[FORMATION OF BILIODIGESTIVE ANASTOMOSES BY THE METHOD OF HIGH-FREQUENCY ELECTRIC WELDING].

The aim of the study was to develop a new method of formation of biliodigestive anastomoses, which would make it possible to form anastomoses both on unchanged bile ducts and in conditions of their inflammation. An experimental study was carried out on 50 rabbits of the "Chinshila" breed, which formed biliodigestive and interintestinal anastomoses by the method of high-frequency (HF) electric welding using the "Patonmed EKVZ-300" coagulator. Anastomoses were formed both on non-inflamed tissues and under conditions of biliary peritonitis. In different terms after the operation macro- and microscopic examination of the formed anastomoses was carried out, their patency, tightness and strength were determined. With HF-electric welding the connection of biological tissues is achieved due to thermal adhesion, the mucous and serous layers in the area of the anastomosis are almost completely destroyed under the influence of electricity and the connection occurs due to the submucosal layer. The suture is well-established, hermetically sealed, the anastomoses have sufficient strength (40-100 mm Hg). The coagulation scar is narrow, thermal damage to the membranes is local (within 2700-3000 microns), the epithelialization of the suture was completed after 3 months and the maturation of the scar after 6 months. The method of HF-electric welding equally allows the formation of reliable biliodigestive and interintestinal anastomoses, both in conditions of unchanged and inflamed tissues. The everting weld connection prevents the occurrence of anastomotic strictures in the future.

[PRINCIPLES OF THE HEPATICO-JEJUNOANASTOMOSIS FORMATION, USING METHOD OF THE SOFT-TISSUES HF-ELECTRIC WELDING IN CLINICAL PRACTICE].

Hepatico-jejunoanastomosis (HJA) was formed in accordance to the high-frequency electric welding method: in 14 patients ­ for the main bile outflow disorders, in 8 of them ­ as a consequence of the periampullar zone malignances, in 6 ­ stricture of a common hepatic duct, HJA earlier formatted, purulent cholangitis, iatrogenic damage of biliary ducts. In all the patients the welded averting one-layered termino-lateral or latero-lateral HJA were formatted. The welded anastomoses have appeared hermetic, sufficiently hard, immediately after the formation and further.

[[Estimation of bilio-oigestive and interintestinal anastomoses, formed in accordance to method of a high-frequency electric welding of tissues, in experiment].]

In the experiment on 50 rabbits cholecysto-entero and entero-entero anastomoses were formed on intestinal Roux loop. In 35 animals (the main group) a single layer evert- ing anastomoses by using high frequence (HF) electric welding method were formed, in 15 (the comparison group) single row suture anastomoses has been done. The anas- tomosis sufficiency were performed by using hydropressure, pneumopressure meth- ods and breakload test. It was established that all anastomoses formed by HF-electric welding method were passable and hermetic, also had strong sufficiency. Strength of weld joint in the postoperative period increased in a linear progression and after 3 weeks almost reached strength intact intestine (240-250 mm Hg).