[Cystic congenital dilatation of main biliary duct]. / Dilatatie congenitala chistica a caii biliare principale.

A case of cystic congenital dilatation of hepatocholedoch, in a patient aged 27, is presented. The malformation affects the entire biliary duct, being classified as Todani Ic type. The diagnosis was intraoperatively established and the surgical solution was the quasitotal extirpation of the hepatocholedoch followed by the reconstruction of the biliary transit through hepaticojejunostomy on Y loop Roux. The postoperative evolution was favourable and the result is still good after 13 years.

[The diagnostic and therapeutic considerations in hepatic hydatid cyst]. / Cîteva consideratii diagnostice si terapeutice în chistul hidatic hepatic.

The paper is based on 213 surgical interventions for hepatic hydatid cyst. The importance of monography in the early diagnosis, detection of multiple sites and postoperative follow-up of the cases suspected of recurrence is underlined.

[Splenohepatoplasty in the treatment of hepatic cirrhosis]. / Splenohepatoplastia în tratamentul cirozei hepatice

The authors review the patho-physiologic arguments that have determined Bénichoux to recommend spleno-hepatoplasty in the treatment of hepatic cirrhosis, and present a group of 7 personal observations in which they have tested this type of intervention. The technique employed is described, as well as the follow-up of the cases that had a favourable evolution. In one of the observations differences between the samples obtained by bioptic puncture before the intervention and those obtained at one and two years after surgery, have demonstrated a marked reduction in the intensity of inflammatory reactions, as well as evident reparation processes in the hepatocytes. The authors consider the intervention as a new type of therapy, allowing for re-vascularization of the ischaemic hepatic tissue, as well as for a slow porto-caval derivation with remarkable results for the cirrhotic patients.

[Morphological and enzymatic studies of the supratumoral distended colonic loop in colorectal cancers (therapeutic aspects)]. / Studii morfologice si enzimatice asupra ansei colice destinse supratumoral in cancerele colorectale (aplicatii terapeutice)

The authors carried out experimental and clinical studies in an attempt to explain the causes leading to anastomotic dehiscences, a major complication of exeresis surgery of the left colon and of the rectum. In this view they have performed in dogs incomplete stenoses at the level of the sigmoid and also made parallel studies of the morphological and histochemical changes occuring in the supra-stenosis colon wall, with those of the supra-tumoral colon wall found in human colo-rectal carcinomas, in the "sub-occlusion" stage. Histological alterations are presented, characterized by marked edema in all the layers of the wall, leading to evidently hampered colon vascularization. From the enzymological viewpoint there was noted an intensive phosphatasic and ATP-ase reaction in all the layers of the colon wall. These studies led to the conclusion that it is necessary to evaluate the degree and the duration of the supra-tumoral colic distension before a decision is taken to carry out primary colectomy or rectal resection (single-step procedure), and not to avoid the practice of a seriated intervention when necessary. The reversibility of the lesions noted by the authors allows for the possibility to perform a resection after the colic wall to be anastomosed has returned to an almost normal condition, thus avoiding the dehiscence of the sutures.

[Radioclinical and morphological comparisons in non-lithiasic gallbladder diseases]. / Confruntari radioclinice si morfologice în colecistopatiile nelitiazice

Confrontation of the clinical, radiologic and morphologic data in a lot of 274 patients operated for non-lithiasic cholecystopathies during the 1966-1972 period, led to the following conclusions: - the painful choleic syndrome whose duration and frequency increase progressively, refractory to the conservative treatment, is a basic criterion in establishing the surgical treatment; - any change in the radiologic image of the gallbladder, especially those evoking a partial or totally inefficient contractile effort are of diagnostic value, suggesting the necessity of the operation, when confirmed by a similar clinical context; - the morphologic substrate consists in inflammatory lesions (infiltrations, atrophy of the mucosa, sclerosis), or degenerative lesions (cholecystoses) due to the reaction of the gallbladder walls to the irritative-chemical action of the bile hyperconcentrated by intermittent stasis caused by an incomplete cystic obstacle; - both types of lesions may determine with time obstruction of the cystic duct (acute cholecystitis), changes in the choledochoduodenal confluence (odditis), co-affection of the pancreas and liver (cholecystopancreatitis, chronic reactive hepatitis); - the late results lend support to the surgical treatment in such circumstances.