Gall-Stone Ileus--Own Patients And Literature Review.

Cholelithiasis is diagnosed in 10% of the population of the USA and Western Europe. A rare but serious complication of cholelithiasis is the obstruction of the digestive tract caused by a gall-stone (Bernard syndrome). It can add up to 1-4% of the mechanical obstructions of a small intestine among the general population but it can result in nonstriangulational mechanical obstructions of a small intestine in 25% cases among the patients over the age of 65. 5 patients have undergone an operation due to a small intestine gall-stone ileus in years 2011-2013 (within 27 months) in the General Surgery Ward of the Beskid Oncology Center - Municipal Hospital. In 4 patients simple enterotomy with a gall-stone extraction was performed. In the fifth patient enterolitotomy was conducted together with cholecystectomy and fistulotomy.

Laparoscopy-assisted total gastrectomy with D2 lymphadenectomy and Roux-en-Y reconstruction--case report.

We report a case of patient with stage IIIb gastric cancer qualified for laparoscopy-assisted gastrectomy and our first impressions about this procedure. Total gastrectomy with complete omentectomy and extended lymphadenectomy (D2) was performed laparoscopically. The intestinal continuity was restored in a Roux-en-Y mode extracorporeally through the abdominal access system. The orogastric tube with anvil of the circular stapler was transorally introduced into the esophagus. Subsequently, intracorporeal stapling esophagojejunostomy was performed. There were no complications after the operation and the patient was discharged in good shape. Oncological radicality was sufficient and patient has undergone chemotherapy treatment.