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Biomedical subjects

W Krautzberger

Publications and source records attributed to W Krautzberger.

At least 19 recordsLinked to original sources
PubMed1986

CA 19-9 and pancreatic adenocarcinoma.

The diagnostic place value of CA 19-9, a tumor-associated antigen, was tested in 611 patients. This group of patients included 273 patients who suffered from a malignant disease (48 patients with pancreatic carcinomas and 225 patients with extrapancreatic malignant growths) and 338 patients with benign diseases (66 patients with chronic pancreatitis, 36 patients with acute pancreatitis, and 236 patients with general surgical diseases). In 93% of the patients with pancreatic carcinoma (media value, 528 U/ml), in 37% and 19% of the patients with carcinoma of the stomach and colorectal carcinomas (median value 8 U/ml), respectively, the CA 19-9 value was estimated as being above the normal limits of 6 to 37 U/ml. A sensitivity of 93% and a specificity of 85%, as well as a total accuracy of 82%, were established in pancreatic carcinoma during preoperative observation. The preoperatively raised CA 19-9 concentration in patients with pancreatic carcinomas dropped after curative resection of the carcinoma to within normal limits. However, a serum concentration of less than 37 U/ml was not recorded in any CA 19-9 estimation after a palliative surgical intervention, or in any case of inoperable carcinomas.

Adenocarcinoma↗
PubMed1985

Total gastrectomy. A 15-year experience with particular reference to the patient over 70 years of age.

Between 1969 and 1984, a total of 186 patients underwent total gastrectomy. Seventy-four patients were more than 70 years of age. Surgical mortality was 13.4%, with only minor differences between those patients younger than 70 years and older patients--12.5% and 14.8%, respectively. Moreover, there was no major difference if surgery was curative or merely palliative. Of 27 patients with tumors at TNM stage IV, only one died. Of the 100 patients who were operated on during the five-year period between 1979 and 1984, only four died, for an operative mortality of 4%. These results suggest that this remarkable decline of mortality is due to a precise standardization of surgical technique and improvements in preoperative patient management and aftercare. The five-year survival was 15.9%; again, there was no major difference between the group of patients older than 70 years and those younger than 70 years (19.4% and 14.5%, respectively). The ten-year survival was 4.9%.

Age Factors↗
PubMed1985

A metastatic endocrine-neurogenic tumor of the ampulla of Vater with multiple endocrine immunoreaction--malignant paraganglioma?

The present case report demonstrates the history of a 50-year-old man with a mixed endocrine-neurogenous tumor of the ampulla of Vater. The tumor was localized endoscopically after an attack of melena. There were no signs of endocrinopathy. A local resection with suturing of the pancreatic duct was performed. Morphologically, there were two different tissue types (neurogenous and carcinoid-like) with numerous cells and nerve fibers reacting immunohistochemically with somatostatin and neurotensin antisera: some immunoreactivity to PP-antibodies was observed. Still, after 20 months, the patient seems to have been cured by local resection.

Ampulla of Vater↗
PubMed1985

Duodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis.

A duodenum-preserving resection of the head of the pancreas was carried out in 57 patients with chronic pancreatitis and a benign tumorous enlargement of the head of the pancreas. The resected tissue showed a diameter of more than 5 cm in 64% of the patients. The postoperative mortality rate was 1.8%. The postoperative hospitalization period was 19 days (median). In a follow-up period of 2.0 years (median) with a minimum of 1 month and a maximum of 10.5 years, the late mortality rate was 3.6%. Of the patients, 85.7% are completely rehabilitated occupationally. In contrast to the Whipple procedure, the duodenum-preserving resection of the head of the pancreas preserves stomach, duodenum, jejunum, and extrahepatic bile ducts in an advantageous way. The subtotal resection of the head of the pancreas decompresses the common bile duct without disturbance of the blood flow to the duodenum.

Adult↗
PubMed1985

[Necrotizing pancreatitis: peritoneal lavage or bursa lavage? Results of a prospective consecutive controlled study].

In 111 patients with necrotizing pancreatitis two different therapeutical procedures were applied since 1974 in addition to the surgical removal of necrotic tissue. In group I with 64 patients a continuous peritoneal lavage and in group II with 47 patients a local lavage of the lesser sac were performed. In case of extrapancreatic necroses and diffuse peritonitis peritoneal lavage was done additionally in 32 patients. Local lavage of the lesser sac, in some cases combined with peritoneal lavage, is the procedure significantly superior to peritoneal lavage alone.

Acute Disease↗
PubMed1984

[Clinical aspects and fine structure of papillary cancer. With special reference to morphological carcinogenesis].

Course of the disease and microscopic work-up of the operative specimens with special consideration of morphological carcinogenesis were analysed in 72 patients with tumour of the ampulla of Vater. Mean duration since onset of symptoms was 6.6 weeks. Cardinal symptoms were jaundice, loss of weight and abdominal pain. Endoscopic-retrograde cholangio-pancreatography, computed tomography and percutaneous transhepatic cholangiography had the highest diagnostic accuracy. Resection rate of the carcinoma was 55%, hospital mortality was 6.7% for partial duodenopancreatectomy and 15.4% for palliative surgery. The mean survival rate was 20 months after partial duodenopancreatectomy and 5 months after palliative surgery. The survival rate was significantly decreased if tumour size was above 2 cm and lymph nodes were positive for tumour. In 82.8% of the examined operative specimens moderate to high-grade epithelial dysplasias were found in carcinoma-free portions of the ampulla, and in 91.4% there were adenomatous structures. It is to be assumed that carcinoma of the ampulla develops via dysplastic epithelial changes or from adenoma of the ampulla.

Aged↗
PubMed1984

[Gastrectomy in the aged].

Between 1969 and 1983 a total of 152 patients underwent total gastrectomy. 58 patients were older than 70 years. Surgical lethality was 14.47% with only minor differences between those patients younger than 70 and the older ones: 13.8 and 15.5%, respectively. Moreover, it did not make any major difference whether surgery was curative or merely palliative. Of 27 patients with the tumor stage TNM IV, only one patient died. Of the 66, who were operated upon during the recent 5 years period between 1979 and 1983, only one patient died. These results suggest that this remarkable decline of lethality is due to a precise standardisation of surgical technique, improvements in preoperative management of the patient and aftercare. 5 years survival rate was 17.3%; again there was no major difference between the group of patients older than 70 and those being younger than 70 years (16.5% and 19.4% respectively). It is of interest that the patients having additional splenectomy presented with an essentially worse prognosis as opposed to those without splenectomy although there were no differences between the TNM-stages. Even if the small numbers of patients can not yet be definitely conclusive, these preliminary results indicate that the indication for splenectomy in the course of total gastrectomy should be critically evaluated.

Age Factors↗
PubMed1984

[Duodenum-sparing pancreas head resection in chronic pancreatitis--results after 10 years' use].

During a ten years period duodenum preserving pancreatic head resection was performed in 56 patients with chronic pancreatitis and related pancreatic head tumor. Immediate lethality was 1.8%, rate of reoperation 3.6%, late lethality after an average follow-up of 24 months (minimum 1, maximum 124 months) 3.6%. At the time of follow-up 87.3% of the patients were back at work, 58% were free of abdominal symptoms, 7.4% complained about occasional to frequent abdominal pains. 72.9% gained weight postoperatively. Duodenum preserving pancreatic head resection constitutes the subtotal resection of the pancreatic head and jejunal interpostition for the parenchymal defect. The procedure is advantageous as compared to Whipple's operation in so far as stomach, duodenum and bile duct remain intact.

Adult↗
PubMed1984

[Ulcer perforation in Meckel's diverticulum].

Ectopic gastric mucosa can be found in 40-80% of Meckel's diverticula; parietal cells producing acid are not inhibited by regulatory factors, giving rise in some cases to ulcers, which may perforate. A case report of a patient with a perforated ulcer in a Meckel's diverticulum is given. Meckel's diverticula should be removed surgically when they are diagnosed or when they are found by chance during surgery because of the risk of complications.

Child↗
PubMed1983

A special method of intra-arterial infusion for treatment of head and neck cancer.

Immediately after radical neck dissection the external carotid artery is lengthened by an autogenic saphenous vein graft and sutured more proximally to the common carotid artery. All branches of the external carotid artery not contributing to the blood supply in the tumor region are ligated. After the wound has healed, the vascular graft will be easily palpable and can be punctured repeatedly for highly selective intra-arterial chemotherapy of the inoperable primary tumor for a prolonged period of time. The method seems to be practicable, innocuous, and more effective than conventional methods of intra-arterial chemotherapy for head and neck cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

[Thromboembolism prevention in surgical medicine: heparin or heparin-dihydroergotamine?].

This review summarizes clinical studies on prevention of venous thromboembolism by heparin or heparin and dihydroergotamine. Advantages and disadvantages of both drugs are described. The value of low-dose-heparin can no longer be seriously disputed. Up to now, however, there is no clear evidence that heparin-dihydroergotamine improves the efficacy and reduces the frequency of complications. The later drug is a new approach still under investigation.

Clinical Trials as Topic↗
PubMed1982

[Necrotizing pancreatitis. Surgical indications and results in 118 patients].

In a ten years period 118 patients were operated with necrotizing pancreatitis. 42% of the patients had a 50% necrosis and 25% a subtotal/total necrosis of the pancreas. Surgical therapy principally includes: necrotectomy with drainage of the pancreas layer and postoperatively local lavage of the pancreatitic cavum (61/24 h). In 28 patients a continuous peritoneal lavage were performed additionally (24.4 +/- 14.71/day, duration 9.6 +/- 8.2 days). The total lethality was 33.9%. The course of the patients with necrotizing pancreatitis is destinated by the extention of the necrosis in the pancrease itself, the development of extrapancreatic necrosis and the bacterial contamination of the necrosis (bacterial retroperitonitis, abscess).

Acute Disease↗