Elective cholecystectomy without drainage and without prophylactic antibiotics. A prospective randomized trial with clinical and bacteriological aspects.

A consecutive series of 50 patients undergoing elective cholecystectomy without prophylactic antibiotics entered a prospective randomized trial to compare the post-operative clinical course whether the subhepatic space was drained or not. 26 patients (mean age 58 yrs) were drained and 24 patients (mean age 59 yrs) were not. The incidence of positive gallbladder bile cultures were respectively 8 and 19% (N.

Postoperative duodenal fistulas. A report of 23 cases with emphasis on the surgical treatment by the Roux-en-Y operation.

A series of 23 patients-15 with a spontaneous postoperative duodenal fistula and 8 with a catheter duodenostomy fistula-admitted in both departments between 1974 and 1983, is reviewed. Overall mortality rate was 9%. Using conservative management and parenteral nutrition, spontaneous closure of the fistula was observed in 78% of the cases after an average duration of 33 days.

[Surgical treatment of chronic pancreatitis].

Two cases of chronic pancreatitis treated by total pancreatectomy are reported. Diagnostic procedures and their impact on surgical strategy, the advantages and inconvenience of the different surgical techniques described in the literature are analysed in terms of mortality, morbidity and long-term results in order to define the appropriate surgical approach of the disease.