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Editorial Jurnalul de Chirurgie, Iaşi, 2011, Vol. 7, Nr. 3 [ISSN 1584 – 9341] 121. Thomson A. Cause anatomique de la hernie inguinale externe. J Conn Med Prat Paris, 1836- 1837, 4 : 137-164 ; 169-176. 122. Totté E, Van Hee R, Kox G, Hendrickx L, van Zwieten KJ. Surgical anatomy of the inguinal region: Implications during Laparoscopic Herniorraphy. Eur Surg Res 2005; 37: 185-190. 123. Toy FK, Smoot RT Jr. Toy-Smoot laparoscopic hernioplasty. Surg. Laparosc. Endosc. 1991; 1: 151-155. 124. Ulhoorn H. Laurens Heisters Heelkundige Onderwyzingen Amsterdam: Janssoons van Waesberge, 1741. 125. Van der Schelling GP, Hendrickx L, Goverde P, Van Hee R. Transperitoneal vs extraperitoneal approach in laparoscopic inguinal hernia repair: a prospective comparative clinical study. Br J Surg 1996; 83 (Suppl. 2): 99-100. 126. Van Hee R. Endoscopic techniques in surgery: ethical aspects. In: De Deyn PP. ed. The ethics of animal and human experimentation. London: John Libbey & Co.Ltd., 1994; p. 287-294. 127. Van Hee R. Laparoscopic repair of inguinal hernia. Symposium held during the Congress of the Royal Belgian Society for Surgery 11 th May 1996. Acta Chir.Belg.1998; 98: 123. 128. Van Hee R., Goverde P, Hendrickx L, Van der Schelling G, Totté E. Laparoscopic transperitoneal versus extraperitoneal inguinal hernia repair: a prospective clinical trial. Acta Chir Belg 1998; 98: 132-135. 129. Van Hee R. Inguinal Hernia Repair. Actual Status. Jurnalul de Chirurgie, Iasi, 2007; 3(2): 180-184. 130. Van Hee R. Inguinal hernia repair in the 16 th century. Acta Chir Belg 2011 (in press). 131. Wagh PV, Leverich AP, Sun CN, White HJ, Read RC. Direct inguinal herniation in men: a disease of collagen. J Surg Res 1974; 17: 425-433. 132. Wall MI, Cherian Th, Lotz JC. Laparoscopic Hernia Repair – The Best Option? Acta Chir Belg 2008; 108: 186-191. 133. Welsh DRJ, Alexander MAJ. The Shouldice Repair. Surg Clin N Amer 1993; 73: 451-469. 134. Wolfe-Coote S. The laboratory primate. London: Elsevier Academic Press, 2005. 135. Wölfler A. Zur Radikaloperation des Freien Leistenbruches. Wien Med. Bl. 1892;15: 677-693. 136. Zimmerman L, Veith I. Great ideas in the History of Surgery. London: Baillière, Tindall & Cox Ltd., 1961. 319
Articole de sinteză Jurnalul de Chirurgie, Iaşi, 2011, Vol. 7, Nr. 3 [ISSN 1584 – 9341] TRATAMENTUL LAPAROSCOPIC AL PSEUDOCHISTURILOR DE PANCREAS D.C. Hîrţan¹, E. Târcoveanu² 1. doctorand Universitatea de Medicină şi Farmacie „Gr.T. Popa” Iaşi Spitalul Municipal Roman, Secţia Chirurgie 2. Clinica I Chirurgie, „I. Tănăsescu – Vl. Buţureanu” Universitatea de Medicină şi Farmacie „Gr.T. Popa” Iaşi LAPAROSCOPIC TREATMENT OF PANCREATIC PSEUDOCYSTS (ABSTRACT): Laparoscopic approach of pancreatic pseudocyst was introduced 15 years ago (1994). Laparoscopic treatment have the same indication as in classic surgery. The evolution of diagnostic techniques allows to chose the best treatment. The laparoscopic advantages from endoscopic approach are: creation of a large anastomosis, exploring inside pseudocyst cavity, necrosis evacuation that can lead to cavity infection and providing an important specimen of cyst wall for pathology. The new techniques development such as NOTES and single port allows to be used successfully in pancreatic pseudocyst drainage. Although laparoscopy and endoscopy seems to be competitive, these procedures are complementary: many of current procedures require both techniques, therefore mini-invasive treatment of pancreatic pseudocyst is somewhere between gastroenterology and surgery. KEY WORDS: PANCREATIC PSEUDOCYST, LAPAROSCOPIC DRAINAGE, NOTES Corespondenţă: Dr. Dragoş Hîrţan,Secţia Chirurgie,Spitalul Municipal Roman; Str.Tineretului 28, 611027, Roman, jud.Neamţ; e-mail: dragos_hirtan@yahoo.com * INTRODUCERE Introducerea abordului miniinvaziv nonoperator în tratamentul pseudochisturilor de pancreas (drenaj percutan, endoscopic) au adus speranţa rezolvării nonchirurgicale a acestora. Totuşi, crearea unei comunicări minime pseudochistodigestive şi imposibilitatea explorării interiorului cavităţii pentru evacuarea necrozelor au dus în multe cazuri la recidivă sau apariţia altor complicaţii(suprainfecţie, hemoragie) ce au determinat scăderea entuziasmului iniţial pentru metodă şi selecţia atentă a cazurilor. În întâmpinarea acestor dificultăţi a venit abordul laparoscopic ca variantă miniinvazivă a procedeelor consacrate, abord ce îşi propune să reunească avantajele metodelor precedente. Tehnicile de drenaj laparoscopic ale pseudochisturilor pancreatice respectă principiile chirurgiei clasice: drenajul decliv, biopsia peretelui, explorarea şi debridarea pereţilor şi hemostaza minuţioasă. Ele reprezintă, în mare măsură, realizarea procedeelor clasice cu mijloace miniinvazive. Cu toate acestea există unele procedee proprii laparoscopiei în care abordul miniinvaziv aduce un avantaj cert. Abordul laparoscopic necesită atât o planificare minuţioasă a intervenţiei pe baza explorărilor preoperatorii cât şi îndemânări deosebite în chirurgia laparoscopică. * received date: 07.04.2011 accepted date: 24.06.2011 320
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