[Results of treatment of diffuse peritonitis in data from the surgery department of St. Barbara Hospital in Roznava]. / Výsledky liecby difúznej peritonitis v materiáli chirurgického oddelenia NsP sv. Barbory v Roznave.

Authors evaluated their own group of 318 patients (5.4% of all patients treated by operation between 1990-1994) 91 patients (28%) had a severe peritonitis. Authors emphasised the need for complete therapy, and an early and appropriate operation. In the conclusion of their study authors emphasised the necessity of evaluation of relevance illness before making a decision in managing peritonitis. (Tab. 2, Fig. 1, Ref. 9.)

[Massive hemorrhage from duodenal adenocarcinoma]. / Masívne krvácanie z adenokarcinómu duodéna.

The authors report the case of a 48 year old patient with duodenal adenocarcinoma. The patient was hospitalized at the internal clinic and due to massive bleeding into GIT was removed into the surgical clinic in a state of shock. The operation revealed a Tu formation on the border between D3 and D4, and a palliative resection was performed. The histologic examination verified the diagnosis of the duodenal carcinoma, WHO gr.II. During the postoperative period the patient received 4 chemotherapeutic treatments, although literature generally refers to chemotherapy as having no effect on the time of survival in patients with duodenal adenocarcinoma. The authors conclude that in patients with a long termed history of atypical abdominal symptoms including bleeding into GIT which are inexplicable owing to fibroscopy and x-ray, it is necessary to take into consideration the possible presence of neoplasms in the small intestine, and hence in the duodenum. In cases with massive bleeding they recommend palliative resection and subsequent chemotherapy. (Fig. 6, Ref. 11.).

[What are the costs of septic complications in surgery?]. / Co stojí septická komplikácia v chirurgii?

Infectious complications have remained the most frequent cause of morbidity in surgical patients, and that despite the constantly broadening range of up-to-date antimicrobial drugs administered prophylactically and therapeutically, the improved methods of cultivating microorganisms and of establishing sensitivity to antibiotics. Infections in surgical patients lead to prolonged hospitalization, prolonged working disability, and to increased cost of treatment. Considerable economic consequences of infections in surgical patients are demonstrated on the basis of the authors' clinical material and possibilities of preventing infections and of their treatment are also discussed. (Fig. 1, Tab. 2, Ref. 21.)

[Liver abscess after elective cholecystectomy]. / Absces pecene po elektívnej cholecystectomii.

The authors submit the case-history of a 39-year-old patient with elective cholecystectomy where the immediate postoperative course was complicated by a liver abscess. The authors discuss aetiological factors, diagnosis and treatment of liver abscesses. In the conclusion they submit a proposal of ATB prophylaxis in severe inflammations of the gallbladder and biliary pathways. In the department of the authors ATB prophylaxis is not used before elective cholecystectomy.

[Is surgical treatment indicated in choledocholithiasis?]. / Je chirurgická liecba choledocholitiázy indikovaná?

Surgical exploration of the biliary pathways on account of relapsing or forgotten concrements in the biliary pathways in patients above 70 years with associated diseases has a high morbidity and mortality. The authors present an account of a group of patients from their departments; these patients with choledocholithiasis were treated by the at present ever more frequently used method--endoscopic sphincteropapillotomy. In the discussion the authors deal with possibilities to use EPS in the treatment of choledocholithiasis with a cholecyst in situ, acute pancreatitis with biliary genesis but also acute cholangoitis with the background of choledocholithiasis. They consider EPS the therapeutic method of choice in choledocholithiasis and report very good immediate as well as long-term results.

[Changes and risks in gastroduodenal surgery]. / Zmeny a riziká v chirurgii gastroduodena.

By retrospective analysis of clinical material changes and risks of gastroduodenal surgery were evaluated. The number of elective operations declined and the number of urgent surgical operations on account of peptic ulceration in conjunction with the development of medicamentous antiulcerous treatment increased. The number of patients with gastric cancer is rising. The range of surgical operations is preserved, none of the operations is ideal treatment. The risk of reoperation involves long-term morbidity and a high mortality.

[The significance of nonsurgical bile duct drainage in patients with icterus]. / Význam neoperacnej drenáze zlcových ciest u ikterických pacientov.

Operation of the biliary pathways in patients with obstructive jaundice is still associated with a significant morbidity and high mortality, in particular in geriatric patients. Recently in the therapy of icteric patients percutaneous or endoscopic drainage of the biliary pathways was introduced. At the Surgical Clinic of the Hospital with Policlinic, Bezrucova in Bratislava in 1988 52 patients with obstructive jaundice were hospitalized. In patients with more than three risk factors the authors introduced preoperative drainage of the biliary pathways. In patients with malignant disease they describe preoperative percutaneous transhepatic drainage with subsequent enterobiliary anastomosis with an in-dwelling drain. Of 52 patients 9 died, i.e. 17.3%. Non-surgical drainage of the biliary pathways in icteric patients reduces the number of risk factors, eliminates the adverse effects of jaundice and improves the prognosis of the icteric patient.

[The Shouldice operation for inguinal hernia]. / Shouldiceova operácia inguinálnej hernie.

Operations of hernias are among the most frequent operations in general and in the SSR they account for 11% of all operations. Despite this incidence of relapse is high and amounts to some 5-30%. In the Surgical Clinic of the Hospital with Polyclinic Bezrucova, the authors operated since April 1, 1988 134 inguinal hernias. They used Shouldice's technique. In the paper the surgical procedure is described. In a perspective study the authors did not record so far any relapses. The incidence of postoperative complications is 8.25%. Despite short-term experience the authors recommend this operation which meets all preprequisites of modern and reliable operations of inguinal hernia - high ligature of the sac, reinforcement of the floor of the inguinal canal, plastic operation of the annulus inguinalis internus and transposition of the funiculus spermaticus.