Endoscopic ultrasound-guided biliary drainage-current status and future perspectives.

Endoscopic retrograde cholangiopancreatography (ERCP) with stenting is the treatment modality of choice for patients with benign and malignant bile duct obstruction. ERCP could fail in cases of duodenal obstruction, duodenal diverticulum, ampullary neoplastic infiltration or surgically altered anatomy. In these cases percutaneous biliary drainage (PTBD) is traditionally used as a rescue procedure but is related to high morbidity and mortality and lower quality of life.

[WOUND HEALING PROPERTIES OF THE RECOMBINANT HUMAN ANGIOGENIN IN THE GEL MEDICINAL FORM USED AS A TREATMENT IN THE MODEL OF PLANAL MUSCULOCUTANEOUS AND LINEAR WOUNDS].

The aim of the study was to evaluate the wound healing properties of the recombinant human angiogenin drug in the gel form on the models of planar musculocutaneous wound and a linear wound. The rats were divided into 3 groups: 1st group - control animals, that did not get any treatment of wounds; 2nd group - experimental, where animals' wound surface was treated with recombinant human angiogenin in a gel medicinal form; and the 3rd group - a comparison group, where animals were treated with "Solcoseryl" drug. The resulted morphology data and the time of complete epithelialization of planar wounds suggest that the human angiogenin drug in gel form has a pronounced wound healing activity.

EPIDEMIOLOGICAL REGISTRY OF NEUROENDOCRINE TUMORS IN BULGARIA--A PILOT SURVEY.

The National registry of patients with neuroendocrine tumors (NET) in Bulgaria was established in 2013 as a joint initiative of the Bulgarian Surgical Society and the Institute for Rare Diseases. The register aims to explore the epidemiology of NET in Bulgaria, as well as the different diagnostic and treatment approaches for the disease throughout the country. This the first of its kind retrospective study of NET in the country is covering the period January 2012 - January 2013.

Surgical treatment of chronic pancreatitis and its complications. Comparative analysis of results in 91 patients.

There is a large variety of proposed conservative, invasive, endoscopic and surgical methods for treatment of chronic pancreatitis and its complications. This study presents a comparative analysis of the results from each group of patients subjected to drainage, resection, denervation and other operative techniques for a total of 91 patients with chronic pancreatitis and its complications. Drainage and resection operative techniques yield comparable results in terms of postoperative pain control 93.

Some aspects of the etiology and the pathogenesis of chronic pancreatitis.

The development of modern technology and advances in medical science make possible understanding of etiology of chronic pancreatitis. From a century ago, the ethanol is connected to chronic pancreatitis. In the last decades medical science made a big footstep in understanding of so called "idiopathic pancreatitis".

[Dirofilariasis--a rare antroponosis. Review of the literature and a report of two clinical cases].

Dirofilariasis is a rare anthroponotic endemic disease caused by nematodes. The dog is the reservoir of this parasite and men are accidentally infected by mosquitoes. A subcutaneous mass or pulmonary nodules are the typical clinical presentation.

[Cystopericystectomy for the treatment of hepatic hydatid disease].

Unlabelled: Hepatic hydatid disease is current problem in Bulgaria as the country in endemic region. The treatment include PAIR, various type surgical procedures and medical therapy. Surgical treatment is conductive.

[Extrinsic obstruction of the ureter in colorectal cancer--aspects of pathogenesis, diagnosis and treatment].

Background: Primary or recurrent colorectal cancer (CRC) may lead to extrinsic obstruction of the ureter (EOU) necessitating differentiated and individual approach based on the genesis of the lesion.

Aim: Analysis of the pathogenesis, risk factors, clinical presentation, diagnosis and treatment of cases of EUO in our experience.

Material And Methods: From Jan.

[Internal biliary fistulas--diagnostic and therapeutic problems].

Background: Internal biliary fistula (IBF) is still a challenging condition. The preoperative diagnosis is established in less than 50% of cases. Treatment is based on individual approach but postoperative morbidity and mortality rates are high.

[Acquierd entero-cutaneous fistulas--diagnostic and therapeutic approach].

The acquired entero-cutaneous fistulas are a current problem in the field of abdominal surgery. Most of them are postoperative--after an intestinal resection and/or anastomosis. Crohn's disease and coplicated colonic diverticulosis rank second as causal factors.

[Postoperative entero-cutaneus fistulas--a study of 24 cases].

Aim: To perform a retrospective study on the experience of the Clinic of General, Liver, Biliary and Pancreatic Surgery, Alexandrovska Hospital in the diagnosis and treatment of patients with acquired entero-cutaneus fistulas and to analyse the early postoperative results.

Material And Methods: We treated 24 patients with postoperative entero-cutaneous fistulas in the period Jan., 2000 - Aug.

[Early and late complications following 388 nephrectomies in different diseases of the kidney and the ureter].

Early and late complications of nephrectomy include: chronic renal failure (CRF), haemorrhagic events, lumbar fistulas and other complications of different origin. This study covers 388 nephrectomies due to different diseases of the kidneys and the urethra. Clinical diagnosis and treatment of the patients are held at the Chair of Urology of the Alexandrovska Hospital for the period 1990-1995.

[Mesenteric-inferior-renal shunt--alternative of proximal and distal spleen-renal shunt for surgical treatment of portal hypertension].

Surgical operations are important for the prevention of recurrent bleeding and better survival rates in patients with portal hypertension and previous haemorrhage from esophageal varices, stopped by conservative treatment. Spleno-renal shunts are among the most frequently used procedures in these cases. Sometimes the proximal spleno-renal shutting operation of Linton or the distal one of Warren may be impossible from the technical point of view due to anomalies or varieties of the lienal vein.

[Modified method of Sugiura-Futagawa for surgical treatment in patients with portal hypertension and esophageal varices].

Background: The esophageal transection and devascularization (Sugiura-Futagawa's operation) is the most frequently used ablative procedure in Japan for the treatment of patients with portal hypertension (PH) and esophageal varices (EV). Recently many authors, who are followers of this method, try to find an alternative one, aiming to shorten the skin-to-skin time and achieve better early and late results.

Aim: To study the postoperative results of our modification of the original Sugiura-Futagawa's method and to conclude whether it is good and reliable or not.

[Hepatic echinococcosis: radical or conservative surgical treatment].

Unlabelled: Hydatid liver disease remains an actual medical and social problem for Bulgaria as an endemic region. Because of the lackage of medicines with satisfactory therapeutic effect the surgical treatment is still the treatment of primary importance.

Aim: The aim of this study was too check the correctness of the following hypothesis: "Radical surgical procedures on hydatid liver disease have lower rates of morbidity and mortality compared to conservative ones".

[Carcinoma of the stomach - our experience with surgical treatment].

Carcinoma of the stomach is among the commonest malignancies of the gastrointestinal tract regardless of the permanent tendency of its diffusion to decrease, observed in the last 25-30 years. The readily accessible methods of diagnosing the disease contribute greatly to its early detection. However, owing to diverse causes, in over 70 per cent of cases the diagnosis is usually made as late as in the advanced III-IV stages.

[Surgical treatment of insulinomas with observations on six cases in one year].

Insulinomas are among the endocrine pancreatic tumors most commonly met with. Regardless of their small proportion compared to other tumors of the digestive system, they give rise to pressing surgical problems on account of a number of reasons, namely: 1) early clinical diagnosis and undertaking opportune operative management in those presenting benign neoplasms, even in oligosymptomatic cases, 2) exact topical preoperative diagnosis using echography, CAT, MRI, angiography and the like; 3) intraoperative identification of the tumor/tumors in the event of multiple involvement, and choice of the most adequate operative approach, 4) intra- and postoperative monitoring of the blood sugar levels and appropriate insulin therapy prescription. Over the period Jan/Oct 1997, six patients presenting clinical, laboratory and instrumental evidence of insulinomas are subjected to operation in Department of General and Operative Surgery of the Medical University-Sofia.