[Minimally invasive laparoscopic cholecystectomy - analgesia and pulmonary function].

This is a report on 27 patients subjected to cholecystectomy for calculous cholecystitis through minilaparotomy. In 21 of them minicholecystectomy is performed under conditions of intubation inhalatory anesthesia. In the remainder (6 cases) intraoperative epidural analgesia is approbated, proceed-in during the short postoperative period.

[Primary colorectal carcinoma as an underlying cause of obturation of the ileum].

This is a report on 169 patients presenting colorectal carcinoma with complication assuming the form of occlusive ileus, observed over the period 1993 through 1998. Obturation is the commonest complication of colonic carcinoma (48.9%) with the left colon being more often involved (58.

[Combined and extended radical operations in colorectal carcinoma patients].

This is a report on radical operative interventions performed in 273/385 patients presenting complicated colorectal carcinoma, covering the period 1993 through 1998. Fifty-four patients are subjected to combined and extended operations, distributed as follows: 31 combined and 23 extended. In fifteen patients with abdomino-perineal extirpation the combined interventions include: hysterectomy (6), ovariectomy (8), resection of vagina (7), prostate gland resection (3) and bladder resection (2).

[Large-intestine perforations caused by primary colorectal cancer].

Twenty-seven cases of perforation, produced by primary colorectal carcinoma over the period 1993-1998, are described. The underlying causes of colorectal carcinoma complication and types of perforations observed are discussed. This is a report on personal experience with the therapeutic approach and operative management of this severest complication of colorectal carcinoma.

[Relaparotomy after an appendectomy].

The analysis covers 2555 appendectomies, performed on an emergency and scheduled surgery basis in the clinic of emergency surgery.--State University Hospital "Queen Giovanna", Sofia, over the period 1985-1997. Relaparotomy is necessitated in 28 cases (1.

[Minicholecystectomy--the technical aspects].

In current interventional medicine operations on the gallbladder and biliary tracts, performed by "mini" access are ever more widely used in practice. Cholecystectomy done through minilaparotomy is an attractive procedure with well established superiorities, irrespective of the enthusiasm for laparoscopic accomplishment of the interventions in this particular field of surgery. Approbation of the method initiates in the early 80-ies, and ever since then it marks a ceaseless improvement in technical respect.

[Necretomy and prolonged local postoperative lavage in the surgery of necrotic pancreatitis].

Over an 8-year period, sixty-one patients with mean age 52.5 years are operated on for necrotic pancreatitis in the clinic of emergency surgery at the Faculty Hospital "Queen Giovanna"--Sofia. The initial prognosis of the severity of disease scores 4.

[The treatment of acute cholecystitis complicated by mechanical jaundice].

After analyzing the summed up treatment results in 368 patients with acute cholecystitis, complicated by obstructive jaundice, the inference is reached that it is a matter of a complication, unfavourable in terms of prognosis, with a definite impact on both immediate and long-term therapeutic results. Early operative intervention following intensive preoperative preparation (including ERHPG with endoscopic papillosphincterotomy and ensuing biliary decompression, or echographic percutaneous cholecystectomy) contribute to control the acute inflammatory process in the gallbladder, and preclude the development of liver (or hepato-renal) failure against the background of obstructive jaundice. Proceeding from the severe, irreversible changes in liver and kidney, hardly responding to treatment, and persisting deterioration of the general condition, acute cholecystitis complicated by obstructive jaundice is defined as an emergency life-endangering condition, requiring a priority operative approach.

[Our experience with treating acute noncalculous cholecystitis].

Based on a comprehensive literature survey, personal experience with the management of 89 patients, presenting acute noncalculous cholecystitis, is shared. All patients are clinically observed in the acute phase of the disease. In 60 cases the latter becomes manifest with recurrent attacks, and in 29 there are no previous signs or symptoms of biliary diseases.

[Echinococcosis--the current surgical aspects].

Over the period 1985 through 1992, forty-four patients presenting echinococcosis (echinococcus of the liver--33 cases, lung--nine, and spleen--two), aged 12 to 79 years, are operated in the emergency surgery clinic of the State Faculty Hospital "Queen Giovanna". The up-to-date methods of diagnosing are comprehensively described, followed by illustration and discussion of the operative procedures used in the treatment of echinococcosis. The early and long-term results are estimated as satisfactory.

[The results of the long-term follow-up of an expanded variant of selective proximal vagotomy].

This is a report on a long-term follow-up study of the results of an extended variant of proximal selective vagotomy in patients undergoing clinical approbation over periods ranging from 7 to 9 years. The details of technical implementation of the variant are described. At zero lethality and complete recovery of the patients followed up, the late results are estimated as excellent.

[Surgical treatment of tracheal bifurcation].

Ninety-eight patients underwent operation for stenosing diseases of the bifurcation of the trachea at the Department of Lung and Mediastinal Surgery of the National Research Center of Surgery (Moscow) from 1963 to 1990. There were 44 females and 54 males. Their ages ranged from 6 to 69, average age of 38.