Zeitschrift für Gastroenterologie
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The value of the lipase/amylase ratio for early etiological differentiation of acute pancreatitis was tested in 103 consecutive patients with acute pancreatitis from an ongoing prospective study. On admission, amylase, but not lipase, was significantly lower in alcoholics than in nonalcoholics in general and especially in patients with biliary pancreatitis. ⋯ Finally, there was no correlation between the ratio and the amount of pancreatic changes as judged from computed tomography. We concluded that the ratio does not allow for early routine clinical differentiation between etiologies of pancreatitis and evaluation of the severity of the disease.
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The definition of Gilbert's syndrome changed in the 1980s. Today this syndrome means a heterogeneous, relatively frequent condition that is caused by moderate, chronic, often familial non-conjugated hyperbilirubinemia with an increased bilirubin turnover in about 30-40% of the cases.
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More than 90% of all common bile duct stones are today extracted endoscopically after papillotomy with the Dormia basket in combination with the mechanical lithotripter. For patients with endoscopically unremovable stones, there are now new therapies as an alternative to surgical intervention. Ductal stones can either be fragmented by extracorporeal shock wave lithotripsy or by peroral cholangioscopic guided electrohydraulic lithotripsy. ⋯ By combination of both techniques, the calculi could be removed in 84% of those patients where before one of both therapies had failed. Finally, the rate of success in the above mentioned 44 patients was 93%. It could be shown by this investigation that both therapeutic methods complete each other in the treatment of the complicated common bile duct stones.
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The reliability and validity of sonographic measurements of gastric emptying employing sagittal antral planimetry were investigated. The intraindividual reproducibility of this procedure was examined in 15 healthy volunteers, who ingested 400 ml of water on two separate study days. ⋯ There was a significant correlation between the relative residual volumes calculated by scintigraphy and by ultrasound (r = 0.82). These results imply that the ultrasonic sagittal antral area method is reliable and valid in the assessment of gastric emptying rates in humans.