ABSTRACT
The results of 212 transcutaneous therapeutical abdominal interventions, performed under the ultrasound control, have been analysed. 190 patients have been treated. The sectorial ultrasound probe was acting at the frequency of 3 MHz. The electronic matrix guided the needle. One-stage percutaneous drainage with an "umbrella" stylet catheter was used in all cases. Percutaneous drainage of the gallbladder was performed in 140 patients; 111 of them had acute cholecystitis with a high surgical risk. The operation of cholecystectomy has been performed in 32 patients after control of the acute stage of the disease. In 47 patients percutaneous drainage was indicated in case of liver cysts and abscesses, intraliver hematomas, liver pseudocysts, liver pseudoabscesses, abdominal abscesses. These types of curative procedures have limited contraindications, can be performed irrespective of the patient's condition, and in certain cases may be an alternative to major surgical interventions.
Subject(s)
Abdomen/diagnostic imaging , Aged , Catheterization/instrumentation , Catheterization/methods , Cholecystostomy/methods , Digestive System Diseases/diagnostic imaging , Digestive System Diseases/surgery , Drainage/methods , Humans , Postoperative Period , Punctures/instrumentation , Punctures/methods , Remission Induction , Ultrasonography/instrumentation , Ultrasonography/methodsABSTRACT
Treatment efficacy was compared for transcutaneous transhepatic microcholecystostomy controlled by laparoscopy (75 patients) against that controlled by ultrasound scanning (67 patients) principally in acute cholecystitis. Basic indications for microcholecystostomy are a high operative risk in elderly patients and decompression of the bile ducts for obstructive jaundice. Four patients (2.8%) developed postmicrocholecystostomy complications treated by urgent surgery. The manipulation is short-term, simple and is well tolerated even in grave condition. This makes microcholecystostomy an alternative to cholecystostomy.
Subject(s)
Cholecystitis/surgery , Cholecystostomy/methods , Cholelithiasis/surgery , Microsurgery/methods , Postoperative Complications/prevention & control , Acute Disease , Aged , Cholecystitis/complications , Cholecystostomy/adverse effects , Cholelithiasis/complications , Humans , Microsurgery/adverse effects , Middle Aged , Postoperative Complications/etiologySubject(s)
Abdomen/surgery , Ultrasonography , Abscess/surgery , Bile Ducts/surgery , Biopsy , Drainage , Gallbladder/surgery , HumansSubject(s)
Cholecystitis/complications , Hemoperitoneum/etiology , Acute Disease , Aged , Female , Humans , Rupture, SpontaneousSubject(s)
Appendicitis/complications , Appendix , Intestinal Fistula/etiology , Intestine, Small , Acute Disease , Cecal Diseases/etiology , Female , Humans , Middle AgedSubject(s)
Cholelithiasis/complications , Duodenal Obstruction/diagnosis , Acute Disease , Adult , Aged , Aged, 80 and over , Biliary Fistula/complications , Biliary Fistula/surgery , Cholelithiasis/surgery , Duodenal Diseases/complications , Duodenal Diseases/surgery , Duodenal Obstruction/etiology , Duodenal Obstruction/surgery , Female , Humans , Intestinal Fistula/complications , Intestinal Fistula/surgery , Male , Middle AgedSubject(s)
Biliary Fistula/complications , Aged , Biliary Fistula/etiology , Biliary Fistula/surgery , Cholangitis/etiology , Cholangitis/surgery , Cholelithiasis/complications , Cholelithiasis/surgery , Female , Humans , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Intestine, Small , Male , Middle Aged , RecurrenceABSTRACT
Experience with the treatment of 137 patients with spontaneous internal biliary fistulas of different etiology is presented. Questions of clinical course, preoperative diagnoses and operative technique are discussed.
Subject(s)
Biliary Fistula/surgery , Common Bile Duct Diseases/surgery , Duodenal Diseases/surgery , Gallbladder Diseases/surgery , Gastric Fistula/surgery , Intestinal Fistula/surgery , Adult , Biliary Fistula/complications , Common Bile Duct Diseases/complications , Female , Gallbladder Diseases/complications , Gastric Fistula/etiology , Humans , Intestinal Fistula/etiology , Male , Middle AgedABSTRACT
Analysis of the treatment of 25 patients with cholelithic intestinal obstruction is given. Questions of etiology, variants of the development, clinical course, diagnosis, operative treatment of the cholelithic ileus, causes of lethal outcomes are discussed. The authors propose measures of prophylactics .
Subject(s)
Biliary Fistula/complications , Cholelithiasis/complications , Intestinal Obstruction/etiology , Aged , Cholelithiasis/diagnosis , Cholelithiasis/surgery , Colonic Diseases/complications , Common Bile Duct Diseases/complications , Duodenal Diseases/complications , Female , Gastric Fistula/complications , Humans , Intestinal Fistula/complications , Intestinal Obstruction/surgery , Male , Middle AgedABSTRACT
The authors have analyzed the causes and results of 469 repeated operations on bile ducts performed on 350 patients for strictures of the inflammatory and accident origins, retained bile duct stones and recurrent cholelithiasis. Recommendations are given for preventing repeated operations on bile ducts and choosing the method of reparative and reconstructive operations.
