M. Classen – författare

Gastroenterologic endoscopy has made important progress in the past decade. New techniques and ideas have given it new life. The end of this evolution is not yet in sight. FuIly flexible fiberoptic instruments have eliminated all blank areas from the map of the gastrointestinal tract. Retro- grade visualization of the pancreatic and biliary system has been achieved in conjunction with radiologic methods. Operative endoscopy has de- veloped beyond the removal of foreign bodies, to a stage where laparotomy can be avoided in a number of situations. Hemostasis by laser coagulation and crushing of concrements by ultrasound and electric energy have reached the threshold of clinical applicability. With all these spectacular develop- ments, however, it is important to maintain a firm grasp of the fundamentals of endoscopy. This is the basis of day-to-day success and includes knowl- edge of the proper indications, the ability to manage complications, famil- iarity with the technical properties of the instruments, their skillful handling, and experience in organizing an endoscopy section.Endoscopists, particu- larly members of the Erlangen group, have undertaken the task of charting these fundamentals and of compiling them into a working manual for those already practicing endoscopy or intending to do so. They have been sup- ported in this effort by colleagues from other parts of the Federal Republic of Germany and from Italy.

Der Atlas für Enteroskopie ist neu in seiner Thematik. Er befaßt sich mit den Fortschritten der modernen gastroentero­ logischen Endoskopie. Sie betreffen den Dünndarm vom Duodenum bis zum Ileum und das gesamte Kolon. Während vor etwa drei Jahren große Teile des Darmkanals einer direk­ ten Betrachtung noch nicht zugänglich waren, kann inan heute von der Speiseröhre bis zum After jegliche Region optisch und bioptisch untersuchen, sei es durch die Kombination von Enteroskopie und Coloskopie oder mit Hilfe der peroralen Entero-Coloskopie. Entzündliche oder peptische Läsionen, Tumoren, Divertikel und Stenosen können gesehen und histo­ logisch überprüft werden. Neu ist auch die Darstellung des biliären und pankreatischen Gangsystems mit Röntgenkon­ trastmitteln über die endoskopisch intubierte Papilla Vateri. Erstmalig wird das Gangsystem der Bauchspeicheldrüse der präoperativen Röntgenuntersuchung zugänglich und kann mit der mesenterialen Angiographie kombiniert werden. Bei der Differentialdiagnose des Verschlußikterus bedeutet die retrograde endoskopische Füllung des biliären Systems einen wesentlichen Fortschritt, da das Verfahren gegenüber der per­ kutanen und der laparoskopischen Cholangiographie sehr schonend ist. Neuland wurde auch betreten mit der opera­ tiven Endoskopie im Dünn-und Dickdarm. Mit ihrer Hilfe können Fremdkörper nach außen befördert, umschriebene Veränderungen lokal behandelt, Blutungen durch Koagula­ tion gestillt und Polypen mit der Diathermieschlinge entfernt werden. Der Atlas zeigt in erster Linie die Möglichkeiten, welche sich durch die Weiterentwicklung der Endoskopie und deren Kombinationen mit dem Röntgenverfahren dem ärztli­ chen Handeln eröffnet haben.

It is my pleasure to introduce you to this new Atlas by Professor DEMLING and his colleagues on the very timely subjects colonoscopy, duodenoscopy and endoscopic cannu­ lation of the bile and pancreatic ducts. Professor DEMLING, unlike many others who carry his teaching and administra­ tive burdens, continues to be very personally involved in performing endoscopies. His clinic is one of the best organized and best equipped in the world. Professor DEM­ LING and his colleagues have been instrumental in introducing to the European continent these new techniques of duodeno­ scopy, colonoscopy and bile duct cannulation which were originally developed in Japan. They have added significant contributions of their own and now present to the reader a clear, concise, very well illustrated description of these methods. Dr. CLASSEN is one of the pioneers in endoscopic cannula­ tion. He has been kind enough to come to the United States and share his expertise with us at several Post Graduate Education programs. The students in these courses have been most enthusiastic about his presentations. Through this text he makes his extensive experience available to all endo­ scopists. The beginner at cannulation will find the illustrations of the various shapes the papilla may assume most helpful. I had the pleasure this summer of teaching a course in Brazil with Dr. FRUHMORGEN. Very few physicians have con­ centrated on colonoscopy to the extent that he has.

Nonsurgical Biliary Drainage is a survey of the currentstatus of the endoscopic and percutaneous transhepaticapproaches. The editors - internationally recognized leadersin gastroenterology - have gathered together articles whichdiscuss both the principles and methodology of thesetechniques as well as their results and limitations. Withthe wealth of authoritative information it contains, thisbook will also help lay the groundwork for future advancesin the field.