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Verschlußikterus — Auswirkungen auf Leber- und andere Organfunktionen sowie Operationsrisiko

Bile Duct Obstruction — Effects on Liver and Organ Functions and Operative Risk

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Die Ambivalenz des Fortschritts — ist weniger mehr?

Part of the book series: Deutsche Gesellschaft für Chirurgie ((KONGRESSBAND,volume 1994))

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Summary

Bile duct obstruction affects microsomal (cytochrome P450) and mitochondrial (adenosine triphosphate, ATP) liver function as well as RES clearance. Increased postoperative morbidity and mortality are linked to bacterial translocation and endotoxemia. The most important reason for postoperative lethal outcome is acute renal failure (>50%). Multivariate analysis of risk factors has identified hyperbilirubinemia, low hematocrit, and malignancy as independent risk factors for postoperative mortality. For a subgroup of patients, preoperative biliary decompression seems to be helpful.

Zusammenfassung

Der Verschlußikterus beeinträchtigt die mikrosomale (Cytochrom P450) und mitochondriale (ATP) Leberfunktion sowie die RES-Clearance. Die erhöhte postoperative Morbidität und Letalität wird der bakteriellen Translokation und Endotoxinämie angelastet. Häufigster Grund für die postoperative Letalität ist das akute Nierenversagen. Multivariate Analyse präoperativer Risikofaktoren identifiziert die Hyperbilirubinämie, den erniedrigten Hämatokrit und die maligne Grunderkrankung als unabhängige, ungünstige Parameter. Präoperative Dekompression der Gallenwege erscheint für bestimmte Patienten sinnvoll.

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Author information

Authors and Affiliations

  1. Abteilung Allgemeine Chirurgie mit Poliklinik, Klinikum der Albert-Ludwigs-Universität, Hugstetter Straße 55, 79106, Freiburg, Deutschland

    E. H. Farthmann & U. Baumgartner

Authors
  1. E. H. Farthmann
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  2. U. Baumgartner
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Editors and Affiliations

  1. Steinhölzle 16, D-89197, Westerstetten-Vorderdenkental, Deutschland

    W. Hartel

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© 1994 Springer-Verlag Berlin Heidelberg

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Farthmann, E.H., Baumgartner, U. (1994). Verschlußikterus — Auswirkungen auf Leber- und andere Organfunktionen sowie Operationsrisiko. In: Hartel, W. (eds) Die Ambivalenz des Fortschritts — ist weniger mehr?. Deutsche Gesellschaft für Chirurgie, vol 1994. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79242-7_8

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  • DOI: https://doi.org/10.1007/978-3-642-79242-7_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-58399-8

  • Online ISBN: 978-3-642-79242-7

  • eBook Packages: Springer Book Archive

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