[The modification of the M.D. Patsiora's operation by portal hypertension].

The direct transcutaneous transhepatic portography was performed in 85 patients with hystologically confirmed liver cirrhosis, portal hypertension and varices of the esophagus and stomach. It was found out, that the left gastric vein partakes the varicous transformation in 100% of cases. The least had an isolated division in 27% of the studied patients. 68% had the significant dilatation of the posterior gastric vein, whereas 19 (22%) patients had the combined posterior, left and short gastric veins dilatation. The study allowed the modification of the M.D. Patsiora's operation (the azygo-portal disintegration), by supplementing it with the gastric devascularization. The new method increased the 2-years survival from 77 to 97%, improved the hemostatic effect from 51 to 89% and decrease the recurrences from 25 to 5%.

[Pathogenesis of esophageal and gastric varicose veins formation in patients with liver cirrhosis].

RESEARCH OBJECTIVE: studying the features of the collateral venous blood flow and the basic ways of the formation of gastroesophageal varices in patients with cirrhosis and portal hypertension. METHODS: The following analysis is based on the interpretation of results from percutaneous transhepatic splenoportography in 85 patients. It has been established that in all 85 patients the left gastric vein plays a key role in the formation of gastroesophageal varices. RESULTS: It is established that a leading collector in 100% of observations participating in formation gastroesophageal varices, is the left gastric vein. In work the attention is focused on an insufficient estimation of a role of a back gastric vein in a pathogenesis of varicose transformation. From 85 observations its presence is taped in 58 (68%) cases, and, at 19 (22%) patients its expansion isn'ted in a combination to expansion left gastric vein, and at 39 (46%) patients - in a combination with left gastric vein and short veins of a stomach. CONCLUSION: The obtained data on the formation mechanism of varicose expanded veins of an esophagus and a stomach defines necessity of changes for algorithm of inspection of patients for the purpose of diagnostics of features of a venous blood flow of a stomach and an esophagus and definition of surgical tactics concerning volume pre- or intraoperational blockade of the basic venous collectors.

[Conservative treatment of giant gastric ulcer].

Clinical supervision of successful conservative treatment of the patient with a huge stomach ulcer with use in the course of performance endoscopic a metabolic homeostasis of solutions of glucose and ascorbic acid of 5%, and also pH-chromoscopy and capillary gastrointestinal a tube is presented.