[Surgical treatment of acute large bowel ileus].

The results of treatment were analyzed in 47 patients, suffering operable cancer of left half of large bowel, complicated by an acute obturation ileus of the large bowel (AOILB), in whom radical obstructive operation of the Hartmann type was performed. In 26 patients (the 1-st group) a typical obstructive operation of Hartmann type was accomplished, and in 21 (2-nd group)--a radical obstructive operation in accordance to the method proposed. In a 1-st group postoperative complications have occurred in 7 (26.9%) patients, duration of stay in stationary was 19 days on average; in the 2-nd group the complications were observed in 2 (9.5%) patients. Duration of treatment in stationary was 13 days. Thus, application of the method of surgical treatment of the AOILB proposed have permitted to reduce postoperative morbidity rate in 2.8 times, the lethality--in 2.4 times, duration of a stationary treatment--in 1.4 times, necessity in postoperative wound dressing procedures and expenditure on dressing material--in 10 times.

[Influence of method of cholecystectomy performance on the central hemodynamics indices in patients with an acute cholecystitis].

There were examined 120 patients, using the method of the integral rheography of the body (according to method of M. I. Tyshchenko), and than operated on for the acute cholecystitis. In 60 patients, constituting the main group, cholecystectomy using minimal approach (CHMA) was done and in 60 (control group)--open cholecystectomy (OCH) using wide laparotomy. After performance of OCH the significant reduction of volumetric indices of blood flow was established. Extremely significant changes of the hemodynamics indices was observed on 1-3 days and than they had slowly improved and on 7-9 day restored, but not completely up to primary data in majority of cases. After performance of CHMA the indices changes were less significant and had restored earlier.

[Diagnosis and treatment of perforative and "mirror-like" duodenal ulcer]. / Diahnostyka i likuvannia perforatyvnoï ta "dzerkal'noï" vyrazky dvanadtsiatypaloï kyshky.

The result of treatment of perforative duodenal ulcer (PDU) in 193 patients was analyzed. The PDU suturing was performed in 100 patients, radical organ-preserving operation--in 93, with the PDU excision--in 80 of them. The "mirror-like" ulcer of posterior wall was revealed in 12 (15%) patients using intraduodenal revision while doing the PDU excision. Selective proximal vagotomy with the PDU excision and processing of duodenal posterior wall is effective method of surgical treatment.

[Surgical treatment of acute cholecystitis in elderly and senile patients]. / Khirurhichne likuvannia hostroho kholetsystytu u khvorykh pokhyloho ta starechoho viku.

There were analyzed the results of treatment of 69 elderly and senile patients, operated on for an acute calculous cholecystitis, in 19 of whom cholecystectomy, using miniapproach was performed. The performance of an assisting manipulating channel, application of oblique-changing puncture of gall bladder and of special instruments were proposed to improve technical condition of cholecystectomy performance while usage of miniapproach, its rational exploitation and reduction of intra- and postoperative complications occurrence.

[Application of auxiliary manipulation channel during performance of cholecystectomy using minimal access]. / Zastosuvannia dopomizhnoho manipuliatsiinoho kanalu pid chas vykonannia kholetsystektomiï minimal'nym dostupom.

The conduction of the supportive manipulation channel (SMCH) during the cholecystectomy and the oblique-changing gall bladder puncture performance was proposed to improve the conditions for doing the operation, rational application of minimal oblique subcostal access (MOSA) and postoperative complications prophylaxis. There were operated 17 patients using MOSA, in 15 SMCH was conducted, including 2 with intervention on extrahepatic biliary ducts: choledocholithotomy with external draining of common biliary ducts. In 12 patients intradermal suture was done.