[Indications for enteral nutrition in surgery]. / Indikace enterální výzivy v chirurgii.

Survey of basic indications of enteral nutrition in Surgery. 1. Application in preoperative preparation. 2. Postoperative preparation in malnutritive and critically-ill patients, at early stage. 3. EN applied also for accelerated motility of the stomach and bowels after major operations (in retroperitoneal operations). 4. Application in traumatology: polytraumas, burns, subsequent sepsis, multiorgan failure; also in specific therapy, e.g. traumatic fistulae of GIT. 5. Use in acute and chronic pancreatitis. 6. Use of enteral probe in special states (e.g. in treatment of fistulae in upper and lower parts of GIT (dehiscence of anastomosis, bowels ruptures). 7. Application in the syndrome of short intestine. 8. Use in reconvalescence after severe operations (sipping) 9. Application in terminal cachectic states.

[Initial experience with treatment of choledocholithiasis using shock waves]. / První zkusenosti s lécbou choledocholitiázy rázovou vlnou.

From March 1996 till August 1997 at the First Surgical Clinic in Olomouc 18 patients with concrements in the biliary pathways were treated by shock waves. All patients were older than 68 years; residual choledocholithiasis was involved which could not be eliminated during ERCP because of the size of the size of the stone. In 125 instances treatment was successfully terminated, i.e. by crushing the stones and their elimination. Only in three patients it was necessary to resolve the situation by surgery. The authors confirmed that it is possible to treat by this method patients with choledocholithiasis and avoid the risk of surgery in particular in older patients.

[Extracorporeal lithotripsy in the treatment of biliary tract calculi]. / Vyuzití extrakorporální litotrypse v lécbe kamenu zlucových cest.

The authors subjected to the effects of a shock wave 20 concrements of the biliary pathways. Their size varied but was within the range of 8-30 mm. Their chemical composition and crystalline pattern from which ensues the hardness of the concrement was verified by the method of X-ray diffraction. It was confirmed that the apparatus MEDILIT 5 which uses discharges of electric sparks between two electrodes deposited under water is able to destroy concrements of the biliary pathways to a maximum size of 3 mm. This effect is independent on the chemical composition of the concrements, their hardness and size up to a diameter of 30 mm.

[Importance of ERCP in laparoscopic cholecystectomy in comparison with classical cholecystectomy]. / Význam ERCP u laparoskopické cholecystektomie ve srovnání s klasickou cholecystektomií.

The authors compare the value of ERCP in laparoscopic and classical cholecystectomy. They analyze groups of 1356 classical and 527 laparoscopic cholecystectomies. The number of ERCP indicated before surgery rose in laparoscopic cholecystectomies 17x, as compared with classical surgery. In ERCP indicated after surgery the number increased 2.3x. In choledocholithiasis ERCP proved to be a reliable diagnostic and therapeutic method. The number of laparotomies in residual choledocholithiasis in laparoscopic cholecystectomies should not exceed 10-12%.

[Injuries of the bile ducts and fundamentals of therapy]. / Poranení zlucových cest a zásady jeho osetrení.

In the submitted paper the authors present an account on 88 patients with reconstructions of the biliary pathways, most frequently after iatrogenic damage. Check-up examinations revealed that the results in patients who survive for prolonged periods and were reoperated in time, unless they developed irreversible liver damage, are very satisfactory. 81.8% of the patients have no subjective complaints and the objective finding (laboratory examination, HIDA) is consistent with the subjective report. In the author's opinion a certain part in these satisfactory long-term results is played by short-term, or if necessary, long-term drainage of the anastomosis. This problem is discussed in detail.

Sutureless biliodigestive anastomosis.

New modification of suture--free biliodigestive anastomosis was proposed. The suture--free anastomosis in our modification is performed by the help of Foley catheter. This technique was verified in dog experiments and than used for operation of four patients. Of these patients none died due to surgical intervention.

[Liver resection using a suction knife in an experiment and in clinical practice]. / Resekce jater s pouzitím sacího noze v experimentu a v praxi.

The authors describe their experience with liver resection by means of an suction knife. In animal experiments, the optimal value of under-pressure for an effective and non-destructive function the knife was tested and the healing process in the vicinity of the cut surface was followed. This simple device was developed that allows evaluation of the results of liver resection (segmentectomy to hemihepatectomy) in clinical practice. The method was applied in ten out of twenty patients in which liver resection was performed in the last fourteen months. The inexpensive device functioned to the authors full satisfaction.

[Post-traumatic hemobilia and successful direct treatment of the arteriobiliary fistula]. / Die posttraumatische Hämobilie und die erfolgreiche direkte Behandlung einer arteriobiliären Fistel.

Traumatic hemobilia is a rare complication of deep and central liver injuries. Repeated and massive bleeding requires an active therapy. For diagnosis of the arterial-biliary fistula, most advantageous is a transcutaneous selective arteriography which can be used also for therapeutic embolization. Of surgical techniques, ligature of the art.hepatica comm. or propria and direct closure of the fistula in the liver parenchyma are recommended. The authors report on such a successful direct intervention in a 9-year-old girl.