[Technics for laparoscopic cholecystectomy--their use and results]. / Tekhniki za laparoskopska kholetsistektomiia--prilozhenie i rezultati.

In mini-invasive surgery mainly two operative techniques for laparoscopic cholecystectomy are familiar and implemented in practice--"American" and "French" technique. Over the period May 1993 to September 1997, in the two surgical clinics of H. M. I.--Pleven a total of 311 laparoscopic cholecystectomies are performed. Of them 218 are done according to the "American" technique, 87--according to the "French" technique, and six patients are operated using the so-called "lifting" technique. In the appear submitted the advantages and shortcomings of the two techniques for laparoscopic cholecystectomy are comparatively studied. The timing of operative intervention CO2 quantity expenditure and intraoperative complications are analyzed. The choice of technique for laparoscopic cholecystectomy depends on the surgeon's personal judgement, but under given situations one of the two techniques or a combination thereof should be mandatorily used.

[The indications for selective intraoperative cholangiography during laparoscopic cholecystectomy]. / Indikatsii za selektivna intraoperativna kholangiografiia pri laparskopska kholetsistektomiia.

The analysis covers 136 cases of laparoscopic cholecystectomy. Intraoperative cholangiography is performed in seven patients. Choledocholithiasis, missed during the operation, is diagnosed in one case only two months later. Preoperative ERCP is done in three patients, and postoperatively--in two. The follow-up study of the rest of patients, not subjected to intraoperative or endoscopic cholangiography, shows that up to one year after the operation there is not a single case of missed choledocholithiasis. The indications for intraoperative cholangiography are established on the ground of criteria worked out in the clinic. The obtained data confirm the hypothesis for selective application of the examination without augmenting the risk of missing pathological changes in the biliary ducts.