[Combined surgical procedures in operations of stomach, duodenum and biliary system (author's transl)]

In a period of 4 years in the Clinic of Abdominal- and Transplantation Surgery of the Medical School Hannover in 52 patients with operations of the biliary system 56 combined surgical procedures and in 48 patients with operations of stomach and duodenum 51 combined surgical procedures were performed. In comparison with groups of patients, treated with similar operations as single procedures, the increase of risk was studied. It was found, that combined procedures of medium-sized trauma, which mostly depended on simultaneous injuries of both organs, caused an elevation of operation stress as well as an increase of complications. Small combined procedures indicated no elevation of risk. In accordance with our results, we postulate a very careful reflection on indication of combined surgical procedures together with operations of stomach, duodenum or biliary system.