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Summarry Following portocaval anastomosis a high lethality (87%) can be observed in a standardized micronodular liver cirrhosis model. By a special preoperative regimen this lethality can be reduced to 10%.

Summary In all described bougienage methods for the treatment of esophageal stenosis (Eder-Puestow, Savary, Celestin) both longitudinal and transversal forces act upon the esophagus. Longitudinal traumatization caused by this procedure contributes to the recurrence of stenosis and is occasionally responsible for perforation (9%). The Grüntzig balloon catheter develops only transversal forces in the stenotic segment. This new procedure was used to perform 71 dilatations in 33 patients. The Grüntzig catheters were placed by an angioguidewire into the esophageal stenosis up to a maximum diameter of 40 mm. Total anesthesia was never needed, and no severe complications were observed.

Summary Surgery and endoscopy are in competition in the treatment of choledocholithiasis. A reduction of endoscopic means, especially in younger patients, seems necessary. A retrospective analysis from 1979–1983 shows that surgery after life-threatening endoscopic complications (n=25) had a mortality of 28% (up to 50% in the literature). Mean age (63) of these patients was lower than that of all endoscopically treated patients. In contrast, surgical mortality of all endoscopic failures (n=26) was 0%. The mortality of primary surgery (mean age 66) was 4% and is due mainly to the higher age. Surgery remains the therapy of choice.