[Sugiura's procedure--a treatment modality for esophageal varices]. / Operatia tip Sugiura--o modalitate de tratament chirurgical a varicelor esofagiene.

This study present the "N. Gh. Lupu" surgical experience with Sugiura technic for bleeding caused by oesophageal varicose. Is a 5 years retrospective study with 30 patients who are submitted of this operation. After the results analysis our opinion is to do this operation in stabilised patient, but she is possible even in emergency.

[Surgical treatment of pelvic subperitoneal tumors]. / Tratamentul chirurgical al tumorilor pelvisubperitoneale.

In the last 5 years in our hospital was operated 25 patients with pelvisubperitoneal tumors. Major clinical symptoms are compression and body mass effect. The localization and tumors dimensions, are established by CT and RMI. Surgical resection, difficult by the relations with iliac vessels and nerves, was do it in sub capsular manners and followed by chemo and radiotherapy. Our results are good, with 6 patients who passed 4 years postoperatively.

[Pancreatoduodenectomy with pancreaticogastric anastomosis]. / Duodenopancreatectomia cefalica cu anastomoza pancreatico-gastrica.

There is not general agreement concerning the ideal way of preventing pancreatic leakage after duodenopancreatectomy. The aim of the present study is to present the experience of a three years period of performing a pancreatogastroanastomosis (PGA) after duodenopancreatectomy (DPC) in 12 consecutive patients. In 7 cases PGA was performed after closure of the gastric stump using a transverse incision of the posterior wall of the stomach. A total layer of nylon 9 points was doubled by an interrupted serocapsular suture. In one case only the seromuscular layers of the stomach were cut, adjusted to the size of the pancreatic section with a central hole for the duct of Wirsung. Four nylon 10 points were used to anastomose the latter to the gastric mucosa. PGA was performed in one layer interrupted suture between the pancreatic capsule and the seromuscular of the stomach. In 4 cases, after closure of the gastric stump an anterior gastrotomy was associated to the posterior incision of the gastric wall in order to perform PGA using an intragastric route. The postoperative follow-up showed a good evolution with only one anastomotic leakage that necessitated reintervention in the 10th day. PGA might be elective after DPC when appropriate dissection and mobilisation of the pancreas is possible.

[Suppurated acute obstructive cholangitis. Anatomoclinical and therapeutic aspects]. / Angiocolitele acute obstructive supurate. Aspecte anatomoclinice si terapeutice.

A total of 134 cases are discussed, with suppurated acute obstructive angiocholitis, that underwent surgical treatment over a period of 10 years, representing 12,8% of the total number of organic obstructions of the hepato-choledocus. From the standpoint of the etiopathogenic mechanisms the angiocholitis was determined by biliary lithiasis in 59 cases, by sclerosis of the Oddi sphincter in 5 cases, by postoperative cicatriceal stenosis of the main biliary pathway in 2 cases, by hepatic hydatitosis in 16 cases, by Vater ampuloma in 10 cases by cancers of the main biliary pathway in 40 cases and by the congenital cyst of the choledocus in one case. The high frequency was noted, of the severe forms of ictero-uremigenic angiocholitis (representing 68 cases, or 50,7% of the total, with a death rate of 34%). Medico-surgical treatment should be performed as early as possible, and it must be intensive, complex, and adapted to the anatomo-clinical forms. The authors performed evacuation choledocotomy with external draining in 22 cases (3 deaths), and choledoco-duodenal anastomosis in 46 cases (10 deaths), choledoco-jejunostomia in 3 cases, Oddi sphincterotomia in 12 cases (2 deaths) ampulectomia in 5 cases (2 deaths). Peripheral bilio-hepatodigestive anastomoses were performed in 40 cases with 5 deaths.