In der Notfallsituation innerhalb von wenigen Minuten eine komplette Diagnostik und Therapieplanung zu erstellen: dafür ist dieses Buch konzipiert, welches sich insbesondere an die Diensthabenden in der Allgemein- und Viszeralchirurgie richtet. Ausgehend von den wichtigsten Leitsymptomen führen übersichtliche, intuitiv gestaltete Algorithmen zur Arbeitsdiagnose, deren Dringlichkeit mit einem eingängigen Farbcode hervorgehoben ist: Rot : Notfallsituation mit sofortiger Therapie, Gelb : dringlich und muss noch im Dienst versorgt werden, Grün: könnte elektiv auch am nächsten Tag therapiert werden. Diagnosesicherung, Therapieoptionen und operative Techniken sind systematisch für jede akute Erkrankung und Verletzung beschrieben und um Praxistipps sowie kurze Hinweise zu Dokumentation und Aufklärung ergänzt. Ein eigenes Kapitel fasst zusammen, welche Besonderheiten der Operationsvorbereitung beirelevanten Nebenerkrankungen der Patienten zu berücksichtigen sind. Das Werk wurde in Kooperation mit der Chirurgischen Arbeitsgemeinschaft Militär- und Notfallchirurgie (CAMIN) der DGAV erstellt. Intuitiv, übersichtlich, effektiv – perfekt zugeschnitten auf chirurgisches Handeln im Notfall!

Abstract: Cancers of the biliary tract are more common in Asia than in Europe, but are highly lethal due to delayed diagnosis and aggressive tumor biology. Since the biliary tract is in direct contact with the gut via the enterohepatic circulation, this suggests a potential role of gut microbiota, but to date, the role of gut microbiota in biliary tract cancers has not been elucidated. This scoping review compiles recent data on the associations between the gut microbiota and diagnosis, progression and prognosis of biliary tract cancer patients. Systematic review of the literature yielded 154 results, of which 12 studies and one systematic review were eligible for evaluation. The analyses of microbiota diversity indices were inconsistent across the included studies. In-depth analyses revealed differences between gut microbiota of biliary tract cancer patients and healthy controls, but without a clear tendency towards particular species in the studies. Additionally, most of the studies showed methodological flaws, for example non-controlling of factors that affect gut microbiota. At the current stage, there is a lack of evidence to support a general utility of gut microbiota diagnostics in biliary tract cancers. Therefore, no recommendation can be made at this time to include gut microbiota analyses in the management of biliary tract cancer patients

Abstract: Leukocytes are essential for the function of the immune system and cell-cell interaction in the human body, but hematological diseases as well as chemotherapeutic treatments due to cancer lead to occasionally or even permanent leukocyte deficiency. Normally, more than 50% of leukocytes are neutrophilic granulocytes, and leukopenia is, therefore, mostly characterized by a decrease in neutrophilic granulocytes. The consequence of neutropenia is increased susceptibility to infection, but also healing disorders are suggestable due to the disturbed cell-cell interaction. While there is no surgical treatment for leucocyte disorders, patients suffering from neutropenia are sometimes in need of surgery for other reasons. Less is known about the morbidity and mortality of this patients, which is why this narrative review critically summarizes the results of recent research in this particular field. The results of this review suggest that neutropenic patients in need of emergency surgery have a higher mortality risk compared to non-neutropenic patients. In contrast, in elective surgery, there was not a clear tendency for a higher mortality risk of neutropenic patients. The role of neutrophilic granulocytes in inflammation and immunity in surgical patients is emphasized by the results, but most of the evaluated studies showed methodological flaws due to small sample sizes or risk of bias. Further research has to evaluate the risk for postoperative complications, particularly of infectious complications such as surgical site infections, in neutropenic patients undergoing elective surgery, and should address the role of neutrophilic function in postoperative morbidity and mortality