Ulcusforschung: Bestandsaufnahme, Perspektiven

  • E. C. Jehle
  • H. D. Becker


In den vergangenen Jahrzehnten bis zum Ende der 70er Jahre hatte die Chirurgie einen bedeutenden Anteil an der Ulcustherapie, und Patienten mit Magen- und Duodenalulcera stellten einen hohen Prozentsatz am abdominalchirurgischen Krankengut dar. Dementsprechend beschäftigte sich bis in die 80er Jahre hinein ein großer Teil der chirurgischen Forschung mit der Pathophysiologie der Ulcuskrankheit, vor allem aber mit der Effizienz, der Sicherheit und den Langzeitfolgen verschiedener resezierender und nicht-resezierender chirurgischer Therapieformen.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Andersen D, Amdrup E, Hostrup H, Sorensen FH (1983) Surgery or Cimetidine? Comparison of two plans of treatment: operation or Cimetidine given as a low maintenance dose. World J Surg 7:378–384PubMedCrossRefGoogle Scholar
  2. Asaka M, Kimura T, Kudo M, Takeda H, Mitani S, Miyazaki T, Miki K, Graham DY (1992) Relationship of Helicobacter pylori to serum pepsinogens in an asymptomatic Japanese population. Gastroenterology 102:760–764PubMedGoogle Scholar
  3. Bell GD, Powell KU (1993) Eradication of Helicobacter pylori and its effect in peptic ulcer disease. Scand J Gastroenterol Suppl 28:7–11CrossRefGoogle Scholar
  4. Black JW, Duncan WAM, Durant CJ, Ganellin CR, Parsons EM (1972) Definition and antagonism of histamine H2-receptors. Nature 236:385–390PubMedCrossRefGoogle Scholar
  5. Blaser MJ (1992) Hypotheses on the pathogenesis and natural history of Helicobacter pylori-induced inflammation. Gastroenterology 102:720–727PubMedGoogle Scholar
  6. Borch K, Renvall H, Leidberg G, Anderson BN (1986) Relations between circulating gastrin and endocrine cell proliferation in the atrophic gastric fundic mucosa. Scand J Gastroenterol 21:357–363PubMedCrossRefGoogle Scholar
  7. Calabrö A, Milani S, Paladini I, Orsini B, Salvadori G, Surrenti C (1995) Role of epidermal growth factor in peptic ulcer healing. Dig Dis Sci 40:2497–2504PubMedCrossRefGoogle Scholar
  8. Chen M, Lee A, Hazell S (1992) Immunisation against gastric Helicobacter infection in a mouse/Helicobacter felis model (letter). Lancet 339:1120–1121PubMedCrossRefGoogle Scholar
  9. Chuang CN, Tanner M, Soil AH (1992) Gastrin induction of histamine release from canine fundic mucosal cells in primary culture. Am J Physiol 263: G460–G465PubMedGoogle Scholar
  10. Corthésy-Theulaz I, Porta N, Glauser M, Saraga E, Vaney AC, Haas R, Kraehenbühl JP, Blum AL, Michetti P (1995) Oral immunization with Helicobacter pylori urease B subunit as a treatment against Helicobacter infection in mice. Gastroenterology 109:115–121PubMedCrossRefGoogle Scholar
  11. Crofts TJ, Park KG, Steele RJ, Chung SS, Li AK (1989) A randomized trial of non-operative treatment for perforated peptic ulcer. N Engl J Med 320:970–973PubMedCrossRefGoogle Scholar
  12. Czinn SJ, Cai A, Nedrud JG (1993) Protection of germ-free mice from infection by Helicobacter felis after active oral or passive IgA immunization. Vaccine 11:637–642PubMedCrossRefGoogle Scholar
  13. Davis GR (1993) Neoplasms of the stomach. In: Sleisenger MH, Fordtran JS (eds) Gastrointestinal Disease. WB Saunders, Philadelphia, pp 763–789Google Scholar
  14. Ell C, Hagenmüller F, Schmitt W, Riemann JF, Hahn EG, Hohenberger W (1995) Multizentrische prospektive Untersuchung zum aktuellen Stand der Therapie der Ulcusblutung in Deutschland. Dtsch Med Wschr 120:3–9PubMedCrossRefGoogle Scholar
  15. Forman D, Newell DG, Fullerton F, Yarnell JWG, Stacey AR, Wald N, Sitas F (1991) Association between infection with Helicobacter pylori and risk of gastric cancer: evidence from a prospective investigation. BMJ 302:1302–1305PubMedCrossRefGoogle Scholar
  16. Graham DYI (1991) Helicobacter pylori: Its epidemiology and its role in duodenal ulcer disease. J Gastro Hepatol 6:97–101CrossRefGoogle Scholar
  17. Graham DY, Malaty HM, Evans DG, Evans DJ, Klein PD, Adam E (1991) Epidemiology of Helicobacter pylori in an asymptomatic population in the United States: Effect of age, race, and socioeconomic status. Gastroenterology 100:1495–1500PubMedGoogle Scholar
  18. Griffin SM, Chung SC, Leung JW, Li AK (1989) Peptic pyloric stenosis treated by endoscopic ballon dilatation. Br J Surg 76:1147–1148PubMedCrossRefGoogle Scholar
  19. Häkanson R, Kroesen JH, Liedberg G, Oscarson J, Rehfeld JF, Stadil F (1974) Correlation between serum gastrin concentration and rat stomach histidine decarboxylase activity. J Physiol (Lond) 243:483–498Google Scholar
  20. Häkanson R, Blom H, Carlsson E, Larsson H, Ryberg B, Sundler F (1986) Hypergastrinemia produces trophic effects on the stomach but not in pancreas and intestines. Regul Pept 13:225–233PubMedCrossRefGoogle Scholar
  21. Häkanson R, Böttcher G, Ekblad E, Panula P, Simonsson M, Dohlsten M, Hallberg T, Sundler F (1986) Histamine in endocrine cells in the stomach. Histochemistry 86:5–17PubMedCrossRefGoogle Scholar
  22. Häkanson R, Chen D, Sundler F (1994) The ECL cell. In: Johnson LR (ed) Physiology of the gastrointestinal tract. Raven Press, New York, pp 1171–1184Google Scholar
  23. Hogan RB, Hamilton JK, Polter DE (1986) Preliminary experience with hydrostatic balloon dilatation of gastric outlet obstruction. Gastrointest Endosc 32:71–74PubMedCrossRefGoogle Scholar
  24. Jaskiewicz K, Louw JA, Marks IN (1993) Local cellular and immune response by antral mucosa in patients undergoing treatment for eradication of Helicobacter pylori. Dig Dis Sci 38:937–943PubMedCrossRefGoogle Scholar
  25. Jehle EC, Siewert JR, Blum AL (1994) Sequelae of gastric surgery. In: Misiewicz J J, Pounder RE, Venables CW (eds) Diseases of the gut and the pancreas. 2nd edition. Blackwell, Oxford, pp 303–318Google Scholar
  26. Johnson AG (1994) Management of peptic ulcer. Br J Surg 81:161–163PubMedCrossRefGoogle Scholar
  27. Klinkenberg-Knol EC, Festen HP, Jansen JB, Lamers CB, Nelis F, Snel P (1994) Efficacy and safety of long-term treatment with omeprazole for refractory reflux esophagitis. Ann Intern Med 121:161–167PubMedGoogle Scholar
  28. Kohler B, Riemann JF (1991) The endoscopic Doppler: its value in evaluating gastroduodenal ulcers after hemorrhage ans as ans instrument of control of endoscopic injection therapy. Scand J Gastroenterol 26:471–476PubMedCrossRefGoogle Scholar
  29. Kuipers EJ, Uyterlinde AM, Pena S, Hazenberg HJA, Loemena E, Lindeman J, Klinkenberg-Knol EC, Meuwissen SGM (1995) Increase of Helicobacter pylori-associated corpus gastritis during acid suppressive therapy: Implications for long-term safety. Am J Gastroenterol 90:1401–1406PubMedGoogle Scholar
  30. Lai KH, Peng SN, Guo WS, Lee YS, Chang FY, Malik U, Wang JY, Lo GH, Cheng JS, Lee SD, Tsai YT (1994) Endoscopic injection for the treatment of bleeding ulcers: local tamponade or drug effect? Endoscopy 26:338–341PubMedCrossRefGoogle Scholar
  31. Lamberts R, Creutzfeldt W, Struber HG, Brunner G, Solcia E (1993) Long-term omeprazole therapy in peptic ulcer disease: gastrin endocrine cell growth, and gastritis. Gastroenterology 104:1356–1370PubMedGoogle Scholar
  32. Lau WY, Leung KL, Zhu XL, Lam YH, Chung SCS, Li AKC (1995) Laparoscopic repair of perforated pepic ulcer. Br J Surg 82:814–816PubMedCrossRefGoogle Scholar
  33. Lindberg P, Nordberg P, Alinger T, Brandstrom A, Wallmark B (1986) The mechanism of action of the gastric aid secretion inhibitor omeprazole. J Med Chem 29:1327–1329PubMedCrossRefGoogle Scholar
  34. Marchetti M, Aricö B, Burroni D, Figura N, Rappuoli R, Ghiara P (1995) Development of a mouse model of Helicobacter pylori infection that mimics human disease. Science 267:1655–1658PubMedCrossRefGoogle Scholar
  35. Marshall BJ (1983) Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet 1:1273–1275Google Scholar
  36. Marshall BJ, Warren JR (1984) Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 1:1311–1315PubMedCrossRefGoogle Scholar
  37. Marshall BJ, Armstrong JA, McGechie DB (1985) Attempt to fulfil Koch’s postulates for pyloric Campylobacter. Med J Austr 142:436–439Google Scholar
  38. Matsuda M, Nishiyama M, Hanai T, Saeki S, Watanabe T (1995) Laparoscopic omental patch repair for perforated peptic ulcer. Ann Surg 221:236–240PubMedCrossRefGoogle Scholar
  39. McCloy R, Nair R (1994) Minimal access surgery — the renaissance of gastric surgery? Yale J Biol Med 67:159–166PubMedGoogle Scholar
  40. Michetti P, Corthesy-Theulaz I, Davin C, Haas R, Vaney AC, Heitz M, Bille J, Kraehenbühl JP, Saraga E, Blum AL (1994) Immunization of BALB7c mice against Helicobacter felis infection with Helicobacter pylori urease. Gastroenterology 107:1002–1011PubMedGoogle Scholar
  41. NIH Consensus Development Conference (1994) Helicobacter pylori in peptic ulcer disease. National Institut of Health, Bethesda, MDGoogle Scholar
  42. Nomura A, Stemmeramn GN, Chyou PH, Kato I, Prez-perez Gl, Blaser MJ (1991) Helicobacter pylori infection and gastric carcinoma among Japanese-Americans in Hawaii. N Engl J Med 325:1132–1134PubMedCrossRefGoogle Scholar
  43. Parsonnet J, Friedman GD, Vandersteen DP, Chang Y, Vogelman JH, Orentreich N, Sibley RK (1991) Helicobacter pylori infection and the risk of gastric carcinoma. N Engl J Med 325:1127–1131PubMedCrossRefGoogle Scholar
  44. Perissat J, Collet D, Edye M (1992) Therapeutic laparoscopy. Endoscopy 24:138–143PubMedCrossRefGoogle Scholar
  45. Rauws EA, Jangenberg W, Houthoff HJ, Zanen H, Tytgat GNJ (1988) Campylobacter pyloridis-associated chronic active antral gastritis. A prospective study of its prevalence and the effects of antibacterial and antiulcer treatment. Gastroenterology 94:33–38PubMedGoogle Scholar
  46. Ryberg B, Bishop AE, Bloom SR, Carlsson E, Hakanson R, Larson H, Mattsson H, Polak JM, Sundler F (1989) Omeprazole and ranitidine, antisecretagogues with different modes of action, are equally effective in causing hyperplasia of enterochromaffin-like cells in rat stomach. Regul Pept 25:235–246PubMedCrossRefGoogle Scholar
  47. Sandvik AK, Waldum HL, Kleveland PM, Sognen BS (1987) Gastrin evokes an immediate and dose dependent histamine release preceding acid secretion in the totally isolated vascularly perfused rat stomach. Scand J Gastroenterol 22:803–808PubMedCrossRefGoogle Scholar
  48. Schmudderich W, Harloff M, Riemann JF (1989) Through-the-scope balloon dilatation of benign pyloric stenoses. Endoscopy 21:7–10PubMedCrossRefGoogle Scholar
  49. Schubert ML, Edwards NF, Arimura A, Makhlouf GM (1987) Paracrine regulation of gastric acid secretion by fundic somatostatin. Am J Physiol 252: G485–G490PubMedGoogle Scholar
  50. Schubert ML, Edwards MF, Makhlouf GM (1988) Regulation of gastric somatostatin secretion in the mouse by luminal acidity: a local feedback mechanism. Gastroenterology 94:317–322PubMedGoogle Scholar
  51. Silen W (1988) Experimental models of gastric ulceration and injury. Am J Physiol 255: G395–G402PubMedGoogle Scholar
  52. Soil AH (1993) Gastric, duodenal, and stress ulcer. In: Sleisenger MH, Fordtran JS (eds) Gastrointestinal Disease. WB Saunders, Philadelphia, pp 580–679Google Scholar
  53. Sonnenberg A (1989) Costs of medical and surgical treatment of duodenal ulcer. Gastroenterology 96:1445–1452PubMedGoogle Scholar
  54. Soper N, Brunt LN, Kerbl K (1994) Laparoscopic general surgery. N Engl J Med 330:409–419PubMedCrossRefGoogle Scholar
  55. Stolte M, Eidt S (1989) Lymphoid follicles in the antral mucosa: immune response to Campylobacter pylori. J Clin Pathol 42:1269–1271PubMedCrossRefGoogle Scholar
  56. Swain CP, Mills TN (1986) An endoscopic sewing machine. Gastrointest Endosc 32:36–38PubMedCrossRefGoogle Scholar
  57. Swain P (1995) What should be done when initial endoscopic therapy for bleeding peptic ulcer fails? Endoscopy 27:321–328PubMedCrossRefGoogle Scholar
  58. Szabo S, Vattay P, Scarbrough E, Folkman J (1991) Role of vascular factores, including angiogenesis, in the mechanisms of action of sucralfate. Am J Med 91:2A–158SCrossRefGoogle Scholar
  59. Thompson AR, Hall TJ, Anglin BA, Scott-Conner CE (1995) Laparoscopic plication of perforated ulcer: results of a selective approach. South Med J 88:185–189PubMedCrossRefGoogle Scholar
  60. Tompkins LS, Falkow S (1995) The new path to preventing ulcers. Science 267:1621–1622PubMedCrossRefGoogle Scholar
  61. Tytgat GNJ, Rauws EAJ (1988) Campylobacter pylori and its role in peptic ulcer disease. Gastroenterol Clin North Am 95:1185–1191Google Scholar
  62. Walsh JH (1994) Gastrointestinal hormones. In: Johnson LR (ed) Physiology of the gastrointestinal tract. Raven Press, New York, pp 1–129Google Scholar
  63. Warren JR (1983) Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet 1:1273Google Scholar
  64. Wotherspoon AC, Ortiz-Hidalgo C, Falzon MR, Isaacson PG (1991) Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet 338:1175–1176PubMedCrossRefGoogle Scholar
  65. Otherspoon AC, Doglioni C, Diss TC, Pan L, Moschini A, de Boni M, Isaacson PG (1993) Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradicatio of Helicobacter pylori. Lancet 342:575–577PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • E. C. Jehle
  • H. D. Becker

There are no affiliations available

Personalised recommendations