From 12 Patients surgically explored because of suspected insulinoma, the diagnosis was correct in 11. In 8 patients there was a solitary insulinoma, which was diagnosed in every case by preoperative ultrasonography, computed tomography or angiography. In one patient with three adenomas, only one was diagnosed preoperatively, the second by palpation and the third by intraoperative sonography. One patient had a diffuse hyperplasia. The intraoperative frozen section was correct in 9 from 11 patients. The preoperative localisation of insulinoma assisted in the intraoperative identification. The intraoperative pancreatico sonography is an useful help in localisation of insulinoma. For treatment the enucleation of tumor is preferable.

Adenoma, Islet Cell↗
PubMed1990

[Analysis of risk in the perioperative period].

Operative risks should be assessed before surgical intervention not only by heuristic means, but in addition also by quantitative methods. ASA-classification and Recovery Index (McPeek) are offered for a critical routine assessment of global perioperative risk.

Aged↗
PubMed1990

[Prognostically relevant factors in follicular thyroid cancer].

The discussion of the prognosis of follicular thyroid carcinoma is controversial. To evaluate the factors which influence the prognosis we retrospectively analyzed our patients from 1. 1. 1964 to 31. 12. 1987. 76 patients with a follicular thyroid carcinoma were treated during this time. Factors influencing the prognosis were: (1) multiple tumor growth; (2) pT-classification; (3) vascular invasion; (4) tumor stage; (5) degree of cellular differentiation and (6) metastases. Because of the prognostic influence of multiple tumor growth and the slight prognostic influence of lymph node metastases we recommend a total thyroidectomy with neck dissection for follicular thyroid carcinoma.

Adenocarcinoma↗
PubMed1990

[Value of preoperative diagnosis in mesenteric vascular occlusion. A prospective study].

In a prospective study the value of preoperative diagnostics in acute mesenteric vascular occlusion was investigated in 46 patients. Seventeen patients had an arterial thrombosis, 17 a venous thrombosis, 10 had an emboli and 2 patients suffered from a non-occlusive mesenteric infarction. All patients had leucocytosis with an average of 21,000/nl; serum lactate was increased in 91.4% and phosphate was increased in 36.4%. In 82.6% of the cases loops of the small bowel were seen on the X-ray of the abdomen, but in none of the patients an acute mesenteric vascular occlusion was suspected based on the X-ray alone. In 5 of the 46 cases the occlusion could be seen sonographically. The angiography had a sensitivity of 77%.

Abdomen, Acute↗
PubMed1990

[Long-term results of corrective surgery of iatrogenic bile duct injuries].

Little is known about the long-term results after surgical correction of iatrogenic bile duct injuries. In 72 (64.9%) out of 111 patients who were treated at the University of Mainz between 1.1. 1964 and 31.21. 1987 it was possible to obtain reliable observations on the course of the disease after an average period of 9.4 years. After a follow-up time of 23 years only 20% (end-to-end anastomosis) and 34% (choledocho- or hepaticojejunostomy) were free of complaints. Within 10 years 35% were relaparotomized after choledocho- or hepaticojejunostomy and 58% were relaparotomized after end-to-end anastomosis because of complaints. After choledocho- and hepaticoduodenostomy 20 out of 22 patients required a second operation. Long-term results were statistically depended on the localization of the stenosis, the number of interventions and the operation method. Long-term results were independent on the fact if the lesion was primarily seen or not.

Adolescent↗
PubMed1989

[Diagnosis and therapy of hypercalcemic crisis].

Between September 1985 and July 1988 at the Surgical Department of University Mainz 113 patients with primary or tertiary hyperparathyroidismus were operated. In four patients a hypercalcemic crisis developed. At the same time two patients with a hypercalcemia as a metabolic complication of cancer were treated. Within a few hours an involution of the life-threatening symptoms could be achieved by rehydration and diuresis at our intensive care unit. The treatment with mithramycin, calcitonin, a hemodialysis or a phosphate infusion were necessary in none of our patients. Because of the prompt starting of those therapeutical treatments at the intensive care unit no patients died as a result of the hypercalcemic crisis. After ending the hypercalcemic crisis the patients with hyperparathyroidismus were operated. In the patients with a hyperparathyroidismus associated with carcinoma a therapy to lower serum calcium with cortisone and calcitonin was performed.

Adult↗
PubMed1989

[Value of diagnostic localization of insulinoma].

The value of diagnostic localization of insulinoma The value of diagnostic localization statements are contradictory. Basing on our own patient material (n = 41) the preoperative localization of an insulinoma was correct with sonography in 57.7%, with computed tomography in 21.4%, with computed tomography with bolus injection of contrast medium in 73.3%, with angiography 63.9% and with percutaneous transhepatic portal vein catheterisation with selective test of hormones (PTP) in 76.9%. Intraoperative 38 of 41 insulinomas were palpable and twelve of 16 insulinomas were seen during intraoperative sonography. Although we palpate more than 90% of all insulinomas we support a preoperative diagnostic localization for easier intraoperative palpation.

Adenoma, Islet Cell↗