ABSTRACT
Analysis of clinical material of 206 patients with tumor obstruction of the distal part of the common bile duct allowed the conclusion to be made on the expediency of applying endoscopic methods for jaundice correction as the first stage in preparation for the operation (122 patients) and also as the only and final operation (70 patients). Study of the immediate and late-term results of different variants of operations for bile diversion in obstruction of the distal choledochus (203 operations) showed the superiority of the Roux hepaticoejunoanastomosis in which recurrent jaundice due to obstruction of the cystic duct does not occur, as is encountered in creation of a cholecystoejunoanastomosis, and there are no conditions for the development of ascending cholangitis.
Subject(s)
Biliopancreatic Diversion/methods , Cholestasis, Extrahepatic/surgery , Adult , Aged , Aged, 80 and over , Cholestasis, Extrahepatic/etiology , Common Bile Duct Neoplasms/complications , Female , Humans , Laparoscopy , Male , Middle Aged , Treatment OutcomeABSTRACT
A method for obliteration of the gallbladder, based on its mucoclasis with phenol preparations, was developed in experiments on unbred dogs. The safety of using preparations based on phenol for chemical demucosation of the gallbladder is demonstrated. The suggested method may serve as a prototype for the development of similar interventions in clinical practice in acute cholecystitis and cholelithiasis after endoscopic cholecystostomy and cholecystolithoextraction. The method was used in clinical practice in 3 patients with acute calculous cholecystitis and severe concomitant pathology and a high operative-anesthesiological risk.
Subject(s)
Cholecystitis/therapy , Cholecystostomy , Cholelithiasis/therapy , Gallbladder/drug effects , Lithotripsy , Phenols/therapeutic use , Acute Disease , Animals , Cholecystitis/complications , Cholelithiasis/complications , Combined Modality Therapy , Dogs , Gallbladder/pathology , Humans , Laparoscopy , Phenol , Phenols/pharmacology , Risk FactorsSubject(s)
Cholecystitis/complications , Gallstones/complications , Acute Disease , Adult , Aged , Female , Humans , Male , Middle AgedSubject(s)
Abdomen, Acute/diagnosis , Laparoscopy , Abdomen, Acute/surgery , Adolescent , Adult , Aged , Emergencies , Female , Humans , Male , Middle Aged , Preoperative CareSubject(s)
Cholecystitis/surgery , Gallbladder/surgery , Acute Disease , Adult , Age Factors , Aged , Bile/analysis , Endoscopy , Female , Humans , Male , Middle AgedABSTRACT
The results of endoscopic and morphological diagnostic methods for gastric polyps in 91 patients are analysed in detail. It is concluded that endoscopic examination makes it possible to reveal gastric polyps of any localization. However, to solve the problem of therapeutic policy it is necessary to examine the biopsy material from polyps, prior to their removal, both cytologically and histologically. This is due to the fact that small size polyps after endoscopic polypectomy are no longer suitable for morphological assay, whereas cytograms obtained from the transverse sections and surface of large polyps are equivalent diagnostically to cytograms of the biopsy specimens.
