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Biomedical subjects

W Grill

Publications and source records attributed to W Grill.

At least 37 records · Page 2Linked to original sources
PubMed1981

[The prognosis of cancers of the efferent bile ducts].

Malignant tumors of the efferent biliary tracts have a serious prognosis. With reference to a large number of patients it can be demonstrated that too high a percentage (14%) are already inoperable at the first intervention and excision of the tumor is only possible in one quarter of the cases. Careful analysis shows that not inconsiderable survival times--often in astonishingly good condition--can be attained even with palliative measures. Major operation is particularly justified on the distal bile duct, because this gives a real chance of a cure. The essential chance, however, lies in early diagnosis of the malignant process: Surgical help is only possible with an operable state. And it must also not be forgotten that the initial symptoms of incipient carcinoma of the efferent biliary tracts are completely uncharacteristic, but that the sum of modern diagnostic methods permits early recognition.

Ampulla of Vater↗
PubMed1981

[Surgical management of malignant obstruction (author's transl)].

Malignant obstructive jaundice is invariably a disease endangering life. Since there are no prodromal symptoms, nearly one-fourth of the patients are primarily inoperable when seen, and in one-fifth is the tumor resectable. Even in operable cases success is moderate; the highest and longest rates of survival can be achieved with papillary carcinoma. A substantial chance lies in the decisive improvement and shortening of preoperative diagnostics.

Ampulla of Vater↗
PubMed1980

[The sunken drain for internal biliary tract drainage (author's transl)].

In over 4000 interventions on the biliary tract a sunken drain was inserted in 35 patients: 3 times because of carcinomatous infiltration from outside, 27 times because of a proximal hepatic carcinoma and 5 times because of Echinococcus multilocularis. The postoperative mortality was 8.5%. Follow-up examinations show that a little more than a quarter of carcinoma patients died of the primary disease within 6 months but also that 5 patients survived their serious cancer disease for up to 2 1/2 years after the removal of the drainage obstruction. The sunken drain gives better results in Echinococcus alveolaris. Trouble-free intervals of many years were observed.

Aged↗
PubMed1980

[Problems of reconstruction of iatrogenic lesions in the biliary tract (author's transl)].

Iatrogenic lesions of the hepatocholedochus are among the most serious complications of upper abdominal surgery. They present the surgeon with difficult problems: unsuccessful attempts to reconstruct easily lead to irreparable liver damage and situations which can no longer be controlled surgically. Consequently, the corrective operation decides the fate of the patient. Contrary to general opinion, we attempt the ideal bilibiliary end-to-end anastomosis over the large T-drain after mobilization of the stump of the biliary tract even in larger defects. With proper mobilization, even defects of the hepatocholedochus up to 4 cm long can be bridged. Naturally, preparation of the distal limb of the bile duct requires adequate surgical experience. We have performed 40 bilibiliary end-to-end anastomoses in 37 patients. Examination and follow-up examinations showed, apart from one death and three reoccurrences of stenosis, satisfactory results in every respect: The successful bilibiliary end-to-end anastomosis is superior to all other corrective measures.

Adult↗
PubMed1979

[Current state and development of biliary tract surgery].

Status and Development of Biliary Tract Surgery: Diseases of the abdominal cavity are no longer the concern of the internist, general practitioner or surgeon alone. They belong in the hands of the gastroenterologist who are the symbiosis of general practitioner, internist and surgeon. This applies particularly to the wide range of diseases of the biliary tract. On the conservative side this means quick recognition of biliary tract diseases with inclusion of the neighboring organs in the diagnosis; conservative therapy of inflammatory or other additional diseases; establishing a condition suitable for operation and referring the patient to the surgeon before the gallbladder disease has become a biliary tract disease and the operative chances are destroyed by serious complications.

Aged↗
PubMed1979

[Whipple's operation for the treatment of diseases in the duodenopancreatic region (author's transl)].

Whipple's operation is a big intervention. Only through it have patients with serious and severe diseases of the duodenopancreatic region a real chance of cure. The decision to perform Whipple's operation in chronic relapsing pancreatitis, which in principle is a benign disease, is certainly not a light one. But there is no doubt that the chronic inflammatory and abscess-forming diseases of the head of the pancreas cannot be considered benign, either clinically or morphologically. The results are not satisfying, but understandable in view of the severity of the disease and the magnitude of the operation. In addition to operative experience, a better early diagnosis in particular gives a better chance of survival.

Ampulla of Vater↗
PubMed1978

[Vater's papilla as an intra-operative problem].

A well-functioning major duodenal papilla is an indispensable condition for freedom from complaint in the region of the biliary tract and pancreas. Intraoperatively, the papilla is the problem of the surgeon. With appropriate morphological changes, transduodenal papillotomy is a necessary and irreplaceable procedure for curing the bile ducts and the pancreas. It should, however, be strongly emphasized that this surgical papillotomy is a major intervention bearing a number of possible risks. For this reason, only the sufficiently functionally disturbed and morphologically altered papilla is to be operated on.

Ampulla of Vater↗
PubMed1978

[Clinical and operative aspects of liver resection (author's transl)].

On the basis of our experience in 57 liver resections (hydatid cyst in the liver 22 times, 7 hepatic cysts, 5 liver abscesses, 7 benign and 16 malignant hepatic tumors) a few tentative conclusions are drawn: A reliable diagnosis and assessment of operability is only possible on laparotomy. Echinococcus alveolaris should be operated as radically as possible. Primary hepatic tumors should be removed as well as malignant hepatomas and their metastases. Simultaneous extirpation of the primary tumor and metastases has given encouraging results so far, especially in easily resectable carcinomata of the colon and rectum. Cytostatic followup therapy is absolutely essential in all cases of malignancy.

Adult↗
PubMed1977

[The postcholecystectomy syndrome. Prophylaxis and therapy (author's transl)].

The postcholecystectomy syndrome is no inevitable sequel to operation on the biliary tract. The conditions for the postcholecystectomy syndrome are only created if the patients do not come for operation early, i.e. in good time, because the gall bladder disease has by then become a disease of the biliary tract and consequently the technique of the operation and prognosis have assumed considerably more serious characteristics. The postcholecystectomy syndrome is an internal medical, surgical and general medical problem which is preprogramed by procrastinators.

Cholecystectomy↗