ABSTRACT
It was done comparative analysis the results of different treatment options using of laparoscopic treatment of 331 patients with perforated ulcers. It was defined that postoperative complications frequency is increased to 1.6% in case of perforated ulcers suturing with diameter to 0.7 cm. This indication is increased to 7.1% in case of perforated ulcers suturing and plugging by greater omentum with holes diameter to 1.0 cm. The complications are absent in case of perforated ulcer excision with subsequent vagotomy and pyloroplasty.
Subject(s)
Duodenal Ulcer/complications , Laparoscopy , Peptic Ulcer Perforation , Postoperative Complications , Stomach Ulcer/complications , Suture Techniques , Adult , Comparative Effectiveness Research , Duodenal Ulcer/mortality , Female , Humans , Laparoscopy/adverse effects , Laparoscopy/classification , Laparoscopy/methods , Laparoscopy/statistics & numerical data , Male , Peptic Ulcer Perforation/etiology , Peptic Ulcer Perforation/surgery , Perioperative Care , Postoperative Complications/classification , Postoperative Complications/etiology , Pylorus/surgery , Recurrence , Stomach Ulcer/mortality , Survival Analysis , Suture Techniques/classification , Suture Techniques/statistics & numerical data , Treatment OutcomeABSTRACT
654 patients with ulcerative gastroduodenal bleeding from duodenum were under observation. It was done the meta-analysis of treatment results of 111 patients with hard scarring duodenal ulcers. It was discovered high efficiency of organ-preserving operations such aslaparoscopic vagotomy and proton pump inhibitors in these observations.
Subject(s)
Cicatrix , Duodenal Ulcer/surgery , Laparoscopy/methods , Peptic Ulcer Hemorrhage/surgery , Postoperative Complications , Proton Pump Inhibitors/therapeutic use , Vagotomy/methods , Cicatrix/etiology , Cicatrix/physiopathology , Cicatrix/surgery , Combined Modality Therapy/methods , Female , Humans , Male , Middle Aged , Organ Sparing Treatments/methods , Postoperative Complications/physiopathology , Postoperative Complications/surgery , Time Factors , Treatment Outcome , Wound HealingABSTRACT
Of 1102 patients with gastrointestinal ulcer bleeding, 143 developed the recurrence during the hospital stay. 9 critical risk factors of the recurrence were distinguished. The optimal treatment strategies of gastrointestinal ulcer bleeding were worked out, which allowed to decrease the mortality rate from 6.4 to 2.4%.
Subject(s)
Duodenal Ulcer , Hemostasis, Surgical/methods , Hemostatics/therapeutic use , Inpatients , Peptic Ulcer Hemorrhage/therapy , Endoscopy, Gastrointestinal , Female , Follow-Up Studies , Humans , Incidence , Male , Middle Aged , Peptic Ulcer Hemorrhage/diagnosis , Peptic Ulcer Hemorrhage/epidemiology , Retrospective Studies , Risk Assessment , Risk Factors , Russia/epidemiology , Secondary Prevention , Survival Rate/trends , Treatment OutcomeABSTRACT
The results of the complex prophylaxis and treatment of 33 458 patients with gastric or duodenal ulcer were analyzed. Of the analyzed group, 1002 (2,99%) patients experienced ulcer bleeding. The complex out-patient and stationary treatment of the ulcer disease allowed of bleeding frequency from 8,6 to 2,1%; the decrease of recurrent bleedings from 13,0% to 0; allowed to avoid major surgery (the previous frequency was as high as 14,5%) and decreased lethality rate from 9 to 1%.
Subject(s)
Peptic Ulcer Hemorrhage/therapy , Peptic Ulcer/complications , Antibiotic Prophylaxis , Humans , Peptic Ulcer/surgery , Peptic Ulcer/therapy , Peptic Ulcer Hemorrhage/prevention & control , Peptic Ulcer Hemorrhage/surgeryABSTRACT
The results of investigations the hepato-pancreatico-duodenal organs are analysed. High diagnostic effectiveness of the ultrasound examination in acute cholecystitis (95.5%) is demonstrated. In chronic calculous cholecystitis and in choledocholithiasis the ultrasound examination appeared to be accurate in 97.0% and 84.2% of cases respectively. Retrograde cholangiopancreatography was the most informative method for detection of the concrements in choledochus (effective in 94.4% of the cases). The diagnostic effectiveness of the ultrasound examination and laparoscopy in detection of mechanical jaundice and acute pancreatitis are considered to be equal. Ultrasound examination, retrograde cholangiopancreatography, laparoscopy appeared to be the most accurate and informative methods in diagnosis of the diseases of the organs of hepato-pancreatico-duodenal zone. The role of the X-ray examination decreased. At the same time the significance and reliability of intraoperative cholangiography has been stressed.
Subject(s)
Biliary Tract Diseases/diagnosis , Liver Diseases/diagnosis , Pancreatitis/diagnosis , Acute Disease , Biliary Tract Diseases/diagnostic imaging , Cholangiopancreatography, Endoscopic Retrograde , Cholecystitis/diagnosis , Cholecystitis/diagnostic imaging , Cholelithiasis/diagnosis , Cholelithiasis/diagnostic imaging , Cholestasis/diagnosis , Cholestasis/diagnostic imaging , Diagnosis, Differential , Gallstones/diagnosis , Gallstones/diagnostic imaging , Humans , Laparoscopy , Liver Diseases/diagnostic imaging , Pancreatitis/diagnostic imaging , UltrasonographyABSTRACT
A comparative analysis of the performance of 51 operations for resection of various parts of the colon, among which were 24 operations conducted by laparoscopy, was undertaken. Certain advantages of laparoscopic resection of the colon, as well as the possibility of lymph dissection, which meets the principles of oncological surgery, were revealed.
Subject(s)
Colonic Diseases/surgery , Laparoscopy , Rectal Diseases/surgery , Colonic Neoplasms/surgery , Evaluation Studies as Topic , Humans , Lymph Node Excision , Rectal Neoplasms/surgeryABSTRACT
In 75 patients with a phasic development of endogenous psychoses the course of the disease before lithium treatment was characterized by statistically valid and successively increasing from attack to attack phenomena such as lengthening of attacks (phases) with a stable duration of the remissions and more frequent double phases. All of these phenomena were regarded by the authors as an unfavourable medicative pathomorphosis. The influence of lithium was expressed in the following symptoms: 1) prevention of hospitalization (56% of the cases); 2) significant shortening of the attacks (phases) and in some of the cases (19%)--their arrest; 3) transition from psychotic syndromes to cyclothymic; 4) a significant drop of double phases and a corresponding rise in the number of "pure" subdepressive states.
