Laparoscopy in routine and emergency surgery: experience with 1,720 cases.

Experience with laparoscopy in 1,720 cases performed for surgical diseases with elective or emergency indications is reported. It is hoped that laparoscopy, a simple and harmless technic of great diagnostic value, will be employed more frequently in routine and emergency surgery.

[Surgical treatment of peritonitis caused by diverticulitis of the sigmoid. Apropos of 12 cases]. / Sul trattamento chirurgico delle peritoniti da diverticolite del sigma. A proposito di 12 osservazioni.

Twelve cases of peritonitis due to sigmoid diverticulitis managed by minimal surgery are reported. Morbidity involved two cases of stenosing sigmoiditis on which sigmoid resection was successfully carried out. Although it is considered that radical surgery is the optimal solution, it is also recalled that the prime objective is to cure the peritonitis, so each case must be assessed carefully on its own merits since the condition is a complication of a benign disease and the risk of emergency sigmoid resections is by no means negligible.

[Acute postoperative necrotizing enteritis. Apropos of one case after total hysterectomy with bilateral annexectomy]. / Entérite aiguë nécrosante post-opératoire. A propos d'une observation après hystérectomie totale avec annexectomie bilatérale

The authors report a case of acute necrotising enteritis occurring on the 7th day after total hysterectomy with bilateral removal of the adnexa for fibroids in a 45 year-old woman. This is the first case in the literature to occur after hysterectomy. The clinical picture included the onset of intestinal obstruction with severe general toxic manifestations. The diagnosis was made at operation and, in spite of intestinal resection, the patient died on the 6th day, with liver and renal failure, anuria and irreversible collapse. The blood and stool cultures were negative, but the histological appearance of the lesions, without any apparent suppuration, were in favour of a vascular etiology. Necrosis of the mucosa and inflammatory oedema of the sub-mucosa, were accompanied by vascular changes suggesting thrombosis and congestion.

Laparoscopic cholangiography in the diagnosis of cholestasis: experience with 103 cases.

The results of 103 laparoscopic cholangiographies performed in patients with cholestasis are reported and the technique used is described. Minimal or no secondary effects were noted. A correct diagnosis was reached in 92 cases, 53 of which presented cholestasis of an extrahepatic nature and 39 of intrahepatic origin. In the latter group, the technique made exploratory laparotomy unnecessary. The procedure allows a roentgenologic examination of the biliary system, a direct evaluation of the liver and gallbladder and, if necessary, a liver biopsy.