[Dilemmas in indications for emergency revision surgery of postoperative complications in abdominal surgery - contribution to the problem]. / Dileme u indikacijama za urgentnu operativnu reviziju postoperativnih komplikacija u abdominalnoj hirurgiji - prilog problematici.

The percentage of complications following an interval or emergency operative interventions in the abdomen is different and depends on several factors: -Proper indication for surgery -Experience of the surgical team, anesthesia -Extent of pathological changes; -patient's general condition (presence of associated diseases, capacity of the cardiovascular system, a.o.). -The immediate postoperative treatment. In more experienced surgical departments this percentage is about 5%, but it can rise higher. Postoperative complications representing an indications for emergency re-laparotomy (besides bleeding, also appearing on the first postoperative day, or immediately following the surgery), usually appear from fourth to the seventh day and their common cause being disruption of the anastomosis at different levels of the guts: from gaster to colon and recto-sigmoid. The authors their ten years experience in 40 patients operated upon because of malignomas of the gastro-intestinal tract, but also because of benign processes. A delay of re-operation can--from one part--have fatal consequences, threatening the patient's life; and from another part the re-operation as a complementary (added) aggression on the almost exhausted patients, can by itself kill such patients. In every case, the mortality rate rises over 50%. The authors detail and systematically present their patients and they point out the importance of making decision, which represents the basic dilemma.

[Our experiences in the treatment of bleeding duodenal ulcer by means of proximal gastric vagotomy]. / Nasa iskustva u leucenju krvareceg duodenalnog ulkusa sa PGV-om

Gastric Vagotomies were performed on fifty four patients suffering from bleeding Duodenal Ulcers. Forty-three cases were operated on following a spontaneous cease in hemorrhaging, and necessary examinations. The remaining eleven patients were opereted on immediately as conservative measures would not be able to stop the bleeding. The procedure used following the admittance of a patient with a bleeding ulcer to the hospital was discussed. A detailed explanation of the technical procedure used in handing the bleeding duodenal ulcer was also presented. The authors believe that a Duodenotomy performed without cutting the pylorus has its advantages inasmuch as hemostasis has been successfully accomplished. All the cases had good clinical results, however, bleeding did recur in a few instances. There were no recidive ocurrences. Ever though many patients were chronically ill ie; Diabetes Mellitus, Myocardiopathia, secondary anemia, exitus lethalis did not occur. P.V.G. in the treatment of bleeding ulcers has a definte advantage over the other radical procedures.