[Diagnostics and surgical treatment of tumors of proximal extrahepatic biliary ducts].

147 patients with tumors of proximal extrahepatic biliary ducts were treated. By 118 patients only palliative surgery was possible. Tumor recanalisation and external biliary drainage was performed on 77 patients; 41 patients received transcutaneous transhepatic cholangiostomy as final treatment; endoprosthesis was inserted in 11 patients. Radical and conditionally radical surgical resections were performed in 29 patients: cholecystectomy, common bile duct resection and hepaticojejunostomy was made in 18 patients. The rest 11 had cholecystectomy, liver resection and bi-hepatic jejuno-anastomosis. Postoperative lethality was 10.2%.

[Surgical treatment of the combined heart, lung and liver hydatid disease].

Results of surgical treatment of 12 patients with the combined hydatid disease of heart and target organs (liver, lungs) are analyzed. Authors recommend echocardiography for all the patients with echinococcosis of target organs as a means of timely heart involvement diagnostics. Simultaneous surgery for the combined hydatid disease is recommended. The use of artificial circulation is reasonable for cardiac echinococcosis (n=66,7%) treatment, whereas pericardial hydatid cysts (n=33,3%) can be operated without such measures. Cyst perforations to the heart cavity should be considered a fatal complication of the disease. Intraoperative lethality achieved 25%.

[Combined diagnostic techniques and contemporary methods of treatment of external biliary fistula]. / Kompleksnaia diagnostika i sovremennye metody lecheniia naruzhnogo zhelchnogo svishcha.

Analysis of surgical treatment results of 103 patients with the extrahepatic biliary ducts external fistula was presented. The external biliary fistula had formatted due to iatrogenic damage of biliary ducts during performance of cholecystectomy, gastric resection and echinococcectomy. Preoperatively correction of water-electrolytic balance disorders was done in all patients, as well as treatment and prophylaxis of hepatorenal insufficiency, anaerobic anti-infection measures. In all patients the reconstructive intervention was performed. Postoperative complications had occurred in 14 (13.6%) patients, mortality was 3.6%. The main cause of mortality is the sutures of anastomosis insufficiency, intoxication, hepatorenal insufficiency due to occurrence of purulent cholangitis and cholangiogenic abscess of liver.

[The combined treatment of cholangitis in patients with intraoperative damage and posttraumatic cicatricial stricture of the extrahepatic bile ducts]. / Kompleksnoe lechenie kholangita u bol'nykh s intraoperatsionnym povrezhdeniem i posttravmaticheskoi rubtsevoi strikturoi vnepechenochnykh zhelchnykh protokov.

The result of treatment of 196 patients with cholangitis, occurred due to intraoperative trauma and posttraumatic cicatricial stricture of extrahepatic biliary ducts (EBD) was analysed. Methods of extracorporeal detoxication-hemosorption (in 53 observations), plasmapheresis (in 32), biohemosorption (in 21) were applied in the complex of treatment. The EBD decompression was conducted using endoscopic diathermocoagulation and bougienage of cicatricial stricture (in 56 patients) with introduction of a hidden drain (in 9) or nasobiliary catheter (in 47). In all the patients reconstructive and restorative operations were conducted. Postoperative complications occurred in 43 (22%) patients, 31 (15.8%) patients died. Stricture recurrence, necessitated reoperation conduction, was noted in 15 (7.6%) patients.

[Prospectives for using the extracorporeal connection of a xenospleen in treating patients with liver cirrhosis and obstructive jaundice complicated by liver failure]. / Perspektivy ispol'zovaniia ékstrakorporal'nogo podkliucheniia ksenoselezenki v lechenii bol'nykh tsirrozom pecheni i obturatsionnoi zheltukhoi, oslozhnennykh pechenochnoi

Results of using extracorporeal connection of the hog spleen for detoxication and correction of immune disorders in 73 patients with severe forms of hepatic insufficiency are analyzed. It was shown that extraorganic connection of the xenospleen in complex with other methods of treatment considerably improved results of the operative intervention for liver cirrhosis and obstructive jaundice. However, the results obtained were noted in patients with the I-II stages of hepatic insufficiency.