The use of monofilament polypropylene mesh for strangulated inguinal hernia repair is safe, and the risk of the local infectious complications is low.

Monofilament polypropylene mesh can be successfully used not only in elective operations, but also in emergency operations for incarcerated inguinal hernias.

Aim: The aim was to determine the outcome from percutaneous sclerosing treatment of solitary non-parasitic hepatic cysts. Methods: The results of treatment of patients with symptomatic solitary non-parasitic hepatic cysts treated between 1995 and 2000 were reviewed. Results: There were 23 women and one man with a median (range) age of 59 (34–79) years. The median (range) diameter of the cysts was 10 (5–24) cm. Five patients were treated by laparoscopic fenestration ab initio as they also required a cholecystectomy because of gallstones. The remaining 19 patients underwent percutaneous sclerotherapy. In one just aspiration was successful without further treatment. In six contrast leaked from the cyst and five of these had laparoscopic fenestration. Twelve patients had sclerosant treatment with good results at a median (range) follow-up of 35 (6–60) months in 10 patients. Good results were also obtained in 10 of the 12 patients who had fenestration.

We used monofilament polypropylene prostheses in 20 emergency operations for strangulated hernias. Sixteen of the operated patients had groin hernias (five of them recurrent), two had incisional and one had a Spigel's type hernia. Intestinal resection was performed because of bowel wall necrosis in one of the patients. During the postoperative period, we observed only one minor complication (a seroma formation). During the follow-up, no recurrence was observed. In our opinion, the use of monofilament polypropylene mesh in emergency hernia operations is safe, simple and effective.

IntroductionAdvanced malignant tumours involving the head of the pancreas, gallbladder or extrahepatic bile ducts usually lead to the development of cholestasis. In such cases improvement of the quality of life of patients can be achieved with the decompression of jaundice. Endoscopic implantation of self-expanding or (seldom) rigid plastic stents into the biliary tree constitutes the most common technique allowing for restoration of bile duct patency. In some patients however the use of such a procedure is technically impossible. In this particular group percutaneous drainage of the biliary tree can constitute the only method of management.AimPresentation of our experience with the use of percutaneous ultrasound-guided drainage of the biliary tree in patients with mechanical jaundice resulting from malignant tumours.Material and methodsThere were 852 patients with mechanical jaundice resulting from malignant neoplasms treated in the 2nd Chair of Surgery of Jagiellonian University Medical College from January 1994 to December 2010. In 199 of them jaundice was decompressed by means of open – radical or palliative – surgical operations. In 539 patients endoscopic treatment was implemented while in 114 of them percutaneous ultrasound-guided drainage was performed.ResultsIn 5 patients percutaneous drainage was introduced to prepare them for radical surgical treatment, while in the remaining 109 it constituted the definitive way of management. The average hospitalization time for women was 6.5 days (range: 1-22 days) and proved to be twice as short as in men – 12.2 days (range: 1-38 days). The duration of percutaneous drainage prior to surgical treatment averaged 7.2 days (range: 6-10 days). Mean volume of the bile drained during the first day was 370 ml (range: 10-1300 ml), increased to 450 ml (range: 100-1150 ml) during the second day and reached 780 ml (range: 80-1600 ml) during the third day. Mean bilirubin level before the drainage was 320-23 µmol/l (range: 658-130.7 µmol/l) and decreased by half before discharge or before the operation, reaching on average 181.87 µmol/l (range: 14.5-343 µmol/l).ConclusionsComplications of the percutaneous ultrasound-guided technique were found sporadically and resulted from leakage of the bile into the peritoneum.