[The structure of microflora in ulcerative-necrotic lesions in patients with diabetic foot syndrome].

The results of dynamic microbiological investigation, conducted in 37 patients, suffering diabetic foot syndrome (DFS) during 2008-2009 yrs period, were presented. There were 103 investigations made and 169 species of microorganisms revealed. The microflora structure of surgical infection in patients with DFS was presented by S. aureus (42.85%), P. aeruginosa (32.09%), E. coli (7.66%), S. pyogenes (7.16%), Enterobacteriaceae aerogenes (6.3%), E fecales (1.97%), E. cloacae (1.97%). S. aureus have shown resistance towards ceftriaxone (66.7%), lincomycine (75%), cyprofloxacine (58.3%); P. aeruginosa--towards cephoperazone (100%), amicacine (66.6%), vancomycine (89.9%), cyprofloxacine (87.8%), imipenem (87.8%). Enterobacteriaceae are resistant towards cefuroxym (60%) and amicacine (80%).

[Effect of spore-free anaerobic microorganisms of pancreatic tissue in experimental acute pancreatitis]. / Vozdeistvie nesporoobrazuiushchikh anaérobnykh mikroorganizmov na tkan' podzheludochnoi zhelezy pri éksperimental'nom ostrom pankreatite.

The simulation model of an acute pancreatitis (AP), using translocation of microorganisms from intestine to ductal system and pancreatic tissue, was created in experiment on dogs. Interrelationships between pancreatic tissue and anaerobic microorganism in an AP were studied, using electron microscopy. Possibility of the microorganisms migration to pancreas from ductal system in early stage of AP due to enhanced reproduction of anaerobic microorganisms in duodenum was established. It is impossible to exclude the possibility of their invasion via the lymph and the blood flow into destructively changed pancreatic tissue in late terms of the disease.

[Strategies of surgical treatment of chronic pancreatitis complicated by obstructive jaundice and cholangitis]. / Taktika khirurgicheskogo lecheniia khronicheskogo pankreatita, oslozhnennogo obturatsionnoi zheltukhoi i kholangitom.

The results of treatment of 295 patients with complicated chronic pancreatitis (CP) for period from 1996 to 2000 yr were presented. CP without the ducts dilatation was revealed in 37 patients, ductal hypertension--in 19, calcinose fibrous-degenerative CP--in 73, cystic form of CP--in 142, CP in combination with external pancreatic fistula--in 24. Frequency of the complications occurrence in various forms of CP--the obstructive jaundice and cholangitis--was analyzed. Complex approach to the choice of tactic of the operation performance was proposed, application of additional methods of sorptional and immune therapy, depending on the CP form, complicated by the obstructive jaundice and cholangitis, was substantiated.

[Dynamic ultrasonic investigation in differential and topical diagnosis of various forms of acute pancreatitis]. / Dinamicheskoe ul'trazvukovoe issledovanie v differentsial'noi i topicheskoi diagnostike razlichnykh form ostrogo pankreatita.

Estimation of possibilities of dynamic ultrasonic investigation and transcutaneous echocontrolled interventions in diagnosis of various forms of an acute pancreatitis and its complications while examination of 283 patients was conducted. High efficacy of echography and of transcutaneous interventions in early diagnosis of the disease was proved.

[Possibilities of transcutaneous intervention under ultrasonographic control in comprehensive treatment of severe necrotizing pancreatitis]. / Vozmozhnosti chreskozhnogo vmeshatel'stva pod kontrolem ul'trazvukovogo issledovaniia v komplekse lecheniia tiazhelogo nekroticheskogo pankreatita.

In 46 patients with an destructive acute pancreatitis (AP) the invasive intervention under control of ultrasonography, in 38 of them--in stage of purulent complications, was performed. It had promoted stabilization of state in 39 (89.8%) patients, normalization of clinic--laboratory indexes, that had permitted to realize radical operative intervention with minimum risk in perspective. Invasive intervention under control of ultrasonography--highly effective primary surgical manipulation in complex of treatment of the destructive AP severe forms.

[The application of electronic microscopic studies in the diagnosis of the degree of inflammation in necrotic pancreatitis]. / Primenenie électronno-mikroskopicheskogo issledovaniia v diagnostike kharaktera vospaleniia pri nekroticheskom pankreatite.

The electron-microscopical investigation of the pancreatic gland necrosis region had permitted to determine the organ inflammation character.

[The use of Sandostatin in the combined treatment of surgical diseases of the pancreas]. / Primenenie sandostatina v kompleksnom lechenii khirurgicheskikh zabolevanii podzheludochnoi zhelezy.

The paper analyzes experience gained with the use of Sandostatin in patients with a surgical operation-induced pathology of pancreas. Sandostatin is known to be capable of suppressing the exocrine activity of pancreas, which fact made for decline in the recordable postoperative complications and improvement of results of surgical treatment. The maiden experience gained with its use showed high efficacy of Sandostatin in a multimodality treatment of patients presenting with surgical pathology of pancreas.

[Modified strategy of the treatment of patients with necrotic pancreatitis]. / Modifitsirovannaia taktika lecheniia bol'nykh s nekroticheskim pankreatitom.

New principle of choice of the surgical treatment method in patients with necrotic pancreatitis was proposed: different operative procedures don't compete one another but are applied in accordance with the disease stage in dynamics. Such tactics permits to choose an optimal surgical approach in every phase of pathologic process course. From 1989 till 1992 the surgical treatment for necrotic pancreatitis was conducted to 54 patients. Pancreatic resection was done to 14 (25.9%) of patients, 4 of whom died. In necrotic focus delimitation or pancreatic tissue sequestration, observed in terms of more than 2 weeks since the disease beginning, necrectomy was conducted in 40 (74.1%) of patients, 4 of whom died.

[State of stress-limiting and stress-responsive systems of the body in pancreatic necrosis during systemic-toxic phase]. / Sostoianie stress-limitiruiushchikh i stress-realizuiushchikh sistem organizma pri pankreonekroze v sistemno-toksicheskoi faze.

Results of dynamic investigation of beta-endorphins and hormonal state were analysed in 34 patients with pancreonecrosis aged from 23 to 54 years. The dependency of this indexes on the severity of clinical course and presence of complications was determined. The correction ways of injurious action of stress-reaction in pancreonecrosis were proposed.

[Prognostication of the reversibility of changes in the bile ducts and choice of tactics in surgical treatment of patients with choledocholithiasis]. / Prognozirovanie obratimosti izmenenii zhelchnykh protokov i vybor taktiki khirurgicheskogo lecheniia bol'nykh s kholedokholitiazom.

The reversibility of the changes in the common bile duct after elimination of mechanical obstruction and its adequate drainage in patients with choledocholithiasis was studied. A programmed system of prognostication permitting to choose the optimal type of operative intervention with regard for the sizes of the common bile duct after correction has been developed.

[Partial resection of the head of the pancreas]. / Partsial'naia rezektsiia golovki podzheludochnoi zhelezy.

Data of performing partial resections of head of the pancreas in 29 patients are described. Depending on the state of the pancreas it is possible to perform external drainage of the major pancreatic duct of the distal stump followed by its delayed occlusion, to form pancreatoenteroanastomosis or recanalization of the duct using a small intestine segment. The partial resections are less traumatic operations and give less amount of postoperative complications.