[Indications for right-sided and total pancreatectomy]. / Unele indicatii ale pancreatectomiei drepte si totale.

The files were studied of 362 patients hospitalized in the Surgical Clinic from Tg. Mures in the last 20 years with various primary or secondary pancreatic affections, and for whom curative, palliative or exploratory surgery was indicated. Of the total 307 had pancreatic cancers, 16 had Vater ampulomas, 23 had gastric cancers, and 5 had primary duodenal tumours. In six patients pseudotumoral chronic pancreatitis was found, 2 had retroperitoneal tumours, and 3 had pancreatic cysts, lymphoma of the spleen, and mesenteric tumour. A total of 212 palliative surgical interventions were performed, 75 radical interventions (pancreatic reactions), and in another 75 patients simple laparotomies were done. In 45 of the pancreatic resections the duodenum was also removed. The other 30 cases included 6 total resections, 6 subtotal pancreatic resections and 18 resections of the left part of the pancreas.

[Late results in 170 patients operated on for breast cancer]. / Rezultate tardive la 170 bolnave operate pentru cancer mamar.

The authors investigated the late results, or survival at 5 years after the intervention, in 170 patients operated for breast cancer. The total number of survivors at 5 years was of 71 patients, of which 78 belonged to stages I and II, and only 3 to stage III. The authors present their personal attitude for such cases, and stress some of the difficulties encountered in the application of complex therapy. Of the late complications noted, which totalled 58 cases, the authors mention generalized carcinomatosis in 17 patients, pleuro-pulmonary metastases in 14 patients and 11 cases of chronic oedema of the arm, or the so-called "thick arm after Halstead operation".

[Recurrent neoplasm in the gastric stump, penetrating the pancreas. Total gastrectomy, total duodenopancreatectomy. Problems of surgical technic]. / Recidiva neoplazica pe bont gastric, penetranta in pancreas. Gastrectomie totala duodenopancreatectomie totala. Probleme de tehnica chirurgicala.

The authors performed a new surgical intervention in a patient with cancer of the gastric stump recidivating after a resection performed two years previously. Due to the extension of the tumour, and to involvement of the pancreas it was necessary to perform total gastrectomy, associated with splenectomy and total pancreatectomy. The refection of the continuity of the digestive-biliary pathways was achieved by eso-jejunostomy of the termino-terminal type associated with choledocho-jejunostomy on omega loop excluded from the digestive pathway by way of the Braun-type fistula. A knowledge of the solution selected by the authors is interesting due to the total pancreatectomy associated to total gastrectomy, and for the surgical technique employed.

[Pancreatic pseudocysts and fistulas]. / False chisturi si fistule pancreatice.

The authors present false pancreatic cysts and fistulae that have been encountered inthe practice of the I-st Clinic of Surgery from Tg-Mures over a period of 10 years (between 1964 ans 1979). The author's personal cases are presented and the rarity of this type of disturbances is stressed. A total of 14 cases are described, of which 8 were false pancreatic cysts and 6 were false pancreatic fistulae. The major complications that occurred in the cases with false pancreatic cysts the most severe was the intra-cyst haemorrhage, that was encountered in 2 patients (of which one developed severe shock), and peritonitis, following rupture of the cyst in the peritoneal cavity. The 6 pancreatic fistulae have developed following surgery (3 cases), trauma (one case), and acute pancreatitis (2 cases). The treatment of the false cysts consisted in the external drainage (two emergencies), and cyst-gastrectomy. Pancreatic fistulae have benefited from fistulo-gastrostomy (two cases), while the remaining 4 patients were treated conservatively. Only one death was recorded in this group of patients.