[Role of Helicobacter pylori in the etiology of duodenal ulcer recurrence after selective proximal vagotomy]. / Rol' Helicobacter pylori v vozniknovenii retsidivov iazvennoi bolezni dvenadtsatiperstnoi kishki posle selektivnoi proksimal'noi vagotomii.

126 patients with duodenal peptic ulcer were examined before and in different periods after operation for selective proximal vagotomy (SPV). Endoscopy was performed and Helicobacter pylori (HP) was detected by the urease, bacteriological, and histological methods. The urease test proved to be the most informative, simple, and available method for revealing infection of the gastric mucosa by HP. The frequency of HP detection by this method made up 97-98%. The frequency of ulcer recurrences after SPV coincided with the degree of contamination of the mucosa with HP and increased to 15% in high contamination. Treatment with agent eliminating HP in the early period after SPV promoted cicatrization of the ulcer.

[Mucous membrane of the gastric antrum in late periods after selective proximal vagotomy with surgical drainage of the stomach and duodenum]. / Slizistaia obolochka antral'nogo otdela zheludka v otdalennye sroki posle selektivnoi proksimal'noi vagotomii s dreniruiushchimi zheludok i dvenadtsatiperstnuiu kishku operatsiiami.

A clinicomorphological analysis was performed of the gastric antrum mucous membrane of 60 patients after selective proximal vagotomy because of stenosing duodenal ulcer. The patients were subdivided into two randomized groups depending on the type of the draining operation. The first group had a gastroduodenoanastomosis for the gastric drainage and the second group underwent duodenum plasty (drainage of the duodenum). Discontinuation of the pylorus function in the gastric drainage operation resulted in higher incidence and intensity of duodenum-gastric reflux and made more severe antrum gastritis; reflux-gastritis developed frequently. Morphological signs of reflux-gastritis in 95% of cases coincided with the results of the radionuclide method. Duodeno-gastric reflux decreased as a rule Helicobacter pylori (HP) contamination of the mucous membrane but did not eliminate it completely in all cases. The combination of these two factors resulted in more severe gastritis than that provoked by each of them separately. The etiology of gastritis and its intensity may be determined only by morphological examination of gastric mucous membrane. The results of endoscopic and histologic methods coincided in 70% of cases. Duodenal-gastric reflux, HP and high acid production play a certain role in ulcer recurrence.

[Selective proximal vagotomy and duodenoplasty in surgical treatment of stenotic duodenal ulcer]. / Selektivnaia proksimal'naia vagotomiia i duodenoplastika v khirurgii stenoziruiushchei duodenal'noi iazvy.

Experience in the treatment of 70 patients with stenotic duodenal ulcer by surgery is generalized. In addition to SPV the patients underwent duodenoplasty as a draining operation. There were 61 (87.1%) males and 9 (12.9%) females. Their ages ranged from 18 to 70 years. The stenosis was compensated in 21 (30%), ++non-compensated in 32 (45.7%), and decompensated in 17 (24.3%) patients. To determine the possibility of performing SPV, the maintenance of the gastric contractile activity was studied by noninvasive methods: computed peripheral electrogastrography and computed gastro-scintigraphy. Involvement of the pylorus into the cicatricial-ulcerous inflammatory infiltration is the main contraindication for duodenoplasty. In view of that, intensive 2-3 week preoperative antiulcer therapy acquires particular significance; it removes or reduces significantly the inflammatory infiltration in most cases and raises the possibility of conducting duodenoplasty. Only intraoperative inspection of the pyloroduodenal segment allows the possibility and type of pylorus -preserving duodenum draining operation to be determined. This operation can be undertaken if the proximal boundary of the stenotic cicatricial-ulcerous deformity is at a distance of at least 1 cm from the pyloric sphincter, whatever the degree and length of the narrowing. A total of 43 operations form the Heineke-Mikulicz Mikulicz duodenoplasty, 17 for Finney's pyloroplasty, and 10 for bulbo-duodenostomy were carried out. The authors consider excision of the duodenal ulcer to be expedient and safe only when it is located on the anterior wall; it was carried out in 9 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

[Ultrasonic endoscopic examination in pancreatic diseases]. / Ul'trazvukovoe éndoskopicheskoe issledovanie pri zabolevaniiakh podzheludochnoi zhelezy.

Under analysis were 76 patients with diseases of the pancreas. The data of the ultrasonic endoscopic method were compared with operative findings in 49 patients and with the final clinical diagnosis in 27 non-operated patients. The correctness of the method in the group of operated patients was 80%, in non-operated patients 96.3%.

[Fiber duodenoscopy and endoscopic retrograde pancreaticocholangiography in assessing the results of pancreatic resection and pancreatojejunostomy in chronic pancreatitis]. / Fibroduodenoskopiia i éndoskopicheskaia retrogradnaia pankreatikokholangiografiia v otsenke rezul'tatov rezektsii podzheludochnoi zhelezy i pankreatoeiunostomii pri khronicheskom pankreatite.

The endoscopic methods including retrograde pancreaticocholangiography were used for examining 78 patients, 14 of them were subjected to resection of the pancreas and 14 to pancreatojejunostomy. Gastroduodenitis was diagnosed in all the patients after resection of the pancreas, in 3 patients repeated surgical interventions (pancreatojejunostomy) were necessary. The examination of patients with pancreatojejunal anastomos has shown that scarring is more frequently found in terminolateral anastomoses while longitudinal pancreatojejunostomy is followed by good patency of the anastomosis.

[Endoscopic papillosphincterotomy in the treatment of choledocholithiasis]. / Endoskopicheskaia papillosfinkterotomiia pri lechenii kholedokholitiaza.

The article analyzes an experience with endoscopic papillosphincterotomy in 45 patients with recurrent or residual choledocholithiasis with/without stenosis of the major duodenal papilla. In 38 pathients stones were removed after endoscopic papillosphincterotomy or were eliminated spontaneously. In later terms none of the patients showed restenosis of the major duodenal papilla. Thus, endoscopic papillosphincterotomy is considered to be an effective method of treatment of choledocholithiasis.

[Endoscopic papillosphincterotomy in treating the complications of gallstones]. / Endoskopicheskaia papillosfinkterotomiia v lechenii oslozhnenii zhelchnokamennoi bolezni.

The authors believe that endoscopic papillosphincterotomy is a relatively safe but sufficiently effective method for dissecting the papilla. It should be used mainly in patients with the postcholecystomic syndrome in order to abolish stenosis of the papilla duodeni major and to liquidate choledocholithiasis. It may be also used in the patients with calculous cholecystitis complicated by choledocholithiasis, stenosis of the papilla and jaundice, if there is an increased degree of surgical risk.