Skip to main content
SpringerLink
Log in

Folgeerkrankungen nach gastrointestinalen Operationen

Chronic diseases after gastrointestinal surgery

  • Schwerpunkt: Folgeerkrankungen
  • Published:
Der Internist Aims and scope Submit manuscript

Zusammenfassung

Operative Eingriffe am Verdauungstrakt können nicht nur durch frühe Komplikationen, sondern auch durch das Auftreten von Folgeerkrankungen für den Patienten therapeutisch relevante Konsequenzen haben. Das Spektrum zu bedenkender Folgeerscheinungen ist dabei abhängig von der Art und dem Ausmaß der durchgeführten Operation. Sie können auf Veränderungen der Anatomie, des zeitlichen Zusammenspiels der Organe des Intestinaltrakts oder der Fähigkeit zur Digestion und Absorption beruhen. Im Falle von Transplantationen kommen Komplikationen der Immunsuppression hinzu. Chronische Konsequenzen operativer Eingriffe sind gelegentlich schwer zu diagnostizieren. Kenntnisse über die typischen Folgeerkrankungen sind von Bedeutung, um eine frühzeitige Diagnosestellung und Therapieeinleitung zu ermöglichen. Manche negativen Folgen lassen sich durch rechtzeitige therapeutische Maßnahmen verhindern. Dieser Beitrag beleuchtet wichtige Folgeerkrankungen der gastrointestinalen Chirurgie.

Abstract

Gastrointestinal surgery may not only lead to early postoperative complications but also chronic consequences. These have therapeutic implications for affected patients. The kind and extent of surgical intervention determines the spectrum of postsurgical phenomena which may occur. These chronic consequences are due to changes in gastrointestinal anatomy, the synchronization of digestive processes, or the ability to digest and absorb food. In case of transplantation surgery, adverse effects of immunosuppression have to be considered. Sometimes, chronic consequences of surgical procedures are difficult to recognize. The knowledge of typical problems associated with gastrointestinal surgery is necessary to enable early and timely diagnosis and treatment. Some negative effects can be avoided by early therapeutic interventions. This article summarizes typical chronic consequences of gastrointestinal surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Literatur

  1. Baba M, Natsugoe S, Shimada M et al. (1999) Does hoarseness of voice from recurrent nerve paralysis after esophagectomy for carcinoma influence patient quality of life? J Am Coll Surg 188: 231–236

    Article  PubMed  Google Scholar 

  2. Bergman JJ, Burgemeister L, Bruno MJ, Rauws EA, Gouma DJ, Tytgat GN, Huibregtse K (2001) Long-term follow-up after biliary stent placement for postoperative bile duct stenosis. Gastrointest Endosc 54: 154–161

    PubMed  Google Scholar 

  3. Buchman AL, Scolapio J, Fryer J (2003) AGA technical review on short bowel syndrome and intestinal transplantation. Gastroenterology 124: 1111–1134

    PubMed  Google Scholar 

  4. Büchler MW, Friess H, Müller MW, Wheatley AM, Beger HG (1995) Randomized trial of duodenum-preserving pancreatic head resection versus pylorus-preserving Whipple in chronic pancreatitis. Am J Surg 169: 65–69

    Article  PubMed  Google Scholar 

  5. Buell JF, Funaki B, Cronin DC et al. (2002) Long-term venous complications after full-size and segmental pediatric liver transplantation. Ann Surg 236: 658–666

    Article  PubMed  Google Scholar 

  6. Costamagna G, Pandolfi M, Mutignani M, Spada, C, Perri V (2001) Long-term results of endoscopic management of postoperative bile duct strictures with increasing number of stents. Gastrointest Endosc 54: 162–168

    PubMed  Google Scholar 

  7. De Boer AG, Genovesi Pl, Sprangers MA, Van Sandick JW, Obertop H, Van Lanschot JJ (2000) Quality of life in long-term survivors after curative transhiatal oesophagectomy for oesophageal carcinoma. Br J Surg 87: 1716–1721

    Article  PubMed  Google Scholar 

  8. Fung J, Kelly D, Kadry Z, Patel-Torn K, Eghtesad B (2005) Immunosuppression in liver transplantation: beyond calcineurin inhibitors. Liver Transpl 11: 267–280

    Article  PubMed  Google Scholar 

  9. Harju E (1985) Dietary habits and eating related symptoms in out-patients following total gastrectomy and Roux-en-Y reconstruction for carcinoma of the stomach. Anticancer Res 5: 277–279

    PubMed  Google Scholar 

  10. Hulscher JB, van Sandick JW, Devriese PP, van Lanschot JJ, Obertop H (1999) Vocal cord paralysis after subtotal oesophagectomy. Br J Surg 86: 1583–1587

    Article  PubMed  Google Scholar 

  11. Kahl S, Malfertheiner P (2004) Exocrine and endocrine pancreatic insufficiency after pancreatic surgery. Best Pract Res Clin Gastroenterol 18: 947–955

    Article  PubMed  Google Scholar 

  12. Keller J, Panter H, Layer P (2004) Management of the short bowel syndrome after extensive small bowel resection. Best Pract Res Clin Gastroenterol 18: 977–992

    Article  PubMed  Google Scholar 

  13. Klebl FH, Bregenzer N, Rogler G, Straub RH, Schölmerich J, Andus T (2003) Treatment of pouchitis with dehydroepiandrosterone (DHEA) — a case report. Z Gastroenterol 41: 1087–1090

    Article  PubMed  Google Scholar 

  14. Koga S, Nishimura 0, lwai N, Kishi K, Takeuchi T, Hinohara T, Okamoto T (1979) Clinical evaluation of long-term survival after total gastrectomy. Am J Surg 138: 635–639

    Article  PubMed  Google Scholar 

  15. Lerut TE, van Lanschot JJB (2004) Chronic symptoms after subtotal or partial oesophagectomy: diagnosis and treatment. Best Pract Res Clin Gastroenterol 18: 901–915

    Article  PubMed  Google Scholar 

  16. Mirnura T, Rizzello F, Helwig U et al. (2004) Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis. Gut 53: 108–114

    Article  PubMed  Google Scholar 

  17. Müller AR, Platz KP, Kremer B (2004) Early postoperative complications following liver transplantation. Best Pract Res Clin Gastroenterol 18: 881–900

    Article  PubMed  Google Scholar 

  18. Neuhaus P, Blumhardt G, Bechstein WO, Steffen R, Platz KP, Keck H (1994) Technique and results of biliary reconstruction using side-to-side choledochocholedochostomy in 300 orthotopic liver transplants. Ann Surg 219: 426–434

    PubMed  Google Scholar 

  19. Rodrigues CA, Lennard-Jones JE, Thompson DG, Farthing MJ (1989) The effects of octreotide, soy polysaccharide, codeine and loperamide on nutrient, fluid and electrolyte absorption in the short-bowel syndrome. Aliment Pharmacol Ther 3: 159–169

    PubMed  Google Scholar 

  20. Sanchez-Bueno F, Robles R, Acosta F et al. (2000) Hepatic artery complications in a series of 300 orthothopic liver transplants. Transplant Proc 32: 2669–2670

    Article  PubMed  Google Scholar 

  21. Sategna-Guidetti C, Bianco L (1989) Malnutrition and malabsolption after total gastrectomy. A pathophysiologic approach. J Clin Gastroenterol 11: 518–524

    PubMed  Google Scholar 

  22. Schölmerich J (2004) Postgastrectomy syndromes — diagnosis and treatment. Best Pract Res Clin Gastroenterol 18: 917–933

    Article  PubMed  Google Scholar 

  23. Schölmerich J, Holstege A (1988) Micronutrients: deficiency and treatment after total gastrectomy. Nutrition 4: 317–319

    Google Scholar 

  24. Seguy D, Vahedi K, Kapel N, Souberbielle JC, Messing B (2003) Low-dose growth hormone in adult home parenteral nutrition-dependent short bowel syndrome patients: a positive study. Gastroenterology 124: 293–302

    Article  PubMed  Google Scholar 

  25. Shibuya S, Fukudo S, Shineha R et al. (2003) High incidence of reflux esophagitis observed by routine endoscopic examination after gastric pull-up esophagectomy. World J Surg 27: 580–583

    Article  PubMed  Google Scholar 

  26. Svedlund J, Sullivan M, Liedman B, Lundell L (1999) Long term consequences of gastrectomy for patients quality of life: the impact of reconstructive techniques. Am J Gastroenterol 94: 438–445

    Article  PubMed  Google Scholar 

  27. Tovey FI, Godfrey JE, Lewin MR (1990) A gastrectomy population: 25–30 years on. Postgrad Med J 66: 450–456

    PubMed  Google Scholar 

  28. Zoepf T, Maldonado-Lopez EJ, Hilgard P et al. (2005) Endoscopic therapy of posttransplant biliary stenoses after right-sided adult living donor liver transplantation. Clin Gastroenterol Hepatol 3: 1144–1149

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt:

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Innere Medizin 1, Klinikum der Universität Regensburg

    I. Zuber-Jerger, J. Schölmerich &  F. Klebl

  2. Klinik und Poliklinik für Innere Medizin 1, Klinikum der Universität, 93042, Regensburg

    F. Klebl

Authors
  1. I. Zuber-Jerger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Schölmerich
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Klebl
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F. Klebl.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zuber-Jerger, I., Schölmerich, J. & Klebl, F. Folgeerkrankungen nach gastrointestinalen Operationen. Internist 47, 242–251 (2006). https://doi.org/10.1007/s00108-005-1570-y

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00108-005-1570-y

Schlüsselwörter

Keywords

Search

Navigation