[Choice of surgical approach in the treatment of patients with deep frost bites]. / Vybor khirurgicheskoi taktiki pri lechenii bol'nykh s glubokimi otmorozheniiami.

Two main approaches to surgical treatment were studied in 114 patients with deep frost bites of the extremities. First - early necrectomy with subsequent local treatment of wounds and their surgical closure on the final stage. Second - long-term conservative treatment until formation of demarcation line and limitation of necrotic tissues with subsequent surgical treatment including their resection and simultaneous formation of the stump of the extremity. It is demonstrated that active surgical policy has significant advantages over expectant one as evident from reduce time of treatment and less number of postoperative pyonecrotic complications (21,7% vs 78,4%).

[Early relaparotomy in the surgical treatment of abdominal viscera]. / Ranniaia relaparotomiia v khirurgii organov briushnoi polosti.

Analysis of 88 repeated surgical interventions after 4,017 operations on the abdominal organs showed the obvious advantages of early relaparotomy with the performance of laparostomy, according to indications, in patients with postoperative pyoinflammatory complications in the abdominal cavity. The mortality rate was 19.3% in early and 80.7% in delayed relaparotomy. A complex of symptoms was determined providing evidence of the development of postoperative pyoinlammatory complications and allowing substantiated indications for a repeated operation to be set.

[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.

[Diagnosis and treatment of post-cholecystectomy syndrome]. / Diagnostika i lechenie postkholetsistéktomicheskogo sindroma.

The authors analyse the results of examination of 154 patients who were admitted for the postcholecystectomy syndrome, 130 of them underwent retrograde cholangiopancreatography. The most common cause of the postcholecystectomy syndrome was residual or recurrent choledocholithiasis (38.5%), stricture of the major duodenal papilla or terminal part of the choledochus (34.6%). Treatment of the syndrome was differentiated and three methods were applied: operative--43 patients, endoscopic--45 patients, and combined--3 patients. Nasobiliary drainage was conducted in 63 patients in preparation for a surgical or endoscopic operation. Indications for the use of different methods of treatment are shown. With the use of the endoscopic techniques and combination of laparoscopic and endoscopic methods of surgical treatment, the number of laparotomies in patients with the postcholecystectomy syndrome reduced by one half and the operative intervention became less injurious.

[Echosonography and retrograde cholangiopancreatography in selecting surgical tactics in mechanical jaundice]. / Ekho-sonografiia i retrogradnaia Kholangiopankreatikografiia v opredelenii khirurgicheskoi taktiki pri mekhanicheskoi zheltukhe.

The results of the diagnosis and treatment of 134 patients with obstructive jaundice are analyzed. The diagnostic potentialities of the ultrasonic method and endoscopic retrograde cholangiopancreatography (ERCPG) are compared. ERCPG has been found more effective for the diagnosis of the causes, localization, and severity of the bile duct obstruction in patients with mechanical jaundice. Endoscopic papillosphincterotomy is an effective treatment modality that helps eliminate or reduce the jaundice, remove the concrements from the duct, and reduce the scope of abdominal cavity surgery in cholelithiasis.

[Surgical treatment of chronic suppurative sacroiliitis]. / Khirurgicheskoe lechenie khronicheskogo gnoinogo sakroileita.

An original method of surgical treatment of purulent sacroiliitis is described. It was used in 8 patients and reduced the period of treatment from 3-6 to 1-1.5 months. Good remote results were noted during 2-10 years of follow-up observations.

[Use of prodigioza in the overall treatment of chronic osteomyelitis]. / Primenenie prodigiozana v kompleksnom lechenii khronicheskogo osteomielita

Treatment of 188 patients suffering from chronic osteomyelitis of various etiology and localization with prodigiosan, a bacterial lipopolysaccharide favoured an increase in the nonspecific immunobiological reactivity: the phagocytic activity and leucocytic intensity increased, the average titers of iso- and heteroagglutinins, as well as the complementary activity of the serum became higher. The results of the clinico-laboratory studies are indicative of advisable use of prodigiosan in complex therapy of cases with chronic osteomyelitis.