[Treatment of acute ulcerous gastroduodenal hemorrhage]. / Lechenie ostrykh gastroduodenal'nykh krovotechenií iazvennoí 'etiologii.

Basic principles of infusion-transfusional therapy, methods of endoscopic hemostasis as well as indications for surgical treatment of acute hemorrhagic ulcers of the stomach and the duodenum are presented. If is stated that valid use of endoscopic methods of hemostasis provides possibility for temporal hemostasis in 70% of patients. It endoscopic hemostasis is ineffective in hemorrhage from ulcer or in recurrent hemorrhage it is recommended to perform urgent surgical interventions. To avoid the relapse of hemorrhage after endoscopic hemostasis from ulcer or revealing endoscopic symptoms of unreliable (unstable) hemostasis it is necessary to perform delayed operations (not later that 2 days from the moment of admission of the patients). If the hemostasis shows to be stable which is proved by endoscopy, early elective operations (in 12-14 days) are indicated.

[Reoperations after closure of perforative gastroduodenal ulcer]. / Povtornye operatsii posle zashivaniia perforativnoi gastroduodenalnoi iazsvy.

Results of surgical treatment of 271 patients with malady recurrence after perforative gastroduodenal ulcer closure were adduced. Resectional methods of treatment were conducted in 118 patients, vagotomy combined with the stomach draining procedure--in 106, in combination with ulcer extraduodenization and duodenoplasty--in 47. Conduction of organpreserving operation with ulcer extraduodenization and duodenoplasty must be supposed mostly rational.

[The diagnosis and treatment of a malignant stomach ulcer]. / Diagnostika i lechenie malignizirovannoi iazvy zheludka.

The results of treatment have been analyzed in 587 patients with stomach ulcer in 52 of whom ulcer was found to be malign. Methods of diagnosing of ulcer malignization are not reliable. Difficulties in differential histodiagnosis, absence of trustworthy diagnostic tests as well as advisability of additional mucus assays are underlined. The results of treatment depend on extension of the process and efficiency of the operation performed. In patients radically operated on for the process limited to gastric mucosa 5-year survival was 84.6%.

[The surgical treatment of malignant stomach ulcers]. / Khirurgicheskoe lechenie malignizirovannykh iazv zheludka.

The authors analyse the specific features of the clinical picture, diagnosis, pathomorphological changes and surgical treatment in 52 patients with gastric ulcer which underwent malignant degeneration. It is noted that malignancy occurs most frequently in close vicinity to the ulcerative defect and rarely in the mucosa beyond the ulcer. The morphostructural reorganizations are determined to a certain degree by the peculiarities of extension of the tumor along the mucosa and the organ as a whole. The authors discuss the principles of the choice of the method for treatment according to the findings of pathomorphological examination of biopsy material and the results of emergency intraoperative examination. Even if the merest suspicion of malignancy of the ulcer arises, the operation should be conducted with observance of all oncological principles. Postoperative mortality was 3.8%, complications occurred in 7.7% of cases. Five-year survival was 84.6% in the absence of metastases and the presence of carcinoma cells within the limits of the mucosa and 12.5% among cases in which metastases were found during the operation. Attention is drawn to the principles of regular medical surveillance over patients receiving nonoperative treatment for gastric ulcer.

[Early diagnosis and treatment of a pyloroduodenal ulcer complicated by stenosis of gastric outlet]. / Ranniaia diagnostika i lechenie piloroduodenalnoi iazvy, oslozhnennoi stenozom vykhoda iz zheludka.

Treated were 193 patients with pyloroduodenal ulcer complicated by stenosis of gastric outlet. Compensated stenosis was noted in 14 (7.2%) patients, subcompensated--in 147 (76.2%), decompensated--in 30 (15.5%), gastric tetany--in 2 (1.04%). Studied were the immunologic indices, peripheric blood flow by means of a roentgenologic method under conditions of double contrasting and artificial hypotony, gastric and duodenal function, bioelectric activity--by the method of duodenokinesiography. Gastric resection was performed in 87 patients, vagotomy with drainage operation and without it--in 82, gastroenterostomy--in 14, antrum resection with vagotomy--in 12, Roux resection of the stomach--in 2. The postoperative lethality was 1%. Good and excellent results after gastric resection were noted in 82.1%, after vagotomy--in 88.4% of the patients.

[Late results of the conservative treatment of patients with cholecystitis]. / Otdalennye rezul'taty konservativnogo lecheniia bol'nykh kholetsistitom.

It is shown that conservative treatment of cholelithiasis in young patients is not effective. In the long-term period these patients show as a rule recurrences, the frequency and degree of functional disorders of the liver and pancreas rises, the number of complications increases. The authors recommend early surgical treatment of this contingent of patients.

[Late results of the surgical treatment of chronic calculous cholecystitis in young patients]. / Otdalennye rezul'taty khirurgicheskogo lecheniia khronicheskogo kal'kuleznogo kholetsistita u bol'nykh molodogo vozrasta.

Long-term results of surgical treatment of chronic calculous cholecystitis were investigated in 139 patients of young age. Good results were observed in 83.5% of cases, satisfactory--in 11.5% of cases and failures--in 5% of cases. The authors present an analysis of the dependence of long-term results of surgical treatment of cholelithiasis in the young on the duration of the diseases before the surgical intervention, clinicomorphological form of cholecystitis, the degree of extension of the pathological process in the bile ducts and neighbouring organs volume of the operation and its character.

[Acute appendicitis in patients with diabetes mellitus]. / Ostryi appenditsit u bo'lnykh sakharnym diabetom.

The peculiarities of clinical picture, preoperative preparation and postoperative course in 157 patients with acute appendicitis, who suffered from diabetes mellitus, are shown. The direct dependence of pathomorphologic changes in the vermiform process on the severity degree and the state of diabetes compensation is noted. For correction of carbohydrate metabolism in the patients' contingent considered, it is the most expedient to use the fractional injection of common (crystalline) insulin at low doses.