[Acute suppurative cholangitis as a result of biliary tract obstruction].
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Biomedical subjects
Publications and source records attributed to B Danicić.
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In the last ten years 375 patients were operated on biliary tract examined with intraoperative choledochoscopy. Sensitivity of choledochoscopy in our investigation was 72% and negative predictive value was 85% while specificity and positive predictive value for flexible choledochoscopy was 100%. There were no false positive results. After the instrumental exploration of the common bile duct, unsuspected stones were found in 9.19% of patients recorded with choledochoscopy and 3.44% of retained stones confirmed by postoperative cholangiography. Choledochoscopy was successful in determination of the level of obstruction by tumors in all patients (100%), but of limited value in determination of tumor extension through the bile duct wall in 66.66% of patients. Interventional procedures through the work channel of the instrument showed little success. Extraction of impacted stones was recorded in one patient (3.70%) while the biopsies were completely unsuccessful. We recommend choledochoscopy for each patient with open common bile duct, especially with proved multiple common bile duct stones.
The paper deals with a patient who was admitted through the surgical emergency service under the suspicion of subphrenic abscess. From the moment of admittance the patient was carefully followed. Laboratory tests were repeated several times. The following examinations were performed within a very short period of time: a posteroanterior X-ray of the chest and both subphrenic spaces, an ultrasonogram of the upper abdomen, a CT scan of the upper abdomen, roenthgenography of the gastroduodenum with gastrografin, an esophagogastroduodenoscopy and irrigography. Apart from the interposition of the colon between the liver and the diaphragm, no other pathological changes were found. Clinical follow-ups of the lungs and the abdomen were normal. The patient was discharged in a good general condition.
In the Institute for Surgery, its Experimental Centre, has already several years an experimental transplantations of pancreas been carried out with the aim of learning surgery technique and performing a clinical transplantation of that organ. In our work we have used a technique of corporacaudal allotransplatation of pancreas with vascular anastomosis. As the blood vessels of the graft we have used the arteria and vena lienalis with parts of aorta and portal vein, which have been anastomosed with a. and v. iliaca communis of the pancretotomized recipient. We have used techniques of the open pancreatic duct, ligated pancreatic duct, our own technique of permanent bleeding of the pancreatic graft during the transplantation pancreaticojejunostomy and pancreatico-vesicular anastomosis. As the parameters of function of allograft we are using: glycaemia, i.v. GT test, K constant, insulinaemia, amylasaemia, length of survival of animals and pathohistological finding. The average term of survival of experimental animals was 28 days. During the function of alograft the experimental animals shown some signs of laboratory subclinical diabetes. Refusal of transplant was followed by sudden increase of glycaemia, without any clinical or laboratory sign of anticipation of the refusal.
From 1983 to 1988 on the Department for Experimental Surgery 20 preservations of the liver has been done, with ice cold Euro- Collins and Ringer solutions, either with in situ or with on banch technique after fast expantation. On five dogs standard 55% left hepatectomy has been done and the right side preserved in situ. Partial heterotopic liver transplantation to the right iliac fossa was performed on five dogs. Total vascular exclusion of the liver and extracorporal inierior vena cava and jugular vein by pass with assisted circulation was performed on one dog, without assistance on four dogs. Total orthotopic liver transplantation was performed on two dogs. The surgical team practiced the technique of liver transplantation in experiment and liver resection with in situ technique and on banch technique.
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Primary echinococcus of abdominal localization at Clinic of Abdominal and Endocrine Surgery in Novi Sad in twenty years period is rare disease, without decreasing tendency. Mostly, there is general and local manifestations on which, one can suspect on disease, and almost in all cases prove it by US and CT. These diagnostical procedures contributed to earlier and better surgical treatment. The most common localization of the cyst is liver. Choice of operative procedure is termed by pathomorphological particularity of the cyst, type of complication and recidive prevention. Intraoperative exploration of biliary tract has an important place in prevention of biliary fistulas. Authors underlined controversy about uncomplicated cyst treatment and emphasized that they are often today grateful to noninvasive diagnostics methods.
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