[TRANSCUTANEOUS PUNCTURE DRAINING OF THE LIQUID ACCUMULATIONS IN RETROPERITONEAL CELLULAR TISSUE IN PURULENT­SEPTIC COMPLICATIONS OF AN ACUTE PANCREATITIS].

The results of miniinvasive transcutaneous interventions for purulent­septic complications of pancreonecrosis are presented. The computeric tomography (CT) and the ultrasound investigation data where compared while choosing of transcutaneous access towards purulent focus. Peculiar attention was drawn to searching of extraperitoneal trajectory for the drain conduction way. The drains were installed, using a one­staged method with a stylet catheters, owing 10 ­ 12 Fr in diameter, or a two­staged one. While comparing various methods of treatment of the pancreonecrosis purulent­septic complications there was established efficacy of miniinvasive interventions, performed for pancreatogenic abscesses and relatively delimited purulent foci in retroperitoneal cellular tissue.

[PECULIARITIES OF ESTIMATION OF THE BURN DAMAGE, USING THE MAGNET RESONANCE TOMOGRAPHY METHOD].

The method of magnet resonance tomography was applied for early diagnosis of the burn depth and dynamics of processes in the tissues in the course of its treatment and verification of occurring complications. Application of the method proposed for diagnosis and control of therapy have permitted to estimate expediency and determination of volume of early surgical treatment objectively.

[[Treatment and prophylaxis of complications of the sternotomy access in thoracic operations].]

Literature data and own experience of the treatment complications, occurring after tho- racic operations, using sternotomy access, were presented. Special attention was drawn to postoperative sternomediastinitis - most frequent infectious complication. Measures for the sternomediastinitis prophylaxis, methods of its diagnosis and treat- ment were presented.

[THE TREATMENT OF POSTOPERATIVE STRICTURE OF BILIARY DUCTS: A 15-YEARS EXPERIENCE AND OBSERVATIONS FROM THE PRACTICE].

Experience of performance of 160 operations for injuries and stricture of biliary ducts, was analyzed. In 36 patients before admittance to hospital there were performed interventions, which provide correction of injuries or their consequences. In majority (141) of patients hepaticojejunoanastomosis in accordance to Roux method or its reconstruction were performed. Other interventions (right-sided hemihepatectomy) were rarely performed. The procedure of anastomosis formation, permitting to connect the mucosae of joining organs in precision, was proposed. Clinical observations of correction of the biliary ducts stricture were presented.

Gas jet transection of liver parenchima. Experimental research.

BACKGROUND: There is a great variety of liver parenchyma transection techniques. The objective of this research lies in developing a new method of liver transection and comparing it to the existing ones. METHODS: The original gas jet transection method of biological tissues and the apparatus for its realization "Pneumojet" were developed in our institute. Efficiency comparison of gas jet,water jet, ultrasonic methods of liver transection and clamp crushing technique were carried out on 24 mini-pigs. We did not use Pringle manoeuver. RESULTS: The mean blood loss was the smallest in the group of animals that had a gas jet transection (3.5+-0.15 ml/cm²) and the highest in the clamp crushing technique group (5.5+-0.46ml/cm²). Indicators present statistically authentic differences(p 0.001). The transection speed was the highest in the Clamp crushing technique group (2.9+-0.25 cm²/min) and was credibly higher than in the gas jet (2.4+-0.16 cm²/min), ultrasonic(2.4+-0.13 cm²/min) and water jet (2.5+-0.14 cm²/min) transection groups. Compared to the water jet and ultrasonic methods of liver transection the original method does not have statistically reliable distinctions on the basic indexes of work. CONCLUSIONS: The research conducted proves high efficiency and safety of the gas jet transection method. Gas jet transection,therefore, can be recommended for further improvement and clinical application.