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Six gastrojejunocolic fistulae were recorded at our service between 1995-2005. All the fistulae occurred in men who had gastric resection performed for duodenal ulcer.Diarrhea, weight loss, postprandial pain and fecal breath were the clinical findings present in descending frequency. Preoperative diagnosis was possible in 5 patients by endoscopy and barium contrast studies. In five patients the option was a one-stage procedure with revision gastrectomy and segmental resection of the transverse colon. In one case simple dismantling of the fistula was performed.Although in two patients anastomotic leakage developed no mortality was recorded.

During 1993-2008 period, in the Surgical Clinic III were conducted several retrospective studies, in order to identify risk factors for complications after cephalic duodenopancreatectomy(DP). As a result of these studies, a preoperative protocol was developed for preparation of patients proposed for DPC, as well as a number of intraoperative technical changes in order to improve postoperative morbidity and mortality. Implementation of the protocol was gradually and inomogenic done in our service.The study is prospective, conducted in 2009-2012, ina group of 180 patients and aims to evaluate immediate results after DPC for periampular malignancy, looking to analyze the effects of implementation of the protocol mentioned above.We analyzed the rates of complications (pancreatic fistula,blunt pancreatitis, bleeding from the pancreatic blunt, delayed gastric emptiness), and the factors that might influence their occurrence.of the 180 patients, 10 (5.5%) developed pancreatic fistula and 24 (13.3%) had delayed gastric emptiness. Among the factors that have been significant associated with these complications we mention: the pancreatico-jejunalanastomosis and gastro-jejunal transmesocolic assembly. With the implementation of the protocol, the risk factors previously identified in retrospective studies performed in our service(elevated transaminases, experienced surgical team, etc.) have lost significance, but they have not disappeared entirely, due to fact that the conduit proposed was not entirely followed. We believe that the homogeneous application of a perioperative guide, together with a standardized surgical technique, will lead to improve immediate results after DP.

Two sets of nanocomposite films consisting about 4,5 at.% and 51 at.% concentrations of Au dispersed in a TiO2 dielectric matrix were deposited by DC reactive magnetron sputtering, and subjected to several thermal annealing experiments in vacuum, for temperatures ranging from 300 to 800 0C. The thermal annealing affected the size of Au nanoparticles, and also the phase of the dielectric matrix. The obtained results show that the structure and the size of Au clusters, together with the matrix crystallinity, changed as a result of the annealing, and were shown to be able to change the optical properties of the films. The optical changes, and the correspondent Surface Plasmon Resonance effect were confirmed by reflectivity and CIELab colour measurements. X-ray diffraction (XRD) was used to determine the thin-film structure and crystallinity as a function of annealing temperature. The XRD data also shows clear evidence of the crystallization of the matrix in the anatase phase. With further increase of the annealing temperature, there is a change from anatase phase into rutile-type structure. Simultaneously, the Au atoms are organized in crystalline nanoparticles (revealing an fcc-type structure, with the (111) preferential growth orientation)., This work was supported by FEDER through the COMPETE Program and by the Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Project PEST-C/FIS/UI607/2011

We analyzed the clinical results of different techniques of resection for malignant colorectal (primary or staged) obstruction.The subjects of this retrospective nonrandomized clinical study were 165 patients with malignant colorectal occlusion who underwent surgery treatment in our Department between 2002-2006. Patients with peritonitis or treated by means of permanent colostomy, palliative anastomosis, primary Hartman resection and rectal excision were excluded.Patients with large bowel obstruction caused by obstructive malignant colorectal lesions underwent either one-stage primary resection with anastomosis (77 patients) or staged interventions (88 patients). There were no differences in age, sex, comorbidities, tumor staging, serum preoperative levels of hemoglobin and proteins between the two groups of patients defined by the different surgical techniques. Regarding mortality and morbidity following surgical treatment for large bowel obstruction no significant difference among the two groups (p0.05) or the fistula rate (p = 0.435) was obtained. Moreover, results showed a higher incidence of mortality (11.8% vs 7.8%), morbidity (13.6 vs 10.4) and increased hospitalization period (p = 0.03) among the patients that undergone series resections.One stage primary resections with anastomosis of the large bowel can be performed safely in case of emergency whenever patient comorbidities and local conditions do not stand as major restrictions.

Case selection criteria for resection of liver metastasis after colorectal cancer are still incompletely elucidated and represent a subject of great interest recently. Our aim was to evaluate 2-year survival after resection and to identify the survival risk and prediction factors in those cases.63 patients diagnosed and undergoing liver resection for colorectal metastatic disease to the liver at the Surgical University Hospital No.3 (Cluj-Napoca, Romania) between 01.01.2002 and 31.12.2005 were included in the study. Exclusion criteria were: palliative treatment as well as surgical treatment performed in a different surgical centre. After the surgical treatment, patients were followed regularly using clinical assessment on a 3 monthly basis with abdominopelvic ultrasound or computerised tomography annually. The following variables were recorded: age, gender, coexisting medical diseases, blood tests results, tumour site, maximal tumour diameter after resection, duration of surgery, surgical procedure and the clinical outcome until last follow-up, including date of death where appropriate.2-year post-operative survival was 65.1%. In univariate analysis: age (65 vs= 65 years, p = 0.041), metastasis number (3 vs= 3 tumors, p = 0.049), maximal tumor dimension (3 vs= 3 cm, p = 0.047), glutamine-oxaloacetic transaminase (GOT) preoperative level (42 vs= 42 mg/dl, p = 0.018) were significant factors correlated to median survival time. However, non of the above mentioned factors presented independent prediction power in multivariate analysis (Cox regression, p0.05).Our results support liver metastasis resection without prior case selection except for technically-operative criteria selection.

Miniinvasive treatment can be used in many early complications following laparoscopic cholecystectomy. In this article are analyzed the indications and the efficiency of these techniques.We analyzed here a group of 9542 laparoscopic cholecystectomy operated in 9 years. The main postoperative complications were: bile leak (54 cases), haemorrhage (15 cases), subhepatic abscess (10 cases) and early diagnosed remnant lithiasis of CBD (11 cases). Miniinvasive techniques that were used were laparoscopic reinterventions (15 cases) and EST (22 cases).Classic reinterventions were practiced in 28.88% of cases with complications. Miniinvasive techniques were used in 42.2% of cases with complications: laparoscopic reinterventions (15 cases) for choleperitoneum, haemoperitoneum and subhepatic abscess and EST (22 cases) for prolonged bile leak on subhepatic drain and for early diagnosed remnant lithiasis of CBD. All cases were healed.Along with a precise diagnosis and a good indication, the miniinvasive treatment of complications proved to have good results, converting the bad operative outcome into a postoperative success.