[Complete section of the main bile duct during laparoscopic cholecystectomy. Surgical treatment]. / Sezione completa della via biliare principale durante colecistectomia laparoscopica. Trattamento chirurgico.

Three cases of biliary tract serious lesions during videolaparoscopic cholecystectomy are reported. They were executed in other hospitals and presented big technical restoring difficulties, not easily resolvable. In 2 cases of lithiasic cholecystitis there was a complete damage of common biliary duct, in the third one there was a double main biliary duct binding with removal of a biliary tract segment. In all cases a biliary confluence-jejunal anastomosis with Roux en y loop was made up. In all cases the operation was difficult because of main bile duct fragility and modest expansion. In the third one the presence of a secondary biliary duct in gallbladder fossa not recognized but drained outside with a common drainage placed during the operation has prevented appearance of jaundice with dilatation of biliary ducts. It has heavily conditioned confluence-jejunal anastomosis with Roux en Y loop. In all cases tubes were left in the biliary duct for few months in order to calibrate it. In 2 patients postoperative course was characterized by the appearance of an external biliary fistula which has spontaneously disappeared. One year later both patients don't present any stenosis or cholangitis problem.

[Use of mechanical staplers in surgical therapy of morbid obesity]. / L'uso delle suturatrici meccaniche nella terapia chirurgica della grande obesità.

The Author reports the experience of the III Surgical Department of the University of Milan on stapling devices in bariatric surgery. The use of stapling devices is now almost irreplaceable for some surgical interventions like gastroplasty, jejuno-ileal bypass, and intestinal bypass revision because staplers simplify and shorten operating procedures, also reducing surgical risk.

[Combination of antimetabolites and alkylating agents in the treatment of advanced breast cancer]. / L'associazione di antimetaboliti ed alchilanti nel trattamento del cancro mammario in fase avanzata

An association of 5-fluoruracyl (or methotrexate) and cyclophosphamide was used in the treatment of 20 cases of hormone-resistant breast cancer. Five objective regressions were obtained. Mean survival here was 28.25 (S.D. 2.87) months, as opposed to 12.75 (S.D. 6.93) months in the remainder. Side-effects of various kinds were noted in 9 patients.