[Diseases of the major duodenal papilla as a cause of post-cholecystectomy syndrome]. / Zabolevaniia bol'shogo duodenal'nogo sosochka kak prichina postkholetsistéktomicheskogo sindroma.

Analysis of 460 patients suffering from the postcholecystectomy syndrome (PCS) revealed an abnormality in the major duodenal papilla (MDP) in 32.4% of them. The development of PCS in this group of patients was caused by coexistence of several pathological processes, which was established in 71% of patients with diseases of the MDP. The most frequently encountered conditions were papillitis (59.1%), cicatricial stenosis (56.3%), and stones (14.7%). Papillitis plays a double cause-effect role in PCS: as a primary chronic disease it may lead to cicatricial stenosis of the MDP, and, on the other hand, it may be a consequence of choledocholithiasis, cholangitis, and other diseases. Endoscopic papillosphincterotomy is the most effective method for the treatment of PCS caused by MDP diseases; it makes it possible to reduce significantly the number of repeated abdominal operations.

[Intraoperative ultrasonic diagnosis of choledocholithiasis]. / Intraoperatsionnaia ul'trazvukovaia diagnostika kholedokholitiaza.

A method of intraductal detection of calculi with the help of ultrasound was used. Ultrasonic probes were employed for the introduction into bile ducts and their sonification from the inside. A comparative analysis of intraoperative methods of detecting biliary calculi was made: the intraoperative cholangiography could reveal the calculi in 86,8% of the observations, the intraductal echolocation--in 94,7% of the observations.

[Choledochotomy in acute cholecystitis in the middle-aged and elderly]. / Kholedokhotomiia pri ostrom kholetsistite u bol'nykh pozhilogo i starcheskogo vozrasta.

Under analysis were 282 patients operated for acute cholecystitis, cholecystectomy being added by the external or internal drainage of bile ducts. It was established that the presence of jaundice, cholangitis, cholecystopancreatitis and gallstones in the ducts were considered as indications for choledochotomy in elderly and senile patients. The general lethality among the patients operated for acute cholecystitis complicated by injuries of the common bile duct made up 10,6%, in the group of elderly and senile patients it was 15,5.