ABSTRACT
The article deals with the results of experimental studies and clinical experience in the use of the plasma scalpel in 25 unbred dogs and 192 patients with diseases of the liver and gallbladder. Histological studies of the hepatic tissue after treatment with the laser scalpel allowed the conclusion that such manipulations are safe. The advantages of using the device for arresting bleeding and the flow of bile from the resected hepatic areas were revealed. The accumulated experience in operations on the liver and gallbladder with a plasma scalpel made it possible to develop optimal approaches to the use of the plasma flow in resections of the liver and to suggest three methods for removal of the gallbladder. Their introduction into practice improved the intraoperative possibilities of treatment of the gallbladder bed.
Subject(s)
Cholecystectomy , Cholecystitis/surgery , Cholelithiasis/surgery , Laser Therapy , Liver Diseases/surgery , Acute Disease , Animals , Cholecystitis/pathology , Cholelithiasis/pathology , Chronic Disease , Dogs , Hemostasis, Surgical/methods , Humans , Liver Diseases/pathology , Treatment OutcomeABSTRACT
Available is pilot experience in the use of extracorporeal shock--wave lithotripsy for acute--stage management of calculous cholecystitis running with obturation of the cystic duct in the absence of complications. Crushing of the stones resulted in elimination of the duct obturation and compression of the gallbladder in 95% of the patients, the acute episode was arrested and 50% of those treated got free of the stones. These therapeutic results are promising and evidence extracorporeal lithotripsy efficiency in acute obstructive cholecystitis.
Subject(s)
Cholecystitis/therapy , Cholelithiasis/therapy , Cholestasis, Extrahepatic/therapy , Cystic Duct , Lithotripsy/methods , Acute Disease , Cholecystitis/complications , Cholecystostomy , Cholelithiasis/complications , Cholestasis, Extrahepatic/complications , Combined Modality Therapy , HumansABSTRACT
The results of complex examination of 352 patients with various forms of jaundice are discussed. All patients underwent ultrasonic examination (USE). Comparison of the results of USE with those of other methods of examination showed it to possess diagnostic value in patients with various forms of jaundice. The highest accuracy of the diagnosis was in patients with parenchymatous jaundice. In patients with benign jaundice as well as in those with jaundice of a neoplastic origin USE is a valuable method in determining the sequence of manipulations in the diagnostic program, but it cannot be a means of making the final diagnosis.
Subject(s)
Common Bile Duct Diseases/diagnostic imaging , Jaundice/diagnostic imaging , Liver Diseases/diagnostic imaging , Pancreatic Diseases/diagnostic imaging , Acute Disease , Adult , Aged , Common Bile Duct Diseases/complications , Diagnosis, Differential , Humans , Jaundice/etiology , Liver Diseases/complications , Middle Aged , Pancreatic Diseases/complications , UltrasonographyABSTRACT
The authors describe their first experience with treatment of 46 patients with extracorporeal lithotripsy. Its high effectiveness has been shown. The method is atraumatic and harmless, there is no risk of lethal outcome. These properties allow using the method both in patients having contraindications to operation because of their critical general state and in patients who refused to be operated upon.
Subject(s)
Cholelithiasis/therapy , Lithotripsy/methods , Adult , Aged , Cholecystectomy , Cholelithiasis/diagnostic imaging , Cholelithiasis/surgery , Contraindications , Gallbladder/diagnostic imaging , Humans , Middle Aged , UltrasonographySubject(s)
Adrenal Glands/physiology , Blood Volume , Hemodilution/methods , Hemodynamics , Kallikreins/blood , Kinins/blood , Pituitary-Adrenal System/physiology , Sympathetic Nervous System/physiology , Humans , Preoperative Care , Stomach Neoplasms/physiopathology , Stomach Neoplasms/therapy , Stomach Ulcer/physiopathology , Stomach Ulcer/therapySubject(s)
Cholelithiasis/surgery , Hemodilution/methods , Neurotransmitter Agents/physiology , Peptic Ulcer/surgery , Pituitary-Adrenal System/physiopathology , Sympathetic Nervous System/physiopathology , Adaptation, Physiological , Adult , Aged , Blood Volume , Cholelithiasis/physiopathology , Humans , Middle Aged , Peptic Ulcer/physiopathology , Postoperative Period , Preoperative CareABSTRACT
Directed normovolemic hemodilution with the preoperative reservation of part of the patients' blood considerably reduced the pathologic effect of the operative aggression on the microcirculation system, allowed reduction of the frequency of postoperative complications and increased the efficiency of treatment of 93 patients with diseases of organs of the abdominal cavity.
Subject(s)
Digestive System Diseases/surgery , Digestive System/blood supply , Hemodilution , Peritoneum/blood supply , Postoperative Complications/prevention & control , Anthropometry , Blood Volume , Digestive System Diseases/prevention & control , Humans , Microcirculation/pathology , Microcirculation/physiopathology , Vascular PatencyABSTRACT
The rheological properties of blood (viscosity, thrombocyte and erythrocyte aggregation activity, ability of erythrocytes for deformation) were studied in 49 patients subjected to surgical operation of different duration and volume of blood loss. It was found that a surgical trauma causes alterations in rheological properties of blood. The degree of hemorheological deviations was shown to correlate with the severity of surgery. In order to reduce the amount of postoperative complications in the patients it is necessary to investigate the main rheological parameters and their correction.
