[A case of choledochal adenoma].
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Biomedical subjects
Publications and source records attributed to V Mladenov.
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Laparoscopy was introduced in the beginning of the 20 century. It is developed as a diagnostic procedure, often combined with biopsy. In the 80 ies the laparoscopy came in surgery, first in appendectomy, later in cholecystectomy, where it achieved exclusive appliance and became an alternative method of conventional surgery. In the beginning of 90-ies the laparoscopic surgery treats more and more of diseases of abdominal surgery.
A case of a 36-year-old man with pancreatic somatostatinoma is reported. Such cases are very rare. The following signs were found; quick ESR, increased alpha 2- and beta-globulins, shortened Weltmann's coagulation band, increased serum bilirubin level, especially of the conjugated fraction, enzyme constellation of cholestasis and moderate liver cytolysis. Ultrasound examination of the abdomen, retrograde cholangiopancreatography and percutaneous liver cholangiography were performed in order to prove the diagnosis. They demonstrated an obstruction in Vater's papilla region and a bulky process in the head of the pancreas. The patient was operated. The microscopic, electron microscopic and immunohistochemical examinations proved a somatostatinoma of the pancreas. The positive immunohistochemical tests for somatostatin and carcinoembryonal antigen in the tumor cels are especially indicative.
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