[Gallbladder puncture - a rare percutaneous liver biopsy complication]. / Punktsiia na zhl'chen mekhur - riadko uslozhnenie ot perkutanna chernodrobna biopsiia.

Mayor complications of 1000 percutaneous liver biopsies, performed with Menghini's needle for 20 years period (1981-2000) are reported. Five severe complications (0.5%) were observed. Operation was unavoidable in three patients. Four of the major complications were caused by bleeding. Two patients had hematological diseases, and one--chronic kidney failure waiting for kidney transplantation. One patient collapsed immediately after the liver biopsy with bile aspiration. That forced urgent operation in one hour. The possible cause of the complication and the limited theoretical potentialities of ultrasonography and laparoscopy to establish it are discussed. Aspiration of bile during liver biopsy was observed in 0.9% of cases despite the exact keeping of contraindications and technics of examination. Transhepatic puncture of the gallblader is also possible in some of those cases. The necessity to check by ultrasonography the chosen point for biopsy is also emphasized. We recommend to name that biopsy "percutaneous" or "puncture" but not "blind". In this way the second reason (after bleeding) for death after liver biopsy--biliary peritonitis will be reduced to the absolute minimum.

[Indications for preoperative laparoscopic ultrasonography]. / Pokazarniia za predoperativna laparoskopska ekhografiia.

109 laparoscopic ultrasound examinations are performed for a period of 7 years (1993-1999). Laparoscope R. Wolf and 7.5 MHz linear probe "Aloka" are used. On the basis of the results analysis the following indications for laparoscopic ultrasonography (LUS) are recommended: 1. Uncertain diagnosis; 2. Contradictory results of imaging technics; 3. Assessment of tumour's stage; 4. Early diagnosis; 5. Negative data for liver lesion on laparoscopic examination and established or suspected tumour by imaging technics; 6. Negative data of laparoscopy and uncertain evidence of the imaging technics for liver lesion in cases with advanced locoregional stage of extrahepatic primary carcinoma and small chance for palliate surgical treatment; 7. Positive laparoscopic data insufficient to determine tumour resectability; 8. Suspicion for endocrine tumour of the pancreas. Laparoscopy and LUS are indicated for staging of hepatocellular carcinoma; gastric and colorectal carcinoma, especially in T3 and T4 stage; "T4b" stage of gastric carcinoma without liver metastases; all cases of carcinoma of the body of pancreas without data of liver metastases. LUS is irreplaceable nonsurgical diagnostic method in deep placed intrahepatic lesions. The main contribution to diagnosis of laparoscopy and LUS is not only to establish the liver lesion but to give differential diagnosis of the lesion and determine the tumour stage.

[Dermoid, epidermoid and teratoma cysts of the tongue and oral cavity floor]. / Dermoidni, epidermoidni i teratomni kisti na ezika i poda na ustnata kukhina.

Most dermoid cysts in the oral cavity floor are derived from epithelial debris or rests, enclaved during midline closure of the bilateral first and second branchial arches. They may also result from ectodermal differentiation of multipotential cells, most likely pinched off at the time of anterior neuropore closure. Congenital epidermoid cysts and teratomata of the tongue may be explained in a similar manner. Only 6.9 per cent of dermoid cysts observed in humans involve the head and neck regions. Treatment consists in complete surgical removal, with excellent prognosis in cases free of complications. This is a report on a rare case of epidermoid cyst, described because of its unusual location and cell population variation of the epithelium lining the cystic cavity.

[Complications in Le Fort facial fractures combined with craniocerebral trauma]. / Uslozhneniia pri frakturi v srednata zona na litseto, s'chetani s cherepno-moz'chna travma.

The present research is based on the most frequent traumas and fractures in the middle zone of the face (second and third type by Rene le Fort) and the proceeded from them complications for a period of four years in the clinic of Neurosurgery in NIUMN "Pirogov". From the 280 patients that were studied the complications were observed in 54 of them. We worked up the received results statistically and presented them in drawing.