[Minimally invasive surgery for the treatment of pancreatic fistulas].

Results of treatment of 6 patients with pancreatic fistula by US-, radioscopy-, and endoscopy-guided formation of transcutaneous pancreatogastric anastomosis are presented. The procedure of pancreatogastric anastomosis is described. The causes of formation of fistulas were: operations due to pancreatitis - 4 cases, trauma of a pancreas -- 1 case, percutaneous drainage of a cyst -- 1 case. By application of the given procedure, complete closure of a fistula without relapses (maximal term of observation 1 year) was possible. The complications linked to performance of transcutaneous manipulation have not been noted. Lethality was not observed. It may be assumed, that the developed original procedure and using the Ivshin's device for the drainage of cavity formations can become a method of a choice in the treatment of patients with non-perishable outside pancreatic fistulas. Assessment of the parameters of the quality of life has shown that patients were quickly reverted to social and intellectual activity.

[Diagnosis and results of surgical treatment of intrathoracic neurogenic tumors]. / Diagnostika i rezul'taty khirurgicheskogo lecheniia vnutrigrudnykh neirogennykh opukholei.

The aim of the study was to study efficiency of diagnosis and surgical treatment of intrathoracic neurogenic tumors. Since 1990 to 2002, 28 patients with neurogenic tumors underwent surgical treatment in National Cancer Center and various clinics of Tbilisi. Age of the patients ranged from 14 to 65 years. The tumors located in the mediastinum in 20 patients, in the chest wall with intrathoracic growth--6 patients, and in the lung--2 patients. Radiology (X-ray, CT), endoscopy and cytology were used for diagnosis. It was demonstrated that CT, CT-guided fine-needle biopsy and videothoracoscopy improve diagnosis of intrathoracic neurogenic tumors. Radical surgery is the method of choice in surgical treatment of intrathoracic neurogenic tumors.

[Percutaneous transhepatic cholangiography, cholangiostomy and endoprosthesis of bile ducts in mechanical jaundice]. / Chreskozhnaia chrespechenochnaia kholangiografiia, kholangiostomiia i éndoprotezirovanie zhelchnykh putei pri mekhanicheskoi zheltukhe.

The following interventions were carried out in obstructive jaundice of various etiology: percutaneous transhepatic cholangiography in 186 cases (3.3% complications), temporary external drainage in 20, external-internal drainage in 8, and endoprosthesis of the bile ducts in 6 cases (17.6% of complications in endobiliary interventions). General efficacy of hepatocholangiography 88.9% (96.4% in dilated bile ducts and 67.8% in non-dilated bile ducts). Drainage and endoprosthesis of the bile ducts were resorted to not only to improve the patient's condition before the operation, but also as an alternative surgical intervention in cases of inoperable new growths of the ++hepato-pancreato-duodenal++ zone.

[Echography and direct anterograde cholangiography in the diagnosis of mechanical jaundice]. / Ekhografiia i priamaia antegradnaia kholangiografiia v diagnostike obstruktsionnykh zheltukh.

A comparison of the data of echography, percutaneous transhepatic cholangiography and operative findings in 35 patients with obstructive jaundice was made. The complex use of the ultrasonic and radiopaque examination gave more exact information of the place and character of obstructive bile ducts and allowed to choose a rational method of treatment.