[Reparative and reconstructive surgery of the bile ducts]. / Vosstanovitel'nye i rekonstruktivnye operatsii na zhelchevyvodiashchikh protokakh.

Fifty-three restorative and 61 reconstructive operations were carried out in 108 patients, 12 of them for the first time and 102 for the second time. The most frequent reasons for the operation were cicatricial strictures of the duct after an iatrogenic injury. The highest reliability of the intervention is attained by exact establishment of the diagnosis, timely intervention, approximation of the walls of the organs which are sutured, and adequate drainage.

[Errors in ultrasonic diagnosis of abdominal diseases]. / Oshibki ul'trazvukovoi diagnostiki zabolevanii organov briushnoi polosti.

Errors in the ultrasonic diagnosis of diseases of the abdominal organs in 2,218 patients were analysed in comparison to endoscopic and operative findings. The errors were few in number. A precise diagnosis was established in 99.6% of cases with acute cholecystitis and in 78% of those with a pathological process in the biliary tract. A maximum number of errors (7 per 42 cases) was encountered in carcinoma of the gallbladder. Ultrasonic examination may serve as the basis for choosing the method of rational therapy in diseases of the liver, pancreas, and complications in the postoperative period. Thus, the results of ultrasonic examination may be fully relied on or may be used as a basis for choosing manipulations which are more invasive in character.

[Special methods of examination in the diagnosis of cholelithiasis]. / Spetsial'nye metody issledovaniia v diagnostike kholelitiaza.

Rational combination of special methods of examination yields exact, objective, and detailed information for the diagnosis of cholelithiasis. Ultrasonic examination (USE) is an absolutely noninvasive method and therefore precedes all the other methods. USE suffices for the diagnosis of uncomplicated calculous cholecystitis. USE and intravenous cholegraphy are indicated in complicated cholecystitis without jaundice, USE and percutaneous transhepatic cholegraphy--in the presence of jaundice. These methods of examination are supplemented with endoscopic retrograde cholangiopancreatography in cases which are difficult for differential diagnosis and in those with cicatricial strictures of the bile ducts. Laparoscopy and aspiration biopsy of the liver usually complete the examination. In emergencies diagnostic laparoscopy, despite its definite invasive character, is conducted after USE.

[Direct cholecystography after laparoscopic cholecystostomy in acute cholecystitis]. / Priamaia kholegrafiia posle laparoskopicheskoi kholetsisto- stomii pri ostrom kholetsistite.

Direct cholegraphy was performed after laparoscopic cholecystostomy in 82 patients. It should be conducted on the operating table if proper fixation of the draining tube is doubtful, but, mainly, on the fourth or fifth postoperative day. Double contrasting of the biliary tract with air and a contrast medium produces the best result.

[Indications for relaparotomy and its results]. / Pokazaniia k relaparotomii i ee rezul'taty.

For the recent six years 6855 operations on abdominal organs have been performed which were followed by relaparotomies in 104 patients (1.5%). The authors show that the greatest amount of relaparotomies followed operations for ulcer disease, tumors and cholecystitis. The main causes of relaparotomies were peritonitis, intestinal obstructions and bleedings. The group of greater risk consisted of men aged 50-60. The amount of relaparotomies can be reduced due to unification of medical tactics, strict observation of the operation technique and responsible management of the patients in the postoperative period.