Subject(s)
Medical Errors/prevention & control , Patient Safety/standards , Societies, Medical , Germany , HumansABSTRACT
Between 1/1980 and 12/1992 at the Surgical Clinic (Charité) 251 patients were treated for benign liver tumors. In 139 cases a laparotomy was necessary. Fourty of these operations were explorative laparotomies only, whereas among the resections there were mainly atypical and segmental resections, respectively (n = 81). In the case of focal nodular hyperplasia (FNH) and hemangioma the indication for operation resulted from the patients' complaints (n = 45) and the preoperatively uncertain dignity of the process (n = 50). If an adenoma was suspected (n = 38) an absolute indication for operation was assumed with respect to the danger of rupture or bleeding reported in the literature as well as the uncertain differentiation from malignancy often experienced. The suspected diagnosis was proved in 30 cases, in 8 patients a FNH was found intraoperatively without the consequence of resection. Six patients were resected for a suspected hepatocellular carcinoma (HCC) which could not be confirmed postoperatively. In conclusion, the rate of preoperative uncertain or wrong diagnoses concerning definitive histology was 25.4%. The mortality rate of the performed liver resections was 2%, but was not directly related to the liver resection per se. In 4 patients the postoperative course required a relaparotomy. By a follow-up starting with 3-months intervals, two patients with an hepatocellular carcinoma were detected 12 weeks after the first diagnosis of FNH. A successful resection was carried out in both cases.
Subject(s)
Liver Diseases/surgery , Liver Neoplasms/surgery , Liver/pathology , Precancerous Conditions/surgery , Adenoma/diagnosis , Adenoma/mortality , Adenoma/pathology , Adenoma/surgery , Adult , Aged , Carcinoma, Hepatocellular/diagnosis , Carcinoma, Hepatocellular/mortality , Carcinoma, Hepatocellular/pathology , Carcinoma, Hepatocellular/surgery , Diagnosis, Differential , Female , Follow-Up Studies , Hemangioma/diagnosis , Hemangioma/mortality , Hemangioma/pathology , Hemangioma/surgery , Hepatectomy , Humans , Hyperplasia , Liver Diseases/diagnosis , Liver Diseases/mortality , Liver Diseases/pathology , Liver Neoplasms/diagnosis , Liver Neoplasms/mortality , Liver Neoplasms/pathology , Male , Middle Aged , Postoperative Complications/diagnosis , Postoperative Complications/mortality , Postoperative Complications/pathology , Postoperative Complications/surgery , Precancerous Conditions/diagnosis , Precancerous Conditions/mortality , Precancerous Conditions/pathology , Reoperation , Survival RateABSTRACT
Nosocomial and other severe infections are able to cause life-threatening complications in organ transplant recipients. Unter such conditions the treatment will be successful only in early status of infection. Fluconazol (Diflucan) has been used in the treatment of candidosis in cardiac and renal transplant patients with good results, and lack of adverse effects.
Subject(s)
Candidiasis/etiology , Cross Infection/etiology , Fluconazole/therapeutic use , Heart Transplantation , Kidney Transplantation , Adult , Candidiasis/drug therapy , Cross Infection/drug therapy , Humans , MaleSubject(s)
Thoracic Surgery/history , Animals , Germany , History, 19th Century , History, 20th Century , Humans , Thoracoplasty/historyABSTRACT
A new method of intraperitoneal transplantation of the whole pancreas as donor-pancreaticoduodeno/recipient-cholecystostomy is described. The pancreas with duodenal segment is placed into the dorsal peritoneal cavity and the portal vein is anastomosed with the subhepatic vena cava and the long aortic segment of the graft with the distal aorta of the recipient. An anastomosis between the donor's duodenal segment and the recipient's gallbladder ensures exocrine pancreatic secretion drainage.
