[ESTIMATION OF FORMATION OF HEPATICOJEJUNOANASTOMOSES, USING METHOD OF THE HF-ELECTRIC WELDING OF BIOLOGICAL TISSUES].

Hepaticojejunoanastomosis (HJА), using the HF-еlectric welding method, was formatted in 14 patients, suffering the bile outflow disorders along main biliary ducts, in 6 of them - with a common hepatic duct stricture, the HJA stricture, purulent cholangitis, iatrogenic injury of biliary ducts, and in 8 ­ with malignant tumours of periampullary zone. In all the patients the welding averting one-layer termino-lateral or latero-lateral HJА were formatted. Welding anastomoses were hermetic, quite hard, immediately after formation and so on. Comparative analysis of clinic-laboratory postoperative indices has confirmed the best results achievement of the method proposed.

[POSTCHOLECYSTECTOMY SYNDROME: CLASSIFICATION, THE RISK FACTORS, CRITERIA OF THE DIAGNOSIS ESTABLISHMENT, TREATMENT-DIAGNOSTIC ALGORITHM].

Own experience of surgical treatment of patients for postcholecystectomy syndrome (PCHES) in a 2010 - 2015 yrs period was enlighten. The PCHES modified classification was adduced, the immediate and remote results of the patients' treatment were analyzed, technical aspects and peculiarities of performance of some operative interventions, the risk factors for the PCHES occurrence were analyzed.

[COMPARATIVE CHARACTERISTIC OF VARIOUS METHODS OF SIMULATION OF BILIARY PERITONITIS IN EXPERIMENT].

In experiment on rabbits a comparative analysis of various methods of a biliary peritonitis simulation was conducted. In 6 animals a biliary peritonitis was simulated, using perforation of a gallbladder, local serous-fibrinous peritonitis have occurred in 50% of them. In 7 animals biliary peritonitis was simulated, applying intraabdominal injection of medical sterile bile in a 5-40 ml volume. Diffuse peritonitis with exudates and stratification of fibrin was absent. Most effective method have appeared that, when intraabdominal injection of bile was done together with E. coli culture in the rate of 0.33 microbal bodies McF (1.0 x 10(8) CFU/ml) on 1 kg of the animal body mass. Diffuse biliary peritonitis have occurred in all 23 animals, including serous-fibrinous one--in 17 (76%), and purulent-fibrinous--in 6 (24%).

[FORMATION OF BILIODIGESTIVE AND INTERINTESTINAL ANASTOMOSES IN ENVIRONMENT OF BILIARY PERITONITIS, USING A HIGH FREQUENCY ELECTRIC WELDING IN EXPERIMENT].

In experiment on 20 rabbits a diffuse biliary peritonitis was simulated, using intraabdominal injection of a laboratory culture of E. coli suspension and a medicinal bile. In 24 h on background of peritonitis on excluded loop of a small bowel in accordance to method of Roux, using a high frequency electric welding with the help of apparatus Patonmed EKB3-300 a one-layered everting cholecystoenteroanastomosis and enteroenteroanastomosis was formated. In a 6 mo postoperatively a connection line was not revealed from outside or from inside, the signs of stenosis were absent. In environment of a diffuse biliary peritonitis a welding technologies have permitted to form a hermetic and competent biliodigestive and interintestinal anastomoses, the processes of a welding suture regeneration postoperatively have a typical course. Using a high frequency-electric welding it is possible to perform a one-staged reconstructive interventions in environment of a pronounced inflammation of tissues due to subsequent precise conjunction of mucosal sheets of connected organs, preventing the anastomotic stricture formation.

[SIMULTANT OPERATIONS FOR BILIARY CALCULOUS DISEASE AS A METHOD OF PREVENTION OF POSTCHOLECYSTECTOMY SYNDROME].

Abstract Own experience of treatment of patients for biliary calculous disease, coexistent with other abdominal and retroperitoneal organs diseases, was analyzed. The rate of postcholecystectomy syndrome (PCHES) occurrence in such patients was determined, the impact of simultant operative interventions using laparoscopic and laparotomic accesses on the rate of the PCHES occurrence was established. The elaborated diagnostic-treatment algorithm with application of measures, directed on the PCHES prophylaxis, was elaborated. There was established, that performance of simultant operations in accordance to strict indications secures a trustworthy reduction of the PCHES occurrence rate.

[REOPERATIONS IN PATIENTS, SUFFERING CYSTIC TRANSFORMATION OF COMMON BILIARY DUCT].

Own experience of treatment of the common biliary duct cysts was analyzed in the patients, to whom earlier noneffective operative procedures for this purpose were performed. The main causes of the operations faults were unmasked, the proposed treatment-diagnostic algorithm was proposed, immediate and remote results of operative treatment were analyzed.