ABSTRACT
The results of endoscopic sclerotherapy (EST) in the patients with portal hypertension (PH) are analyzed. Efficacy of methods in the treatment of gastroesophageal varicosity in urgent situations (bleeding) and "cold" period was evaluated. Schemes of staged minimally-invasive surgical correction of PH syndrome are described. Etoxisclerol is regarded as the most appropriate sclerosant. It is concluded that EST is an effective method of treatment in PH, it is alternative to "open" abdominal surgery and may improve results of treatment in this group of patients.
Subject(s)
Esophageal and Gastric Varices/therapy , Esophagoscopy , Hypertension, Portal/complications , Sclerotherapy , Adolescent , Adult , Child , Child, Preschool , Emergencies , Esophageal Perforation/etiology , Esophageal Perforation/therapy , Esophageal Stenosis/etiology , Esophageal Stenosis/therapy , Esophageal and Gastric Varices/complications , Esophageal and Gastric Varices/etiology , Female , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/therapy , Humans , Infant , Male , Middle Aged , Sclerotherapy/methods , Time Factors , Treatment OutcomeABSTRACT
Laparoscopic cholecystostomy was undertaken in 178 elderly and old-aged patients with acute cholecystitis. Dynamic cholecystoscopy with biopsy of the cystic mucosa and bacteriologic study of the bile was conducted for objective appraisal of the inflammatory process in the gallbladder. Concluding operations on the bile tract were carried out in 147 patients. New methods were applied in 10 patients: filling of the gallbladder and contact solution of the stones in the gallbladder and bile ducts.
Subject(s)
Cholecystitis/surgery , Cholecystostomy/methods , Drainage/methods , Acute Disease , Aged , Cholecystitis/diagnosis , Humans , Intraoperative Care , Laparoscopy , Middle AgedABSTRACT
Direct cholegraphy was performed after laparoscopic cholecystostomy in 82 patients. It should be conducted on the operating table if proper fixation of the draining tube is doubtful, but, mainly, on the fourth or fifth postoperative day. Double contrasting of the biliary tract with air and a contrast medium produces the best result.
