Hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic cholecystectomy. A retrospective study on 51 cases.

Background/aims: Laparoscopic cholecystectomy is characterized by a higher incidence of iatrogenic biliary lesions. The Authors evaluate the role of hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic cholecystectomy in 51 patients observed in the Campania region, Italy from 1991 to 2003.

Methodology: The Authors report the data of a retrospective multicentric study of 51 patients -39 women (76.

[Surgical treatment of iatrogenic bile duct injuries following laparoscopic cholecystectomy: analysis of long-term results. Retrospective clinical study in 51 patients operated in the Campania region from 1991 to 2003].

An higher incidence rate of iatrogenic bile duct injuries is reported in cholecystectomy performed with the laparoscopy than with the laparotomy approach. The aim of this study was to provide a multicentre report on surgical treatment and the outcome of biliary complications during and following laparoscopic cholecystectomy. A questionnaire was mailed to all surgeons with experience in laparoscopic cholecystectomy in the Campania region.

[Comparison of five synthetic absorbable suture materials in intestinal anastomosis: experimental study in rats].

The purpose of this experimental study was to evaluate the efficacy of five synthetic absorbable suture materials in intestinal anastomoses in rats together with their interference with the normal physiopathological cicatrization process. The materials analysed were polyglycolic acid (Dexon), polygluconate (Maxon), polydioxanone (PDS), polygalactic acid (Vycril) and Glycomer 631 (Byosin). An anatomopathological study, performed in three groups of rats undergoing postmortem examinations after 6, 20 and 90 days showed that the least interference was caused by Glycomer 631, while polyglycolic acid and polygluconate yielded very good results though giving rise to a greater fibrous component.

Cholecystoenteric fistula (CF) is not a contraindication for laparoscopic surgery.

Background: Cholecystoenteric fistula (CF) is a rare complication of cholelithiasis. The aim of this study was to evaluate the safety and risk of complications when the laparoscopic approach is applied in patients with CF.

Methods: A questionnaire was mailed to all surgeons with experience of >100 cholecystectomies working in Naples, Italy, and the neighboring area.

[Video-laparoscopic Nissen-Rossetti fundoplication].

The authors describe the application of Nissen-Rossetti fundoplication for the treatment of hiatus hernia using a laparoscopic approach. They report excellent results both immediately after surgery and in the medium term.

Hydatid cyst of the lumbosacral spine with large pelvic mass.

A rare case of hydatid cyst of the lumbosacral spine, causing extensive destruction of the sacrum and a large pelvis mass, is reported; a cutaneous fistula from the pelvic cavity to the posterior lumbar region was also present. The patient was studied by computerized tomography and operated on by combined anterior and posterior approach. The sacral localization of the spinal hydatidosis and its extension into the pelvic cavity are unusual.

[Mucocele of the appendix. Some diagnostic features].

The description of a case of mucocele of the appendix shows the difficulties of arriving at a preoperative diagnosis. Following an analysis of the diagnostic features it's possible to affirm that only surgery can confirm the diagnosis with the histological result. Careful surgical dissection is very important when a malignant tumor is suspected.

[An indirect hemagglutination study of total IgE and complement fractions C3c and C4 in patients with hepatic hydatidosis and undergoing therapy].

The trend of antibodies tested with indirect hemagglutination, of total IgE and complement fraction was examined in patients with liver hydatid disease, treated with surgery and benzoimidazoles.

Effects of total parenteral nutrition enriched with branched chain amino acid infusion on liver function and serum amino acid pattern in dogs undergoing hepatectomy.

In order to study effects of different total parenteral nutritional regimens on the recovery of liver function and on plasma amino acid pattern after major hepatectomy, twelve healthy mongrel dogs were submitted to 70% liver resection and randomly divided into three different groups: group I (control group) received only 10% glucose; group II received 10% glucose plus 8.5% Freamine; group III received 10% glucose plus 100% branched chain amino acid (BCAA) solution. Blood samples were analyzed for determining biochemical parameters, including plasma amino acid levels, before surgery and on 3rd and 7th postoperative day.

Hepatico-jejuno-duodenoplasty for biliary stricture.

The authors present the results of their experience in the therapy of biliary strictures, using a jejunal loop interposed between the biliary tract and duodenum. This procedure allows extensive biliary discharge and aims to prevent the pathophysiologic disturbances of gastroduodenal functions, which result from Roux-en-Y anastomosis, and has the advantages of both Roux-en-Y and choledochoduodenostomy procedures. The authors report nine years positive experience with this technique.

[Comparative experimental physiopathological evaluation of Roux-en-Y biliary shunt and choledocho-duodenal anastomosis with an interposed jejunal loop in dogs].

The authors compare in an experimental study two biliary tract reconstructive procedures in dogs: Roux-en-Y hepatico-jejuno-stomy and hepatico-jejunoduodenoplasty. The former causes in increase of plasma gastrin and insulin and moreover a decrease of duodenal pH after alimentary stimules, whereas the latter, preserving biliary flux through the duodenum doesn't alter such parameters, and therefore should be preferred.

[Percutaneous punctures guided by echography].

It is possible to carry out percutaneous injections of lesions in any organ under the direction of echography. This is particularly so in the liver, pancreas and kidney. The procedure has been used in 79 patients for diagnostic and/or therapeutic purposes and has provided very good and promising results.

[Liver transplantation: an experimental model with rats].

In this report the Authors describe their surgical technique of liver transplantation in the rat. The operation has been performed on fifty rats of 400 gms of weight, stabulated in standard conditions. The surgical technique has been extremely simplified, requiring only two end-two-end vascular anastomoses and another anastomoses between common bile duct and duodenum.

Normal inferior vena cava: caliber changes observed by dynamic ultrasound.

A review of the literature revealed conflicting reports on the physiologic variations of the caliber of the normal inferior vena cava as seen by sonography. In this study, 25 normal volunteers were examined using dynamic scanning, and the upper parts of their inferior vena cavas were observed for changes during various phases of respiration as well a Valsalva maneuver. Optimum distension and, therefore, optimum visualization of the inferior vena cava were achieved after simple breath holding or at end expiration.

[Personal experience with bilio-digestive anastomosis].

The indications and contraindications for the various types of bilio-digestive anastomosis operations are assessed with due allowance for the physiopathological aspects of main bile way function. Careful analysis of the data obtained in pre- and intra-operative investigation permits a precise choice of the required intervention in all cases. The advantages offered by restoral of bile flow at duodenal level, as occurs in EDDP, are stressed.

[Treatment of hepatic metastases in tumors of the gastrointestinal tract. Considerations on 25 cases].

Results with liver resection over a period of 3 yr in the treatment of metastases derived from tumours of the gastroenteric tube are reported. An account is given of the data and the techniques used by Italian and foreign workers for this purpose. A personal series of 25 cases is presented and its 2-yr survival figure is stated.