Die geschichtliche Entwicklung der Sphinktererhaltung beim Rektumkarzinom

Kronberger, L

doi:10.1007/bf02620010

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…Surgery is required for large posterior duodenal bleeding ulcers in patients who are in shock on admission in order to prevent death from recurrent hemorrhage (Table 2). For these large posterior and penetrating ulcers, resection using antr0pylororectomy with truncal vagotomy is often recommended [1,[7][8][9][10], but a main problem may consist in dissecting an adequate cuff of distal duodenum to allow safe closure [11]. Mobilization of the duodenum from the pancreas runs the risk of pancreatic fistula, hemorrhage from the pancreatic area, and injury of the bile duct [11].…”

Section: Discussionmentioning

confidence: 99%

“…For these large posterior and penetrating ulcers, resection using antr0pylororectomy with truncal vagotomy is often recommended [1,[7][8][9][10], but a main problem may consist in dissecting an adequate cuff of distal duodenum to allow safe closure [11]. Mobilization of the duodenum from the pancreas runs the risk of pancreatic fistula, hemorrhage from the pancreatic area, and injury of the bile duct [11]. Some methods, such as the Nissen procedure, suture the anterior duodenal wall to the fibrosed lower margin of the ulcer bed [1,2,12].…”

Section: Discussionmentioning

confidence: 99%

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Reliable procedure for closing the duodenal stump for bleeding posterior duodenal ulcer

et al. 1994

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Bleeding posterior duodenal ulcers is a critical problem especially in patients of advanced age. Surgical treatment should obtain efficient and stable hemostasis and avoid digestive fistulas due to leakage of the duodenal stump. The main difficulty lies in the closure of the duodenal stump. A procedure using intramural dissection of the duodenum and closure by means of a stapler is reported for a series of 40 patients without recurrent bleeding or duodenal fistula. Seven patients (17%) died from associated diseases, especially respiratory insufficiency (3 patients) and cirrhotic liver failure (2 patients).

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