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V Tasev

Publications and source records attributed to V Tasev.

At least 19 recordsLinked to original sources
PubMed2003

[A variant of hepatico-jejunostomy in Klatskin tumors].

The authors present their own variant of performing anastomoses between the common hepatic duct/right and left hepatic ducts and the jejunum in radical treatment of Klatskin tumors. The procedure is indicated in cases of proximal (hilar) resection of both hepatic ducts, in technical difficulties for performing the standard drainage protected end-to-side anastomosis between the right and left hepatic ducts on the one hand and the jejunum on the other as well as a method for double biliary derivation. The advantages of the procedure include decreased incidence rate of bile leakage in the subhepatic region, low risk of diffuse biliary peritonitis respectively and restricted possibility of intestinal reflux into the biliary tract.

Bile Duct Neoplasms↗
PubMed2003

[Anterior approach for major hepatic resection for large liver malignancy].

The large liver cancers in the right lobe are difficult to be resected with conventional approach. We report for 2 cases--43 old year man with cholangiocellular carcinoma and 50-old year woman with metastatic liver tumor from breast cancer, both with diameter of 30 cm, successfully resected using nonconventional "anterior approach". The postoperative period was uneventful. They were discharged from hospital in 10 and 14 days.

Adult↗
PubMed2003

[Postoperative liver failure after hepatic resections for hepatocellular carcinoma].

Postoperative liver failure is a life-threatening complication after hepatic resection. The purpose of this study was to review the liver failure as a result of hepatic resection and to propose strategy for decreasing the risk of its developing. From January 1991 to December 2000 73 patients with primary liver cancer (PLC) were operated and identified in a retrospective database. Seven (13.2%) of resected 53 patients developed postoperative liver failure. There were 4 male and 3 female with mean age 52.3+/-29.2 (from 1 to 78). 3 patients had underlying cirrhosis. Major resections were 5 and minor--2. Mean hemotransfusion was 1012, 13 ml (370-2000 ml). Five patients (71%) died by the 30th day. The causes of liver failure were analyzed, based on both the preoperative data and the intraoperative findings. Significant prognostic factors were the preoperative serum level of bilirubin (p=0.024) and intraoperative hemotransfusion (0.031). The right hemihepatectomy was a prevalent hepatic resection in these patients.

Adolescent↗
PubMed2002

[Hepatic echinococcosis: radical or conservative surgical treatment].

UNLABELLED: Hydatid liver disease remains an actual medical and social problem for Bulgaria as an endemic region. Because of the lackage of medicines with satisfactory therapeutic effect the surgical treatment is still the treatment of primary importance. AIM: The aim of this study was too check the correctness of the following hypothesis: "Radical surgical procedures on hydatid liver disease have lower rates of morbidity and mortality compared to conservative ones". MATERIAL AND METHODS: In order to achieve the above mentioned aim we analysed the results of 361 patients with hydatid liver disease (267 (74%) of whom retrospectively and 94 (26%) prospectively), treated at the Clinic of General, Liver and Pancreatic Surgery during the period 1st, Jan., 1985-1st, Jan., 2001. The patients were divided in two main groups: 102 (28.25%) of them received radical surgical procedures and 250 (69.25%)--conservative ones. Nine of the patients (2.50%) had multiple echinococcal cysts and received surgical procedures of both types. That's why the results of those patients did not correspond to the aim of the study and they were not included in it. The analysis consisted of a comparison between the two main groups according to several criteria: sex, age, location and average size of the cysts, postoperative complications, reoperations, mean postoperative stay at hospital and mortality rate. RESULTS: There was a prevalence of the female in the ratio male/female in the group of patients who received a radical procedure. The location of echinococcal cysts in the left hepatic lobe was found to be more frequent. In the group of radical surgical operations the postoperative morbidity and mortality rates were lower and the postoperative stay at hospital was shorter, compared to the group of conservative procedures. CONCLUSION: Radical surgical procedures showed better postoperative results. But those procedures had to be performed only on patients who had certain indications and according to criteria described in surgical literature. The proper surgical equipment and well experienced surgical team were the other important conditions for good outcome.

Adolescent↗
PubMed2002

[Central segments resections in primary liver neoplasms--three clinical cases].

BACKGROUND/AIMS: The resections of the central paramedial hepatic sectors are most rarely reported due to their technical complexity. We present three cases in which we carried out this rare operative intervention for occasion of primary hepatic neoplasm in the central hepatic segments. MATERIAL AND METHODS: In three cases (two of primary hepatic cancer and one of sarcoma) we carried out resection of the central segments in the following steps: mobilization of the liver, subhepatic approach to the inferior v. cava, preparation for vascular isolation of the liver by Pringle's maneuver, dissection of the biliary, arterial and venous vessels in the hepatic hilus, intraoperative assessment of the involvement of these structures in the neoplastic process and subsequent hepatic resection. RESULTS: For a period of 5 to 24 months of follow up we have not established a relapse of the disease in the cases ascribed. CONCLUSION: The outcome of the hepatic resections strongly depends from the various factors including accurate preoperative diagnosis, the assessment of the resection volume according to the involvement of the hepatic vessels in the neoplastic process. Hepatic resection can be performed with the same degree of confidence and similar low morbidity as any other major surgical procedure.

Aged↗
PubMed2002

[Anterior rectal resection--early postoperative results].

BACKGROUND: The development of the mechanic staplers gave the opportunity to perform sphincter-saving operations in patients with middle and low rectal carcinoma. It has been gained experience in performing this operation as the anastomosis was sewed in both ways--manually and mechanically. PURPOSE: The purpose of this retrospective research is to analyse the early postoperative results after anterior rectal resection with manually and mechanically made anastomosis. MATERIAL AND METHODS: For the period 01.01.1995-01.012000 in the DEPARTMENT OF GENERAL, LIVER AND PANCREATIC SURGERY, 69 patients with rectal carcinoma underwent the operation anterior rectal resection. In 60 cases (89.96%) the anastomosis was made manually and in 9 cases (13.04)--with mechanical staplers. Both patient groups are studied and classified by sex, age, tumor localisation, type of anastomosis, early postoperative results. RESULTS: From the group with manually sewn anastomosis 6/10%/ of the patients had complications in the early postoperative period, one of them terminated (1.7%). From the second group 3 (33.3%) of the patients had complications in the early postoperative period. The average postoperative hospitalisation was 13.5 vs. 19.2 days. CONCLUSION: The results achieved in anterior rectal resection depend on a complex of factors among which more important is the early diagnosis of the disease and the skills of the surgeon in coloproctology.

Aged↗
PubMed2002

[Modified method of Sugiura-Futagawa for surgical treatment in patients with portal hypertension and esophageal varices].

BACKGROUND: The esophageal transection and devascularization (Sugiura-Futagawa's operation) is the most frequently used ablative procedure in Japan for the treatment of patients with portal hypertension (PH) and esophageal varices (EV). Recently many authors, who are followers of this method, try to find an alternative one, aiming to shorten the skin-to-skin time and achieve better early and late results. AIM: To study the postoperative results of our modification of the original Sugiura-Futagawa's method and to conclude whether it is good and reliable or not. MATERIAL AND METHODS: From Jan. 1988 till Apr. 2001 we operated 25 patients with liver cirrhosis, PH and previous hemorrhage from EV, of whom 12 were male (48%) and 13--female (52%). Age of the patients--26-67 years. The ethiology of cirrhosis was alcoholic in 8 cases (32%) and post viral hepatitis--in 17 cases (68%). All our patients belonged to Child-Pugh's group A. The operative technique of our modification is described--transabdominal esophageal devascularisation, deconnection and reanastomosis. RESULTS: The early postoperative mortality rate after our modification of the Sugiura-Futagawa's method was 12% (in 3 cases). Death cause--fulminant hepatic failure with hepato-renal syndrome (in all three cases). The mortality rate was also 12% but no one of the complications was life threatening or an indication for reoperation. The 5-year survival rate accounted 78%, recurrent esophageal bleeding--7.14% and late hepatal encephalopathy--also 7.14% of the followed patients. DISCUSSION: The surgical treatment is of main importance for better survival in cases of PH and previously bled EV. A comparison between the results of other authors and our results is made. CONCLUSION: The proposed by us transabdominal esophageal devascularisation, deconnection and reanastomosis as a modification of the Sugiura-Futagawa's procedure is easy fro the technical point of view and leads to good results.

Adult↗
PubMed2002

[Mesenteric-inferior-renal shunt--alternative of proximal and distal spleen-renal shunt for surgical treatment of portal hypertension].

Surgical operations are important for the prevention of recurrent bleeding and better survival rates in patients with portal hypertension and previous haemorrhage from esophageal varices, stopped by conservative treatment. Spleno-renal shunts are among the most frequently used procedures in these cases. Sometimes the proximal spleno-renal shutting operation of Linton or the distal one of Warren may be impossible from the technical point of view due to anomalies or varieties of the lienal vein. This makes it necessary to look for an alternative decision. This case report is about a 33-year old man indicated for surgical treatment because of portal hypertension, caused by prehepatic portal vein obstruction and esophageal varices with previous bleeding. Performing Linton's or Warren's procedure was not the proper decision. That's why we made a shunt between the inferior mesenteric vein and the left renal vein. The surgical technique and the postoperative results are described and discussed.

Adult↗
PubMed2000

[Echinococcosis of the spleen-notes on some diagnostic and therapeutic problems].

Twenty patients with hydatid disease of the spleen--14 presenting isolated location within the spleen, five--combined with liver cyst, and one--polyorganic involvement--are operated in the Department of general and operative surgery--Sofia over the period January 1985 through December 1998. The currently used methods of echinococcosis diagnosing are described, and the indications for splenectomy and organ salvaging echinococcotomy in the aforementioned localization are discussed.

Adolescent↗
PubMed2000

[Laser use in various fields of surgery].

A total of 236 patients presenting various pathological conditions are operated in the Department of General and Operative Surgery of the Medical University--Sofia over the period 1993 through 1998, using laser radiation--CO2-laser in 216 cases, ans Nd-YAG laser--in 20 cases. Both focused and unfocussed laser beam is applied. The superiorities of laser surgery in definite diseases and the results thus far obtained are analyzed.

Adolescent↗
PubMed2000

[Carcinoma of the stomach - our experience with surgical treatment].

Carcinoma of the stomach is among the commonest malignancies of the gastrointestinal tract regardless of the permanent tendency of its diffusion to decrease, observed in the last 25-30 years. The readily accessible methods of diagnosing the disease contribute greatly to its early detection. However, owing to diverse causes, in over 70 per cent of cases the diagnosis is usually made as late as in the advanced III-IV stages. The latter circumstance preordains largely the unfavourable long-term results of the treatment undertaken where surgery plays a major role. It is the purpose of this study to analyze the surgical strategy and tactics currently used in the management of gastric carcinoma. Over a 5-year period (Jan 1995 through Dec 1999), in the Chair of General and Operative Surgery of the Medical University--Sofia a total of 184 gastric carcinoma patients, including 116 men (63.1%) and 68 women (36.9%) with age ranging from 23 to 80 years, undergo operation. Diagnosing is based on past history, physical, laboratory and x-ray data, but first and foremost on evidence from FGS and histological assessment of biopsy material (carried out in all patients). With a view to precise preoperative staging of the lesion, roentgenoscopy + roentgenography of lungs, USD and CAT of the abdominal organs are also done. The following intervention are performed: gastrectomy 18 (9.8%), upper pole resection 43 (23.4%), subtotal resection of stomach 4 (2.2%), prosthetic replacement of cardia 8 (4.3%), derivations 22 (11.9%), and explorative laparotomies. Combined subtotal gastric resections of gastrectomies are necessitated in 73 patients (39.7%) because of carcinomatous infiltration of contiguous organs and/or presence of liver metastases. Morbidity involves 29 patients (15.7%) with lethality amounting to 16 (8.7%). The long-term postoperative results are discussed under a separate heading. Operative treatment of gastric carcinoma patients is the only chance of survival. The scope of indication for more aggressive surgical interventions, including combined resections and gastrectomies, are broadened leading in turn to a considerable reduction of the proportion of explorative laparotomies.

Adult↗
PubMed2000

[Carcinoma of extrahepatic bile ducts - operative management of lesions located in the distal segments].

Experience with operative management of patients presenting carcinomas located in the distal third of the extrahepatic bile ducts, accumulated in the Department of General and Operative Surgery of the Medical University--Sofia, is analyzed. The condition is characterized by manifestation of clinical signs typical of a well advanced pathological process, found in a considerable number of patients with obstructive jaundice syndrome, and necessitating surgery on an emergency basis because of the danger of hepatorenal failure development with a fatal outcome. Over a 10-year period (1989-1998), a total of 219 patients with histological evidence of carcinoma in various segments of the extrahepatic bile ducts are operated on. The series includes 107 men (48.9%) and 112 women (51.1%) at mean age 59.2 years. In 64 cases (29.2%) the process involves the distal third only (terminal choledochus and papilla Vateri). In this group 41 radical and 23 palliative operations are performed. The indications for radical resection, the basic principles of radical and palliative interventions, and the results of their practical implementation are comprehensively discussed. The basic parameters--resectability, survivorship, early postoperative lethality (EPL) and morbidity--are comparable to the ones presented in recently published reports on biliopancreatic oncosurgery.

Adult↗
PubMed2000

[Surgical management of liver hydatid disease after complications or other pathology].

In the period 1985 through 1999, in the Department of General and Operative Surgery of the University Hospital "Alexandrovska" a total of 299 patients are operated for hydatid disease, with 71 of them (23.74%) subjected to combined operative interventions. Operations on the biliary system and other organs and systems, necessitated by intercurrent complications of the basic disease or other pathology, are described and thoroughly discussed. A constellation of criteria for assessment of the conditions and indications for their implementation are also presented. The early postoperative results are estimated as satisfactory.

Animals↗
PubMed2000

[Caustic sclerosing cholangitis following injection of anthelmintics into rat bile duct. An experimental study].

It is the purpose of the study to assay the effect of intrabiliary injection of scolicide agents most frequently used in clinical practice. Fifty-five albino rats are divided up into 4 groups according to type of solution injected, as follows: control group A--with physiological saline, B--20 per cent natrium chloratum, C--10 per cent povidone iodine, and D--3 per cent hydrogenium hyperoxidatum. Histological assessment of extrahepatic bile ducts and liver parenchyma are conducted at 10 and 90 days of treatment. Lesions along with cholestatic and reparative changes are documented, most markedly expressed after injecting 20 per cent NaCl, rather weakly--after 10 per cent povidone iodine, and least pronpunced after injecting 3 per cent hydrogen peroxide. Periductal sclerosis is noted in three rats only injected with hypertonic saline. The experimental results are analyzed, and clinically relevant inferences reached.

Animals↗
PubMed1998

[The Nd YAG laser in the treatment of hepatic echinococcosis].

Nd YAG Laser photocoagulation for the purpose of residual cavity treatment following echinococcectomy was introduced in 1996, and practically implemented in the Department of General and Operative Surgery. Eleven patients with uncomplicated echinococcus of the hepar, 4 with purulent echinococcosis and 4 with rupture of the biliary tree, aged 26 to 80 years, are subjected to operation. The advantages and possibilities of dispersed laser application in hydatid disease treatment are discussed. The short-term results are estimated as satisfactory.

Adult↗
PubMed1998

[Sclerosing cholangitis after the surgical treatment of hepatic echinococcosis].

The constellation of four basic factors is taken to be the underlying cause of caustic sclerosing cholangitis development, namely: 1) scolicide agent injection into the cyst cavity, 2) cystobiliary communication, 3) p. Vateri stenosis and other causes leading to prolonged scolicide agent exposure on the biliary tree, and 4) individual sensitivity. The clinical course of the disease, its diagnosis and treatment are outlined. The prognosis of the condition is estimated as exclusively serious.

Cholangitis, Sclerosing↗