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Intraoperative ultrasound examination of the liver, biliary tree, pancreas, and kidney is described. Twenty-three patients were included in the study. In the authors' view the three important indications for operating room sonography of the abdomen are (a) locating biliary, pancreatic, or renal calculi, (b) defining the echostructure and precise location of tumors, and (c) evaluating the spread of tumor. It is concluded that intraoperative ultrasound shortens the length of an operation and increases the safety of the surgical procedure since it is more precise than palpation by the surgeon.

Cefoxitin is a bactericidal beta lactam antibiotic of the cephamycins group, with wide antimicrobial efficacy and active against both aerobes and anaerobes. In this study, 58 patients were divided in four groups according to the site of the disease (stomach, gallbladder and biliary tract, jejunum ileum and colon-rectum). The efficacy of cefoxitin in the prophylaxis of surgical infections was assessed for each group and for all patients. When compared with the combination of antibiotics used previously, cefoxitin led to a reduction of the mean duration of fever (7.2 and 5 days respectively with ampicillin/cloxacillin and lincomycin/gentamycin, 3.2 days with cefoxitin). Cefoxitin also led to a reduction in the incidence of surgical infections (50% with ampicillin/cloxacillin, 9.19% with lincomycin/gentamycin, 8.6% with cefoxitin) and in the incidence of localized surgical infections (29.6%, 20.3%, 8.6% respectively). In this study, cefoxitin has been found to be very useful and well tolerated in the prophylaxis of surgical infections.

Two groups of ten patients each, staying in a Intensive Care Unit, received exclusive parenteral alimentation with different concentrations of branched chain amino acids (BCAA). Group A received studied solution containing 12 g N (852 mmol) with 41,1 p. 100 BCAA. Group B received control solution containing 18 g N (1278 mmol) with 21,1 p. 100 BCAA. Every patient received 60 nonprotein Kcal x kg-1 body weight/24 hr. The study was performed on five days. Measured parameters were: daily (D0 to D5) N balance, blood urea N and total protein and urinary alpha amine N, and after therapy (D6) amino acid levels. Results have shown no statistical significant difference between both groups. N balance became less negative during the therapy. Amino acid levels were in the normal range and alpha amine urinary elimination remained low in patients with parenteral nutrition. These results indicate that 12 g (852 mmol) N in BCAA rich solution are as efficient as 18 g (1278 mmol) N in standard solution, allowing a N sparing.

The gastric secretion was systematically examined in 58 patients during the first days after operations on organs of the abdominal cavity, 23 of them having it considerably increased. In three of these patients the operation was followed by gastric bleeding from acute ulcers. Higher gastric secretion was most frequently observed in patients with mechanical jaundice, purulent peritonitis and intestinal obstruction. Changes in the gastric secretion depend on the composition and volume of infusion therapy.

During planned and urgent operations on the liver, spleen, pancreas in 156 patients laser devices "Scalpel-1" and "Romashka" based on CO2-lasers with the wave length of 10,6 mkm were used. The laser radiation was used for the dissection and coagulation of tissues. The selection of radiation parameters was determined by the aim of operation and organ structure. Good results were obtained.

The authors have found that subdiaphragmatic abscesses developed in 67 (0.62%) out of 10,757 patients operated on organs of the abdominal cavity. A detailed analysis of incidence, causes and localization of subdiaphragmatic abscesses after different operations is given. Questions of clinical and roentgenological diagnostics and results of the treatment of these complications are discussed.

Jejunostomy was put in 21 patients operated on the gastrointestinal tract, and on the 3-4 day after operation it was used for entero-probe nutrition (amino acid mixtures, fat emulsions, glucose solutions meant for parenteral nutrition, 3 1 a day at a speed 30-50 drops per minute). Clinical observations have shown high therapeutic effect, safely and technical simplicity of this entero-probe nutrition.

From the clinical and experimental studies, the following results were obtained. The serum lysozyme activity decreased postoperatively and returned to the preoperative level 2 weeks later. Postoperative changes of the activity reflected the state of surgical stress inflicted on the subjects, namely, the changes were parallel to the degree of the stress and their postoperative courses. The postoperative elevation of lysozyme activity in anastomosed colonic tissues or abdominal walls, in which the activity was not determined preoperatively was supposed to be a reasonable phenomenon and closely related to tissue regeneration or protection from bacterial infection. The mechanism of this local elevation should be due to migration from the peripheral blood and movement of the lysozyme-producing or -secreting cells to the wounds. The phagocytic activity of peritoneal macrophage hyperfunctioned postoperatively. This might suggest lysozyme synthesis or secretion by peritoneal macrophage and participate in the protective action of the subjects. The postoperative serum lysozyme activity was maintained at the normal level by preoperative peroral administration of egg-white lysozyme preparation, therefore, the administration was thought to be very effective to the acceleration of protective action of the subjects on whom the surgical stress was imposed.