ABSTRACT
AIM: To develop an optimal diagnostic algorithm in order to the most reliable decrease of inflammatory changes severity in large duodenal papilla in patients with chronic opisthorchiasis. MATERIAL AND METHODS: Medical reports of 384 patients with opisthorchiasis-induced cholangitis have been analyzed. Diagnostic methods were abdominal ultrasound, endoscopic ultrasound of terminal common bile duct, CT scans, MRI of abdominal organs including magnetic resonance cholangiopancreatography and esophagogastroduodenoscopy with biopsy of the papilla, ERCP and PTHC. Comprehensive general and individual analysis of each of them has determined their advantages and disadvantages. CONCLUSION: Examination should by comprehensive to evaluate visual appearance of large duodenal papilla, lumen dimensions, state of its walls with histological research. Imaging tests are favorable to determine the diagnosis of papillitis due to possible assessment of lumen dimensions and state of the walls. While making a choice the priority should be given to endoscopic ultrasound examination. It allows visual inspection, assessment of the lumen, the walls of papilla and provides biopsy of deep structures.
Subject(s)
Ampulla of Vater , Cholangiopancreatography, Endoscopic Retrograde/methods , Cholangitis , Endosonography/methods , Opisthorchiasis/complications , Ampulla of Vater/diagnostic imaging , Ampulla of Vater/pathology , Biopsy/methods , Cholangitis/diagnosis , Cholangitis/etiology , Endoscopy, Digestive System/methods , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Reproducibility of Results , Tomography, X-Ray Computed/methodsABSTRACT
Results of treatment of 2415 patients with acute pancreatitis, including 285 cases of the acute necrotizing pancreatitis, are analyzed. The algorithm of diagnostics and treatment of this category of patients is worked out and successfully applied. The comparative results of the acute pancreatitis treatment before (1995-1999) and after (2000-2005) introducing the algorithm to practice are analyzed. Thus, the rate of postoperative complications decreased from 16,7 to 4,95% and postoperative lethality came down from 25 to 9,1%.
Subject(s)
Laparotomy/methods , Minimally Invasive Surgical Procedures/methods , Pancreatitis, Acute Necrotizing/surgery , Adult , Aged , Aged, 80 and over , Drainage/methods , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications/prevention & control , Retrospective Studies , Treatment Outcome , Young AdultABSTRACT
Results of surgical treatment of 106 patients with complications of colon malignant tumors are analyzed. Diagnostic and treatment algorithm for these patients has been developed and used in clinical practice. Standardization and use of this algorithm permitted to increase the rate of radical operations from 48.9 to 62.6%, to reduce the rate of purulent complications more in 2 times and postoperative lethality - in 1.6 times.
Subject(s)
Colectomy/methods , Colonic Neoplasms/complications , Colonoscopy/methods , Gastrointestinal Hemorrhage/surgery , Hemostasis, Endoscopic/methods , Intestinal Obstruction/surgery , Peritonitis/surgery , Adult , Aged , Algorithms , Anastomosis, Surgical , Colon, Transverse , Female , Follow-Up Studies , Gastrointestinal Hemorrhage/etiology , Humans , Intestinal Obstruction/etiology , Male , Middle Aged , Peritonitis/etiology , Retrospective Studies , Rupture, Spontaneous , Treatment OutcomeABSTRACT
One of important aspects influencing the results of surgical treatment of patients with diseases of the colon is thought to be stepwise diagnostic and treatment measures. A retrospective analysis of treatment of 171 patients with pathology of the colon has been made. A medical-diagnostic algorithm has been developed and introduced which allowed improvement of effectiveness of medical aid in the group under study. Of importance was also modernization of certain technical aspects of operation. Efficiency of the developed method of the formation of colonic anastomosis with strengthening the line connection with a plate "Tahokomb" was proved in experiment and confirmed in clinical practice. The application of the medical-diagnostic algorithm allowed unification and standardization of approaches to treatment of patients with a pathology of the colon and better results were obtained with 3 times less number of complications.
