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Effects of pneumoperitoneum on liver function during laparoscopic procedures in most patients have no clinical relevance. However, with increasing number and types of surgical procedures the laparoscopic operation is now performed in high-risk patients, including patients with pre-existing liver disease. In these patients laparoscopic procedures may lead to serious complication, including acute liver failure. Because postoperative liver damage induced by pneumoperitoneum has been underestimated, the aim of this article is to review the numerous factors influencing liver damage during laparoscopy and review of therapeutic options for their reduction.

The first laparoscopic appendectomy was performed by Senn in 1982. Since then, the dilemmas about the validity of this operation in relation to open operation have persisted. Many authors presented the technique modifications and results that are very different. The retrospective results, cost, duration of hospital stay and postoperative recovery analyses for fifty patients in each group were done in this study. Laparoscopic operations were done by "two-handed" technique and in different ways of appendix and mesoappendix closing and cutting. Endoscopic linear cutters were used in the second part of the study. When comparing parameters, laparoscopic operation in relation to open operation is equally safe; quicker; with less postoperative pain; with less wound infections rate; with shorter hospital stay; with less staff time involved; with faster recovery and return to work; more expensive; with better cosmetic effect. In conclusion, laparoscopic appendectomy is better, although more expensive, than open operation, so it should be recommended.

In this study doppler ultrasound methods were evaluated from the point diagnostical values, and were compared with the standard X-ray methods (angiography). One of the basic question was, whether noninvasive doppler ultrasonic methods could replace the invasive contrast angiography i. e. in what relations and volume. The investigations were done by CW Doppler and angiodynography, and the results obtained, were compared with the ones of angiography that was taken as the referent method. The 264 segments of blood vessels of lower extremities arterial three were analyzed, and then ranged into the advance defined categories, on the basis of the degree of obstruction. The evaluation of the data obtained was statistically accomplished by the means of "decision matrix" test, and results were displayed by positive predictive values. Positive predictive value for the CW Doppler was 94.07 (in groups varied from 93.10-100) and for angiodynography was 97.35 (in groups varied from 93.15 to 100). From the data obtained, it could be concluded that Doppler's methods are very accurate in a way of diagnostical interpretation (96.03%). The advantages of the Doppler's methods against the conventional standard radiological researches reflect in the following facts: they enable dynamic indicators in real time, they are noninvasive, very exact, and the possibility of verification of stenosis is enabling us to apply the adequate diagnosic (angiography) and therapeutic methods in time.