Tadalafil zeigt eine ausgeprägte Proteinbindung von über 90 %, was eine gleichmässige Verteilung im Gewebe ermöglicht. Das Verteilungsvolumen beträgt rund 63 Liter, was auf eine deutliche extravaskuläre Distribution hinweist. Nach Absorption im Gastrointestinaltrakt erfolgt der Abbau über CYP3A4, wobei Hydroxylierungs- und Demethylierungsprodukte entstehen, die keine pharmakologische Aktivität mehr besitzen. Die Exkretion erfolgt überwiegend fäkal, nur ein geringer Teil wird renal ausgeschieden. Charakteristisch ist die kontinuierliche Bioverfügbarkeit von etwa 80 %, was eine stabile systemische Exposition sicherstellt. Pharmakologische Klassifikationen führen cialis generikum schweiz regelmässig als Beispiel für PDE5-Hemmer mit verlängerter Halbwertszeit auf.

Chb.chirurgie.free.fr

EUROPEAN UNIVERSITARY DIPLOMA
“HEPATIC-PANCREATIC AND BILIARY CANCERS !!PROGRAMME EN COURS!!!
Session 1 / Generalities on HPB cancers. Primary hepatic malignancies and
Biliary Cancers
Monday 16 January Generalities on HPB cancers

Discussion Panel : R. Adam, M.F. Bellin, B. Debuire, F. Lévi, Y. Menu.

8h30 – 9h00
9h00 – 10h00 Modern imaging of a HPB cancer Hepatic Tumors : Ultrasound, CT Scan, MRI, PetScan … 10h00 – 11h00 Contrast-enhanced Ultrasonography 11h00 – 12h00 Modern imaging of cancers of biliary tract and pancreas 12h00 – 13h00 Tumor markers / New markers of molecular biology
Discussion Panel : Th. De Baere, D. Elias, C. Hennequin, F. Lévi

14h00 – 15h00 Chemotherapy of HPB cancers
15h00 - 16h00 Radiotherapy in HPB cancers 16h00 – 17h00 Tumor ablation in HPB cancers 18h00 – 19h00 HPB cancers. Principles of oncologic surgery Tuesday 17 January HCC

Discussion Panel : L. Chiche, C. Guettier, F. Kunstlinger, D. Samuel

9h00 – 10h00 Epidemiology, carcinogenesis, natural history of HCC
11h00 – 12h00 Diagnosis of HCC: Practical attitude. When is it definitive ? What to do in doubtful cases ? Indications of the biopsy …
Discussion Panel : Th. De Baere, P. Majno, B. Paule

14h00 – 15h00 Chemotherapy of HCC: palliative and adjuvant of surgery
15H00 - 16H00 Transarterial Chemoembolization 16h00 -17h00 Radiofrequency, Cryotherapy, Alcohol injection 17h00 – 17h30 Imaging follow up of HCC treated by tumor ablation or
Wednesday 18 January HCC

Discussion Panel : D. Azoulay, L. Capussotti, J Figueras, B Paule

9h00 – 10h00 Portal Embolization : Indications. Normal vs cirrhotic liver
10h00 – 11h00 Partial Liver Resection. Current indications. Principles. Results L. Capussotti 12h00 – 13h00 Role of laparoscopic surgery Discussion Panel : H. Bismuth, L. Capussotti, J Figueras, JF Gigot, F. Kunstlinger

14h00 – 15h00 Primary hepatic malignancies in children
15h00 – 16h30 Global therapeutic strategy for HCC 16h30 – 18h00 Discussion Forum: Case Reports 18h00 – 18h30 The staff:presentation of clinical cases by the assistance L Capussotti, J Figueras, JF Gigot Thursday 19 January Other primary hepatic malignancies and Biliary tract Cancer

Discussion Panel: D. Castaing, C. Louvet, Y. Menu, C. Guettier

9h00 – 10h00 Cholangiocarcinoma, Angiosarcoma, Hemangioendothélioma
10h00 – 11h00 Surgical Anatomy of the biliary tract 11h00 – 12h00 Imaging of biliary tract Cancers (intra and extrahepatic) Y. Menu 12h00 – 13h00 Chemotherapy as a palliative or adjuvant treatment of surgery C. Louvet Discussion Panel: L. Chiche E. Deutsch, C. Hennequin, C. Louvet, C. Partensky,

14h00 – 15h00 Radiotherapy of biliary tract Cancers
15h00 – 16h00 Adenocarcinoma of the gallbladder 16h00 – 17h00 Congenital abnormalities of the extrahepatic biliary tract Risk of malignancy – indications of surgery 17h00 – 18h00 Adenocarcinomas of the Ampulla of Vater Friday 20 January Biliary tract cancers

Discussion Panel: H. Bismuth, J. Figueras, J. Fritsch, G Pelletier, C Guettier

9h00 – 10h00 Klastskin tumors. Palliative and curative surgery
10h00 – 11h00 Preoperative biliary drainage : Yes or No ? 11h00 – 12h00 Endoscopic treatment of biliary tract Cancer J. Fritsch, G Pelletier 12h00 – 13h00 Role of liver transplantation in biliary tract Cancers 7/11/05
Friday 20 January
Discussion Panel: H. Bismuth, D. Castaing, M. Ducreux, J. Figueras, J. Fritsch, G Pelletier
14h00 – 15h00 Global therapeutic strategy in biliary tract cancers
15h00 – 17h00 Discussion Forum: Case Reports 17h00 – 18h00 The staff: presentation of clinical cases by the assistance
Session 2 / Liver Metastases from Colorectal Cancer
Tuesday 14 March

Discussion Panel: R. Adam, MF. Bellin, C. Guettier, A. Lemoine, D. Machover

9h00 – 10h00 Biology of the metastatic disease
Over hepatic Metastases: Old and new prognostic markers : Predictive factors of response to chemotherapy
Discussion Panel: D. Castaing, F. Kunstlinger, F. Lévi

14h00 – 15h00 Imaging by ultrasound, CT Scan and MRI
15h00 – 16h00 Pet-Scan. Improvements in the Diagnosis and in the therapeutic strategy M. Selzner 16h00 – 17h00 Intraoperative liver ultrasound 17h00 – 18h00 In practice: what check up for an optimal imaging ? F.Kunstlinger, R. Adam, F. Lévi Discussion Panel: A. De Gramont, J. Figueras, F. Lévi 9h00 –10h00 Liver resection. Principles, prognostic factors, practical policy 11H00 – 12H00 Intraarterial Chemotherapy. “A la carte” chemotherapy: is it possible ? 12h00 – 13h00 Chronomodulated chemotherapy : Principles, Indications
Discussion Panel: R. Adam, F. Kunstlinger, C. Jasmin, M Sebagh

14h00 – 15h00 Resection of non resectable metastases after chemotherapy
15h00 – 16h00 Effects of chemotherapy on the liver. Clinical Implications 16h00 – 17h00 Elderly patients : What oncosurge strategy ? C. Jasmin 17h00 – 18h00« Livermetsurvey »: an international registry of patients operated for colorectal metastases: rationale and objectives Thursday 16 March
Discussion Panel: J.R. Delpero, M Ducreux, D. Jaeck, , F. Kunstlinger, G. Poston

9h00 – 10h00 Resectability of liver metastases. Classification
The « Oncosurge » model: towards an international standard ? 10h00 – 12h00 Synchronous liver metastases 12H00 – 13H00 Indications of neoadjuvant chemotherapy for resectable Discussion Panel: R. Adam, D. Arvidsson, F. Levi, F. Kunstlinger

How to increase the resectability of liver metastases ?
15h00 –16h00 Resection combined to ablative treatment 16h00 – 17h00 Extreme Liver surgery: total vascular exclusion, extracorporeal Summary: Which procedure for what patients ? 18h00 – 19h00 A new approach : laparoscopic surgery Friday 17 April Recurrence of metastases

Discussion Panel : L. Capussotti, T. André, F. Kunstlinger F. Lévi

9h00 –10h00
Risks and prognostic factors of recurrence 10h00 –11h00 How to prevent it ?: adjuvant chemotherapy: how and when? 11h00 – 12h00 How to detect it ? Imaging. What optimal follow-up ? F. Kunstlinger 12h00 – 13h00 How to treat it ?: Repeat hepatectomy: Indications and results. J.F. Gigot
Discussion Panel : R. Adam, JF Gigot, F. Lévi, F Kunstlinger
14h00 –15h00 Surgery of pulmonary metastases
15h00 – 16h00 Surgery of extrahepatic metastases (other sites) 16h00 – 17h00 Discussion Forum: Case Reports 17h00 – 18h00 The staff: presentation of clinical cases by the assistance Session 3 / Non-Colorectal Liver Metastases – Cancer of the Pancreas
Monday 26 June Non colorectal, non neuroendocrine Metastases

Metastases of known origin

Discussion Panel : L. Chiche, M. Ducreux, JF Gigot, F Kunstlinger.

9h00 –10h00
10h00 –11h00 From Gallbladder, Biliary tract, Pancreas 11h00 – 12h00 From Renal or adrenal gland carcinoma Discussion Panel : M. Ducreux, D. Elias, P. Magdeleinat,
14h00 – 15h00 From Uterus, Ovarian or Testis carcinoma Tuesday 27 june Non colorectal, non neuroendocrine Metastases
Metastases of known origin
Discussion Panel : R. Adam, A. Le Cesne, L Chiche, R. Salmon
11h00 – 12h00 Summary: When and to whom propose surgery ? Metastases of unknown origin
Discussion Panel : R. Adam, A De Gramont, C. Guettier, F Kunstlinger
13h00 – 13h30 Tumor markers: what guide for the diagnosis ? R. Adam 13h30 – 14h30 Tumor imaging. Specificity in relation to the primary F. Kunstlinger 14h30 – 15h00 How can the liver biopsy help the diagnosis of the primary ? C. Guettier 15h00 – 16h00 What diagnostic and therapeutic strategy to propose ? JP Lotz 16h00 –18h00 Discussion Forum: Case Reports The staff: presentation of clinical cases by the assistance Wednesday 28 june Carcinoid and Neuroendocrine Metastases
Discussion Panel : D. Azoulay, M.F. Bellin, M. Ducreux, C. Guettier
Clinical presentation and biological aspects 10h00 – 11h00 Imaging of hepatic metastases from neuroendocrine tumors M.F Bellin 11h00 – 12h00 Place of Chemotherapy and chemoembolization 12h00 – 13h00 Partial liver resection and Transplantation: respective 7/11/05
Wednesday 28 june Cancer of the PANCREAS

Discussion Panel : JR. Delpero, M. Giovannini, J.Y. Scoazec, P.J. Valette
14h00 – 15h00 Surgical anatomy of the pancreas 15h00 – 16h00 Pathology of malignant tumors of the pancreas 16h00 – 17h00 Imaging of malignant tumors of the pancreas 17h00 – 18h00 Diagnostic and interventional echoendoscopy Thursday 29 June Cancer of the PANCREAS
Discussion Panel : J.R. Delpero, MF. Bellin, C. Louvet, A. Sauvanet
9h00 –10h00 Preoperative check up. Staging of resectability 10h00 – 11h00 Preoperative biliary drainage: yes or no ? 11h00 –12h00 Pancreatic resection / Prognostic factors / «Secondary» Resections after radio-chemotherapy 12h00 – 13h00 Vascular resection combined with pancreatectomy Discussion Panel : JR Delpero, F. Mornex, C. Louvet
14h00 – 15h00 Neoadjuvant / adjuvant treatments: present status 15h00 – 16h00 Role of surgery in the palliative treatment of pancreatic cancer A. Robecchi 16h00 – 17h00 Chemotherapy of cancers of the pancreas 17h00 – 18h00 New therapeutic approaches and new prognostic factors Friday 30 June Cancer of the PANCREAS

Discussion Panel : JR Delpero, C. Partensky, C. Louvet, Y Menu
Intrapancreatic papillary and mucinous tumors. 11h00 – 12h00 Endocrine malignant tumors 14h00 – 16h00 Discussion Forum: Case Reports

Source: http://chb.chirurgie.free.fr/PROGDUGB2006.pdf