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Introduction: We present our department experience in pancreatic surgery over the last 6 years. From its inception the number of pancreatic resections has been continuously growing each year. Method: We performed a retrospective analysis of a prospectively maintained database where we included all the patients with pancreatic resections over the last 6 years. We present the main indication and the different types of pancreatic resections, postoperative morbidity, intrahospital and 90-day mortality and an analysis of survival for the patients with pancreatic ductal adenocarcinoma. Results: We analyzed 198 patients, 193 with pancreatic resections and 5 patients with open surgery microwave ablation. There were 145 pancreaticoduodenectomies, 37 distal pancreatectomies, one total pancreatectomy, 3 distal pancreatectomies with celiac axis resection and 7 surgical interventions for chronic pancreatitis. Conclusion: We presented our center's experience in pancreatic surgery with good overall results, however, there is still room for continuous improvement and refinements to achieve better shortterm outcomes, regarding postoperative morbidity and mortality.

Introduction. Focal liver lesions represent one of the main indications of ultrasound-guided liver biopsy. The purpose of the study was to evaluate the advantages and risks of liver biopsy, and to highlight the importance of a close follow-up in the prevention of postprocedural complications. Methods. We have retrospectively analyzed a number of 52 patients, who underwent liver biopsies in the Clinical Emergency Hospital of Bucharest, Romania, after being diagnosed with various types of focal liver lesions through ultrasound scanning. Results. Regarding the quality of the bioptic samples obtained: 98% of them were diagnostic, only 2% being nondiagnostic, mainly due to the tissue necrosis found within the tumor. The majority of the cases selected for the study had multiple liver lesions (70%), the rest of 30% had single lesions identified by ultrasound scanning. After histopathological analysis, in 89 % of the cases the lesion proved to be malignant (of which 70% were hepatic metastases and 30% were liver carcinomas), the rest of 11% were benign. This last category included hepatic adenomas and focal nodular hyperplasia, identified in young female population. Our study did not reveal any relation between the location of the lesion within the liver and the number of needle passes needed in order to obtain viable biopsy specimens (P = 0.16). Of all the cases that underwent liver biopsy, only 4% had complications, mainly minor bleeding and only 1% major bleeding and transitory hypotension. There was no case of death registered. Conclusions. Ultrasound guided percutaneous liver biopsy is a fast, economical and user-friendly procedure, frequently used in the diagnosis of focal liver lesions. The success rate of the biopsy in obtaining viable samples is high and it depends more on the structure of the lesion and the materials used, rather than on the anatomical localization of the lesion within the liver. Severe complications can be avoided if a close follow-up of the patients is performed.

Introduction. Ingestion of corrosive substances often causes serious damage to the upper gastrointestinal mucosa, occasionally perforation and, in rare cases, death. Most of these events are accidental, especially in children and the elderly, and voluntary (for suicidal purposes) in adults. If the patient survives the acute episode, the long-term complications are mainly esophageal and/or gastric stenosis and esophageal cancer after 1-2 decades of evolution. Endoscopic treatment of benign esophageal stenosis consists of dilation with Savary bougies and dilation balloon, esophageal stent assembly, with the purpose of restoring esophageal luminal patency. Superior digestive endoscopy plays an important role in the evaluation of benign esophageal stenosis in terms of the severity and the extent of stenosis. Case presentation. We present the case of a 47-yearold patient admitted to our clinic for dysphagia for solid and semi-solid foods. Endoscopy revealed an esophageal stricture due to the voluntary ingestion of caustic substance with suicidal purpose, 9 months before presentation. After multiple sessions of endoscopic dilatation with Savary bougies, an esophageal stent was placed, that solved patient’s dysphagia. Conclusions. Post-caustic esophageal stenosis is a common cause of dysphagia in patients with ingestion of corrosive substances. Patients can benefit from endoscopic esophageal stent placement treatment.

Background and aims Postoperative esophageal leaks are one of the major causes of postoperative mortality and morbidity. The purpose of this study was to review current knowledge of current methods of diagnosis and management of postoperative esophageal leaks. Methods: A systematic literature search was performed in the PubMed/Medline database using the terms "postoperative esophageal leaks" and "postesophagectomy complications" to identify articles relevant to the current diagnostic and prophylactic and curative treatment of post-oesophagectomy anastomotic fistulas. Results: Several papers have shown that the incidence of fistulas varies and is dependent on several factors: the location of the anastomosis, the type of suture used, the biological condition of the patient. Due to the severity of the mediastinal anastomotic fistula, great importance is being given to the methods of preventing its occurrence by intraoperative testing or improving the gastric tube vascularity. The most recent articles present endoscopic methods of treating this complication by using coated esophageal stents and endoluminal vacuum therapy. Conclusion In patients with mediastinal postoperative esophageal fistulas, diagnosis and management represent a real challenge for the surgeon-endoscopist-therapist team. The early diagnosis and the establishment of an optimal therapy to address the parietal defect and the biological status of the patient are mandatory conditions for resolving this postoperative complication.