[Cholecystolithiasis as a cause of local hepatitis].

In an acute inflammation of gallbladder inflammatory process spreads on surrounding tissues, including hepatic tissue, what causes the regional hepatitis occurrence. In some patients, suffering calculous cholecystitis on background of transition of inflammatory process from gallbladder to hepatic tissue likewise a regional hepatitis, hyperbilirubinemia, the skin yellowness are revealed, what simulates choledocholithiasis and obturation jaundice.

[Infiltrate of a gallbladder].

Infiltrate of a gallbladder, as a complication of an acute cholecystitis constitute a separate form of the disease. In this case a destructive changes in gallbladder are restricted from surrounding tissues. While presence of infiltrate of a small size and favorable course under the influence of conservative therapy it is necessary to follow an expectant tactics up to complete dissolving of the infiltrate with a consequent obligate operative treatment in a "cold" period of the disease. Not rarely the infiltrate is transformed into a gallbladder oedema, what demands performance of a deferred operation. In a deep destructive process a gallbladder empyema may occur or paravesical abscess formated, what demands performance of urgent operative intervention.

[An improvement in a new method for the surgical treatment of echinococcosis]. / Sovershenstvovanie novogo sposoba khirurgicheskogo lecheniia ékhinokokkoza.

Parasitic cysts were intraoperatively treated with glycerol in 179 patients with echinococcosis at various sites and 3% hydrogen peroxide in 165 patients with hepatic echinococcosis. Experiments on 60 cotton rats experimentally infected with Echinococcus alveolaris and 156 albino mice with E. granulosus provided evidence for the surgical use of 80-100% glycerol or 3% hydrogen peroxide to treat the cysts. Intraoperative glycerol treatment of cysts in patients with complicated hepatic echinococcosis fails to normalize amino acid metabolism, as well as immunity even a year postoperatively. The glycerol method has no contraindications for pulmonary and hepatic echinococcosis. Hydrogen peroxide has a damaging effect on all germinal elements of both E. alveolaris and E. granulosus. The authors recommend that 3% hydrogen peroxide should be intraoperatively used for treatment of cysts. After surgery, there is a tendency for amino acid metabolism to become normal in such patients.

[The surgical treatment of echinococcosis of the diaphragmatic surface of the liver]. / Khirurgicheskoe lechenie ékhinokokkoza diafragmal'noi poverkhnosti pecheni.

The results of surgical treatment of 628 patients aged 15-76 years operated on for echinococcosis of diaphragmatic surface of the liver have been analysed for period from 1976 to 1996. 333 patients had complicated echinococcosis, 124 combined pathology of other organs. Methods which have been applied for diagnosis of echinococcosis of the liver and its complications are described. Details of surgical treatment of the echinococcosis of the diaphragmatic surface of the liver are elucidated in time course aspects, as a staged treatment, during which various factors were used for antiparasitic treatment of cystic cavity as well as various methods of elimination of the residual cavity. Problems concerning application of laser and plasmatic scalpel during various stages of the operation, as well as low-intensity lasers and low-frequency ultrasound during the operation and in postoperative period are considered. Postoperative complications were detected in 99 (15.8%) patients, lethal outcomes were in 5 (0.8%) cases.

[Diagnosis and treatment of liver echinococcosis complicated by cysto-biliary fistula]. / Diagnostika i lechenie ékhinokokkoza pecheni, oslozhnennogo tsistobiliarnym svishchom.

890 patients with echinococcosis of the liver were operated during 1976-1992. Complicated forms of the disease were li detected in 222 (24.9%) patients, among them 141 (15.8%) patients with cysto-biliary fistulas. Ultrasonography examination and endoscopic retrograde cholangiography were regarded as the most informative methods of preoperative diagnosis of cysto-biliary fistulas. Three-stage management was worked out. The usage of laser, plasmatic scalpel and ultrasound of low frequency substantially contributed to improvement of the results of treatment of these patients.

[Minimally invasive transcutaneous interventions in elimination of suppurative residual cavities in liver after echinococcectomy]. / Maloinvazivnye chrezkozhnye vmeshatel'stva pri nagnoivshikhsia ostatochnykh polostiakh v pecheni posle ékhinokokkéktomii.

The results of treatment of 34 patients with suppurative residual cavities in the liver (SRCL) after echinococcectomy are analyzed. New method of elimination of SRCL consisted in transcutaneous puncture and drainage of the infected cavity followed by transdrainage laser irradiation of its walls by Nitrogen UV laser and Helium-Neon laser of visible spectrum, was applied in 31 patients. Transdrainage irradiation was carried out at the background of daily procedures of transcutaneous laser radiation of the liver (Arsenid-Gallium infrared laser). Minimal traumatism of transcutaneous interventions and pronounced antibacterial, antiinflammatory and stimulating influence of low-energy lasers made it possible to improve significantly the results of treatment of SRCL patients.

[Lasers and plasma scalpel in the surgery of hepatic echinococcosis]. / Lazery i plazmennyi skal'pel' v khirurgii ékhinokokkoza pecheni.

A plasma surgical device and a CO2-laser device were used in operative treatment of 46 patients with hydatid disease of the liver; in 25 in the patients these measures were combined with exposure to low-energy helium-neon laser radiation. The patients' condition improved more rapidly, the frequency of postoperative complications reduced, the term of postoperative hospital stay of the patients decreased. The fibrous capsule was studied morphologically before and after manipulations with the laser and plasma scalpel.