[Comparative characteristics of efficacy of operations in ulcerous pyloroduodenal stenosis]. / Sravnitel'naia kharakteristika éffektivnosti operatsii pri iazvennom piloroduodenal'nom stenoze.

1107 patients with ulcerous pyloroduodenal stenosis (UPDS) were operated since 1968 to 2000. Duodenal ulcers caused stenosis in 1053 (95%) patients, gastric ulcers of types II and III--in 54 (5%). Various stomach resections were performed in 287 (92%) patients organ-saving operations--in 795 (71.8%) patients Longterm outcomes were studied in 797 (71.9%) patients, 491 (61.6%) of them were examined in hospital and 306 (38.4%) responded to questionnaires. Mean follow-up was 17 +/- 8.4 years. Early postoperative complications were in 138 (12.5%) patients, after resections--in 20.5%, after organ-saving operations--in 9.3%. General lethality after UPDS surgery was 0.6%, after organ-saving operations--0.2%, after resections--1.3%. Pathologic syndromes were seen in 31% patients. Recurrence of ulcer after organ-saving operations was revealed in 11% in remote terms. Demping-syndrome was in 22.9% patients. Most often it was revealed after 2/3 stomach resection by Bilrot-II in Gofmeister--Finsterer (G--F) modification, less often--after SPV with duodenoplasty. The only operation preventing reflux-gastritis was economic stomach resection with Roux anastomosis and trunk vagotomy (TV + Er Roux). Good and excellent results by Visick scale were achieved in 85% patients with UPDS. Evaluation by D. Johnston scale demonstrated best results after SPV in duodenoplasty (238 points) and TV + ER Roux (272 points), the worst results--after B-1 (773 points) and B-II G--F (1124 points). Optimal results like healthy quality of life was seen after TV + ER Roux and SPV with duodenoplasty.

[Topical diagnosis of pancreatic insulinomas]. / Topicheskaia diagnostika insulinom podzheludochnoi zhelezy.

Diagnosis of pancreatic insulinomas has been performed. Celiacography appeared to be the most efficient diagnostic method (more than 50% of sensitivity). Intraoperative ultrasound testing, that have been done in 16 patients, managed to make a topical diagnosis with a high accuracy and to evaluate relation of a tumor with portal vessels and pancreatic duct that is very important in choosing a proper surgical technique.

[Late results of the treatment of patients with the extreme degree of alimentary-constitutional obesity by the method of formation of a small stomach]. / Otdalennye rezul'taty lecheniia bol'nykh s krainymi stepeniami alimentarno-konstitutsional'nogo ozhireniia metodom formirovaniia malogo zheludka.

The work analyses the results of treatment of 311 patients with extreme degrees of alimentary-constitutional obesity by formation of a small stomach. Fatal outcomes (1.9%) were encountered in the period of operative technique mastering. The late-term results were studied in 167 patients in follow-up periods of up to 3 years. The patients' average body weight was 149.4 kg, average height 166.2 cm, average body weight excess as compared to the ideal weight was 125.6%. Study of the late-term results of the operation showed that the postoperative weight loss depends on the initial weight excess and the diameter of the anastomosis formed between the proximal and distal parts of the stomach. The more the initial excess of weight as compared to the ideal value, the more the loss of body weight is. The diameter of the formed anastomosis should be no larger than 15 mm. Besides loss of weight, the activity of vital organs and systems is normalized after the operation, and arterial hypertension, diabetes mellitus, the Pickwickian syndrome, and metabolic polyarthritis take a milder course. The operation for formation of a small stomach made it possible for the patients to resume their customary occupation, freed them of the threat of invalidation, and reduced the duration of the disability period by 4.3 times. After surgical treatment the nature of the patients' life significantly improved; 95.8% of patients appraised the effect of the treatment as excellent and good.