ABSTRACT
The modern laparoscopic surgery trents the minimization of the access, which led to the workout of the novel surgical access for the laparoscopic cholecystectomy using only two ports. The advantages of the access, empowered by the positive authors' experience is cited.
Subject(s)
Cholecystectomy, Laparoscopic/instrumentation , Cholecystitis/surgery , Laparoscopes , Adolescent , Adult , Aged , Equipment Design , Female , Humans , Male , Middle Aged , Young AdultABSTRACT
Treatment results in 110 patients with stenotic bleeding pyloroduodenal ulcers (SBPU) were analyzed. Correlation dependence of hemorrhage severity and recurrence frequency from the degree of pyloroduodenal stenosis was revealed. Recurrence of ulcer gastroduodenal bleeding - is the main factor that determines lethality at SPBU. The total lethality against a background of SPBU recurrence was 16%, whereas in the absence of recurrence it was 10%. Treatment tactics in patients with SPBU was worked out. The best results were received after urgent operations which had been carried out after short-term preoperative preparation, aimed to blood replacement and correction of water-electrolytic and protein-energy disturbances at pyloroduodenal stenosis.
Subject(s)
Hemorrhage/pathology , Peptic Ulcer/pathology , Pyloric Stenosis/pathology , Adult , Aged , Aged, 80 and over , Female , Hemorrhage/complications , Hemorrhage/surgery , Humans , Male , Middle Aged , Peptic Ulcer/complications , Peptic Ulcer/surgery , Pyloric Stenosis/complications , Pyloric Stenosis/surgeryABSTRACT
Experience in gastrectomy with suturing of varicose veins (VV) of the esophagus and stomach (M.D. Patsiora's surgery) in 349 patients with extrahepatic portal hypertension (EPH) is reviewed. Short and long-term results of this surgery through abdominal and transthoracal approach are analyzed. Postoperative lethality in patients with EPH after elective surgery was 5.0%, urgent surgery--16%. Recurrence of esophagogastric bleeding in postoperative period was seen in 23 (6.6%) patients. 286 patients were followed up from 1 to 10 years. Recurrence of esophageal-gastric bleeding was seen in 104 (36.4%) patients and led to death in 19 (18.3%) of them. It is concluded that suturing of esophageal and gastric VV in patients with EPH is a method of choice both in prolonged bleeding and as preventive elective surgery when creation of vascular anastomosis is impossible.
Subject(s)
Esophageal and Gastric Varices/surgery , Gastrointestinal Hemorrhage/surgery , Hypertension, Portal/complications , Adolescent , Adult , Emergencies , Esophageal and Gastric Varices/complications , Esophageal and Gastric Varices/etiology , Female , Follow-Up Studies , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/mortality , Humans , Male , Middle Aged , Recurrence , Suture Techniques , Time Factors , Treatment OutcomeABSTRACT
Diagnostic value of verification methods for abdominal injuries in patients with combined trauma (CT) was analyzed, severity of injuries by Injuries Severity Scale (ISS) was specified. From 503 patients with CT (ISS = 17.6 +/- 9) diagnostic laparocentesis (DLC) was used in 224 (44.6%), USI--in 204 (40.4%), diagnostic laparoscopy (DLS)--in 49 (9.8%). Diagnostic value of each method is not optimal as they do not confirm or exclude injuries of abdominal organs requiring emergency surgery. Absence of clear criteria of diagnosis of intraabdominal catastrophe leads to significant number of unnecessary laparotomies (DLC--39%, USI--43%, DLS--48.6%) that makes graver state of patients with CT and prognosis.
