ISSN:
1435-2451
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Description / Table of Contents:
Zusammenfassung An Hand eines Krankengutes von nahezu 3000 Gallenoperationen in den Jahren 1961 bis 1967 werden die Vorteile und die Indikation zur Sphincterotomie zur Sanierung der tiefen Gallenwege und der Papilla Vateri dargelegt. Das bei 455 Sphincterotomien erarbeitete und durchgeführte operations-technische Vorgehen wird beschrieben, die Einwände gegen die Sphincterotomie werden diskutiert. In geübter Hand stellt die Sphincterotomie gegenüber den anderen gebräuchlichen Operationsverfahren kein erhöhtes Risiko dar und bietet Gewähr für einen ungestörten Gallenabfluß ins Duodenum.
Notes:
Summary For the sanitation of the lower biliary tracts and the papilla of Vater, the sphincterotomy, as compared with the usual standardized procedures (choledochotomy with sealed-off T-Drainage, choledochotomy with primary occlusion, choledochoduodenostomy) offers the following advantages: 1. Drainage of the biliary tract system at the deepest point, at the physiological point in the intestinal tract. 2. Surer diagnosis and causative elimination of the organic obstruction in the papillary area. 3. Relief of the pancreatic duct system. 4. Removal of bile duct stones without supplementary choledochotomy. 5. Greater safety factor, since concrements which may be left behind can be discharged spontaneously. 6. Easily surveyed operating as secondary operation for shrunken bilidigestive anastomoses. The indication for sphincterotomy is revealed with the aid of a case study involving nearly 3,000 biliary tract operations between the years of 1961 to 1967. The technical operating procedure developed and employed for 455 sphincterotomies is presented with narrative and illustrations. The objections to the sphincterotomy are discussed and comparisons are made with the results of other case-study reports. In experienced hands the sphincterotomy, compared with the other operating procedures in use, does not represent increased risk-mortality in the present case study: 2.8%—while it does offer the certainty of a lasting, undisturbed bile flow into the duodenum.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01444957
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