[The late results of the treatment of stress incontinence in women after double-needle suspension plastic repair]. / Kusni rezultati ot lechenieto na stres-inkontinentsiiata pri zheni sled dvoinoiglena suspenzionna plastika.

Percutaneous suspension plasty, using Eickenberg's double-needle applicator, is a further development of the semi-open endoscopic method suggested by Stamey for precluding urinary incontinence in women. The operative technique is outlined, and the follow-up results in 53 patients are analyzes. This is a contribution to the broadening scope of endourologic and percutaneous operative technique.

[Our experience with the diagnosis and treatment of biliary pancreatitis]. / Nashiiat opit vurkhu diagnozata i lechenieto na biliopankreatita.

The diagnostic and therapeutic problems faced during treatment of thirty-nine patients presenting biliopancreatitis (BP) are discussed. BP diagnosis is made on the ground of clinical picture, laboratory indicators, abdominal ultrasonography, intraoperative cholangio-pancreatography and cholangioscopy. Patients with cholelithiasis (ChL) of long-standing in the previous history are predominant, with the age group exceeding 50 years of age being most numerous, and the female gender prevailing. All patients undergo conservative pre- and postoperative treatment. Operative treatment in BP is performed as an emergency intervention. Cholecystectomy is done in all cases, and in 56.3 per cent of them it proves sufficient to promote a favourable outcome of the pathologic condition. External or internal drainage of the choledochus is necessitated in the presence of definite indications (obstruction of extrahepatic biliary ducts and pancreas documented by operative cholangiography, choledochoscopy and probing). Dilatation of the papillary sphincter is carried out in five patients (12.8 per cent) because of partial papillary stenosis. The destructive forms of pancreatitis are treated by gland draining in conjunction with necrectomy and drainage of the extrahepatic biliary ducts. A correlation is established between the incidence of destructive forms of pancreatitis and therapeutic results, on the one hand, and timing of the operative intervention, on the other. Operative management of BP is a method of choice insofar as it contributes to the complex and thorough treatment of the condition. Preoperative BP diagnosis is still a problem not well enough clarified which leads to delayed operation with an adverse impact on the prognosis of the disease.

[A retrospective survey study of diagnosis and surgical treatment in peptic ulcer]. / Obzorno retrospektivno prouchvane vurkhu diagnozata i khirurgichnoto lechenie na iazvenata bolest.

A total of 239 patients of which 183 operated over the period 1987 through 1992 are reviewed. Cases with duodenal location of the lesion predominate (84 per cent), next ranking gastric ulcers (14 per cent), and type II according to Johnson (2 per cent). Among the patients operated on resection methods, type Billroth II, with antecolic gastroenteroanastomosis and Braun's anastomosis, accounting for 84.1 per cent of the total of planned operations, are mainly used. Retrocolic gastroenteroanastomosis type Hoffmeister-Finsterer is performed in five, and Billroth I-in one patient. Three patients presenting gastric ulcer, free of malignization signs, are subjected to pylorus-preserving resection according to MacKee. Resection methods as a definitive therapeutic approach to ulcers, at that according to Billroth II, are predominant owing to the fact that most patients operated on present ulcers penetrating the pancreas, involving ligamentum hepatoduodenale and the descending portion of the duodenum, and pyloric stenosis, making impossible the restoration of passage by Billroth I or other operations. A lasting good result is attained in 92 per cent of cases, minor complaints are recorded in 6 per cent, and substantial complaints-in 2 per cent. The study results lead to the inference that standard resections with anterior gastroenteroanastomosis in complicated ulcers, ruling out other alternatives, yield a permanent therapeutic effect. The approach to individual patients should be by no means unified, and the most expedient operative procedure should be used. Owing to delayed operative treatment and numerous complications, the classical resection methods prove to be the method of choice in the surgical management of ulcers.