[The modified laparostomy with the use of ultrasound dissector and garamycin sponge in the treatment of complicated acute pancreatitis]. / Zmodyfikowana laparostomia z zastosowaniem dyssektora ultradzwiekowego i gabki garamycynowej w leczeniu powiklan ostrego zapalenia trzustki.

In the report a new modified technique of complicated pancreatitis treatment by laparostomy was showed. In included the use of ultrasound dissector for removing necrotic tissues and locating of garamycin sponge which should protect against secondary infection. Between January and May 1998 12 patients were treated using this method. In 8 cases (66%) we obtained rapid improvement of patients' general condition. One patient died and in 6 cases postoperative complications occurred. The use of ultrasound dissector shortens time of necrotic demarcation in pancreas and peripancreatic tissues. Garamycin sponge is effective protection from late infections concerning laparostomic wound. Modified laparostomy decreases about 50% number of secondary re-laparostomies, period of hospitalization and cost of complications treatment in acute pancreatitis in comparison with conventional method.

[Experimental evaluation of vascularization by various methods of forming a synthetic stomal pseudosphincter]. / Doswiadczalna ocena unaczynienia róznie wytworzonego sztucznego zwieracza przetoki kalowej.

Authors presents the own method of formation of the stomal pseudosphincter using a pedunculated intestinal flap devoid of mucosa. The experimental and clinical evaluation of blood supply of the sphincter was carried out by means of the doppler and fluorescence method. The study revealed no impairment of the blood supply of the sphincter and it's connect function.

[Evaluation of stomach emptying under extreme obstruction of gastrointestinal transit treated with gastro-intestinal or duodenal-intestinal anastomosis]. / Ocena oprózniania zoladkowego w warunkach wysokiej niedroznosci przewodu pokarmowego leczonej zespoleniem zoladkowo-jelitowym lub dwunastniczo-jelitowym.

The purpose of the present study was to compare gastric emptying in two groups of dogs in which a gastrojejunal or duodenojejunal Roux-en-Y anastomosis was performed over the site of an experimental obstruction in the distal duodenum. The experiment was carried out on 10 mongrel dogs. Gastric emptying was assessed twice in each dog before the experiment (control examination); the solid phase of the test meal was labelled with 99mTc. Following a control examination, the dogs were divided into two groups of 5 animals each, and subjected to the above mentioned surgical procedures. Postoperative gastric emptying was carried out 3 weeks after the operation, and then at 3 and 6 months following the procedure. The following parameters describing quantitatively gastric emptying were determined: mean transit time MTT0-60. MTT0-120 and total mean transit time MTT0-180. The comparison of these parameters revealed statistically significant differences confirming delay of gastric emptying in dogs with a gastrojejunal anastomosis.

[Duodenojejunostomy in the symptomatic treatment of neoplastic obstruction of the duodenum--clinical observations]. / Zespolenie dwunastniczo-czcze w objawowym leczeniu nowotworowych niedroznosci dwunastnicy--spostrzezenia kliniczne.

The aim of the study was to evaluate the value of duodenojejunostomy and gastrojejunostomy in the treatment of neoplastic obstruction in the distal part of the duodenum. From 1992-1996, 37 patients (15 women, 22 men, aged 31-76 years) underwent a palliative operation for pancreatic cancer infiltrating the distal part of duodenum. Roux-en-Y procedure was used to create anastomoses between the duodenal bulb and jejunal loop. In 13 patients only alimentary by-pass was made whereas in the remaining 24 biliary decompression was also performed. The results were compared with the outcome in 26 patients in whom gastrojejunal side-to-side anastomosis been made. The advantage of Roux-en-Y duodenojejunostomy is that it does not interfere with gastric emptying and thus prevents jejuno biliary reflux and the consequent complications. Improvement of nutrition and quality of life in patients with inoperable pancreatic cancer, were noticed with this method.