[Cholecystoduodenal fistule as a consequence of calculouse cholecystitis in a female elderly patient].

Bilioenteric fistules are fairly rare, cholecystoduodenal fistules are the commonest type, accounting for 70-80% of cases. Cholecystoduodenal fistules usually occur as a consequence of cholecystolithiasis and cholecystitis. Their symptomatology is atypical and fistules are frequently detected during surgery.

[How long to wait with operations for necrotizing pancreatitis?].

Introduction: Severe acute pancreatitis (pancreatitis with local and systemic complications) remains a therapeutical problem. Even more complicated is ESAP (Early Severe Acute Pancreatitis), which presents itself as a fulminant form (FAP--fulminant acute pancreatitis) and subfulminant form (SFAP--subfulminant acute pancreatitis). Severity of acute pancreatitis can be assessed with help of prognostic markers.

[The role of Hartmann's procedure and options for its reconstruction at the present time].

Introduction: Hartmann operation (rectosigmal resection, blind closure of rectum and terminal sigmostomy) is one of the options of treatment of pathology of left colon. Despite great effort to treat such surgical conditions with primary anastomosis, Hartmann's operation is in selected cases preferred. It requires, though, secondary reconstruction, which might be associated with complications.

[The role of classical surgery in treatment of acute abdomen in oncological patients].

Acute abdomen in patients with malignity may present itself as a first sign, or might manifest itself during therapy of diagnosed disease. Clinical picture might be modified by age of patients, comorbidity, and side effects of multimodal therapy. Authors analyze their group of patients, admitted to their department with malignant disease.

[The role of surgery in Crohn's disease treatment].

Unlabelled: Crohn's disease is a chronic, transmural inflammatory disease of the gastrointestinal tract of unknown origin. Even though surgical therapy may relieve symptoms in patients with complications, it still remains, together with medicamentous therapy, palliative. According to literature, cummulative probability of operation is 78% during 20 years.

[Experience with ventral hernioplasties according to Chevrel with "on-lay" prolene mesh].

The authors present a retrospective study including 85 patients with ventral hernias Chevrel technique repairs. The study group included 33 males and 52 females, the mean age was 56.09 years.

[The "pancreatic unit" in the treatment of severe necrotizing pancreatitis].

The course of acute pancreatitis varies from mild, fortuitous forms to grave, life threatening disease. Approximately 80-90% of all forms are mild with low morbidity and mortality. The rest consist of severe, sometimes even fatal forms with present necrosis.

[Giant retroperitoneal liposarcomas].

According to literature liposarcomas account to less than 0.1% of all human tumors, 13% of which are localiced retroperitoneally. Authors describe two cases of giant retroperitoneal liposarcoms treated in their department.

[Prevention of the anastomosis dehiscence following low anterior rectal resections].

Authors analyse 106 patients that were operated in their department by Dixon's method, in retrospective study. They analyse indications for operations, lesions distance in rectum, endosonographic and CT findings. Basic principles of the operation technique are adequate blood flow, sufficient colon mobilization and tightness of the anastomosis being supplemented with transanal pertubation.

[Treatment of gunshot wounds of the liver].

The objective of the work was to draw attention to the rising trend of gunshot wounds of the abdomen with affection of the liver. The authors analyze their own group of five patients with gunshot wounds of the liver incl. one who died during the resuscitation operation, another one on the 15th day from complications, two recovered without sequelae, and the fate of one was unknown as he was referred to another department.

[Rupture of the laparotomy incision and its suture using Ventrofilm].

The authors analyze a group of patients operated at their department with the objective to assess factors involved in the development of ruptures of laparotomic wounds and to evaluate resuture by suspended ventrofil stitches. In the whole group of 5554 laparotomized patients the incidence was 0.4%, in 1685 urgently operated patients the incidence was 0.

[Methods of surgical treatment of necrotizing pancreatitis].

The authors present a group of 49 patients operated on account of acute necrotizing pancreattis in 1990-1999. They describe the indications and methods of treatment. The principle of treatment was careful necrosectomy with an additional procedure which involved rinsing and drainage of the omental bursa, laparostomy ("open packing") or a combination of both methods.

[The current method of staging gastrointestinal (GIT) tumors].

The authors analyzed in a retrospective study the stage of carcinomas of the stomach and colorectum in their material. In 1996-1998 they operated 35 patients with gastric tumours and 77 patients with colorectal cancer. In both groups they operated more than 50% of the patients in the IIIrd or more advanced stage of the disease.

[Modern trends in the treatment of diffuse peritonitis].

The authors describe new approaches to the treatment of diffuse peritonitis, using the Mannheim Peritonitis Index scoring system. Depending on the score, the authors determined the types of additional surgical procedures such as "sipping drainage", laparostomy and repeated laparotomies.

[Complications of colostomy--how to avoid them].

According to data in the literature complications develop in association with colostomy in 20-66% of patients, occlusion of the colostomy occurs in 10-17%. The authors analyze their own group of 122 patients where in 1994-1998 a colostomy was made. Sixty-two patients were operated with developed ileus, 19 colostomies were later abolished and the passage per vias naturales was reconstructed.

[Bile leak after surgery of the gallbladder and bile ducts].

The authors present a brief review of the most frequent complications of operations of the gallbladder and biliary pathways and demonstrate a group of patients of the Department of Surgery of the hospital and policlinic Ruzinov in Bratislava treated during the last six years. They emphasize conservative treatment of escape of bile except cases of acute biliary peritonitis or peroperatively revealed lesions of the biliary pathways. In the conclusion they submit an algorithm of treatment of escape of bile after surgery of the gallbladder and biliary pathways.

[Carcinoma of the gastric stump].

The authors present a group of seven patients operated in 1992 to 1996 on account of carcinoma of the gastric stump. All patients had a Billroth II resection at the age of 52 to 77 years. The mean period after resection was 21.

[Personal experience with the Lichtenstein surgical method in recurrent abdominal hernia].

The authors present a group of 21 patients treated with the method of Lichtenstein with the use of polypropylene mesh Prolen. They used the method of an "inlay" mesh for recurrent groin and epigastric hernias, mostly by men. The men:women ratio was 19:2.

[Injury of the femoral vein--a complication in inguinal hernia surgery].

In a 21-year-old patient with recurrence of the right-sided inguinal hernia the right femoral vein was injured during the operative repair. The vein had to be reconstructed by the use of the right saphena vein and anticoagulative therapy was begun. Since the coagulation parameters were satisfactory the haematoma was produced in the operative wound and had to be evacuated through the second operation.

[Obstructive ileus--a complication of laparoscopic cholecystectomy].

A 45-year old patient admitted with confirmed calculous pancreatitis underwent the laparoscopic cholecystectomy at the 14th day of the hospitalization. 4 days after the operation he had to be reoperated due to small-bowel-obstruction caused by the herniation of the loop through the supraumbilical port. The small bowel was reduced and plasty of the operative wound was done.

[Evaluation of the clinical status of patients with gastrointestinal hemorrhage and acute pancreatitis using the APACHE II score].

In the group of 35 patients with gastrointestinal bleeding and in the group of 15 patients with acute edematous pancreatitis before beginning of treatment Apache II score was calculated. The obtained score values ranging from 2 to 18 were subsequently compared with the duration of the interval from appearing of the clinical signs to the beginning of treatment, the way of treatment, duration of hospitalization and recurrence of the diseases during hospitalization. The relations were evaluated through correlation analysis and T-test.

[Right-sided pneumothorax--a complication of laparoscopic cholecystectomy].

In a 49-years old woman cholecystolithiasis was confirmed by sonography and she was admitted for laparoscopic cholecystectomy. During the operation right-sided pneumothorax developed as a result of the injury of diaphragma by monopolar electrocautery. Operation was converted and the injury was treated by continuous suture.

[Personal experience with laparoscopic cholecystectomy].

During the period of 29 months the first 100 laparoscopic cholecystectomies were performed at the Department of Surgery of the Ruzinov Hospital in Bratislava. There were 79 women and 21 men with mean age of 41.5 years (16-67).

[Use of the Apache II scoring system for clinical evaluation of the status of patients with gastrointestinal hemorrhage].

The Apache II scoring system has been used to identify a clinical status of 10 patients, admitted to the intensive therapy unit with bleeding to gastrointestinal tract during the period 1. January - 30. Juni 1992.

[Aspects of therapeutic approach in hemorrhage in gastroduodenal ulcers].

The most dramatic complications of gastroduodenal ulcers are haemorrhage. According to the literature 20-25% of chronic ulcers bleed. The authors analyze a group of 71 patients treated on account of bleeding gastric or duodenal ulcers.