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The treatment results in 312 patients with cholelithiasis, covering the period 1989 to 1993, are retrospectively analyzed. Overall postoperative lethality amounts to 4.4 per cent. The obtained results are fully comparable in terms of both missed concrements left behind within the extrahepatic bile ducts, and in terms of postoperative complications, associated with the indications for choledochotomy. This is attributed to the therapeutic approach algorithm adopted with respect to the indications for intraoperative cholangiography and choledochotomy.

Experience had with application of spleen salvaging operations in adult patients is shared. They are used traumatic lesions of the spleen in eleven patients, employing the method of Delany, as modified with the Bulgarian polyamide meshwork Ampoxen. In two of them the hemostasis fails, and splenectomy is resorted to. Preservation of the spleen is accomplished in one patient with chronic pancreatitis where left pancreatectomy with spleen preservation according to the technique of Pradere et al is done. In another female patient, presenting echinococcus of the spleen, echinococcectomy with preservation of the organ is performed. Based on updated knowledge of the role played by the spleen in promoting protection against infection, the strive for its salvage whenever possible is fully justified.

A method is described for producing continent colostomal by smooth-muscle sphincteroplasty. There are variants of operative technique: autogenic smooth-muscle intestinal grafting and pediculated plasty. A 10 cm long intestinal segment is split along the free tenia, mucosectomized and wrapped around the precolostomal part of the colon. Essential element of the operation is the 100 per cent stretching of the seromuscular flap when fixed. A tight sphincter-like cuff results. The method is unassociated with specific complications. The first impressions of the sphincteroplasty with encouraging results are recorded. In cases when no sphincter effect was obtained there was inadequacy in some elements of the operation. Then the stoma functions as a conventional one.

A total of 208 patients with diseases of the extremities, 56 of whom with diabetes mellitus, were included in the study. Septicemia developed in 6 patients, in 4 of them being caused by anaerobic pathogens. The following surgical interventions were performed: 193 incisions, 32 amputations of varying extent and 15 large-scale necrotomies. The case fatality rate was 1.44 per cent. To achieve superior therapeutic results and a better life for patients with diabetes mellitus, it is necessary to change the former approach to their long-term medical surveillance.