[Clinical forms and surgical strategy for chronic pancreatitis]. / Klinicheskie varianty techeniya i khirurgicheskaya taktika pri khronicheskom pankreatite.

OBJECTIVE: To analyze treatment outcomes in patients with various forms of chronic pancreatitis. MATERIAL AND METHODS: We analyzed 434 patients with chronic pancreatitis. These ones underwent 2879 different examinations to determine morphological type of pancreatitis and dynamics of pathological process, as well as substantiate treatment strategy and functional monitoring of various organs and systems. Morphological type A (Buchler et al. 2002) was present in 51.6% of cases, type B - 40.0%, type C - 4.3%. Cystic lesions were detected in 41.7% of cases, pancreatic calculi - 45.7%, choledocholithiasis - 19.1%, tubular stricture of distal choledochus - 21.4%, pancreatic duct enlargement - 95.7%, narrowing or interruption of the duct - 93.5%, communication of the duct with the cyst - in 17.4% of patients. Induration of pancreatic parenchyma was noted in 97% of patients, heterogeneous structure - 94.4%, enlargement of the pancreas - 10.8%, shrinkage of the gland - in 49.5% of cases. Surgical treatment was performed in 186 patients: ERCP + EPST in 8 patients, ERCP + EPST + pancreatic duct stenting in 2 patients, ERCP + EPST + wirsungotomy with stenting in 2 patients, laparotomy with hepaticocholedochojejunostomy in 6 patients, laparotomy with gastropancreatoduodenal resection in 19 patients, laparotomy with Puestow I procedure in 18 patients, Puestow II procedure in 34 patients, laparotomy + pancreatic tail resection + Duval procedure in 3 patients, laparotomy with Frey surgery in 19 cases, laparotomy and Beger procedure in 2 patients, external drainage of pseudocyst in 21 patients, endoscopic internal drainage of pseudocyst in 9 patients, laparotomy with cystodigestive anastomosis in 34 patients, excision of fistula and distal pancreatectomy in 9 cases). RESULTS: Postoperative complications developed in 22 (11.8%) patients. Mortality rate was 2.2%.

[Nonstrain seamless hernioplasty trabucco performed in elderly and senile patients with the inguinal hernia].

An analysis of results of "nonstrain" methods of hernioplasty is presented in the elderly and senile patients with the pronounced accompanying pathology in the overwhelming majority of patients (93,5%). The Lichtenstein and Trabucco operations are suggested in these cases. The article describes the technique of "nonstrain" and seamless hernioplasty in detail.

[Laser autofluorescent spectroscopy in the diagnostics of tumor masses in the abdominal cavity].

Laser autofluorescent spectroscopy was fulfilled to 93 patients during laparoscopy. A device of the authors' construction was used for the excitation of autofluorescence and the method of performing laser autofluorescent spectroscopy during laparoscopy is described. Parallel morphological investigations of the affected tissues showed high sensitivity (93.6%) and specificity (98.6%) of the method.

[Ultrasonography in differential diagnosis of focal liver neoplasms].

Results of diagnosis and treatment of 2576 patients with focal lesions of the liver are analyzed. Differential ultrasound characteristics for all studied types of liver focal lesions are worked out. The effectiveness of the ultrasound investigation amounted for echinococcosis 91-95%, non-hydatid cysts--95.5%, hepatic tumors--99%, hepatic abscesses--87% and for the hemangioma of the liver--76.3%.

[Method of laparoscopy in ventral hernia]. / Sposob vvedeniia laparoskopa pri ventral'noi gryzhe.

A new method of laparoscopy have been designed: a laparoscope is introduced through a ventral hernia. The method can be used in patients with contraindications for a regular laparoscopy. Umbilical hernia with the hernia orifice less than 3 cm is a contraindication for "herniolaparoscopy". The method was used in 32 patients, including 17 patients with the acute cholecystitis. In 12 patients besides of umbilical hernia there were other contraindications, including postoperative scarring, obesity etc. There were no any complications with the use of the new method. In all cases pneumoperitoneum was preserved till the end of a procedure.

[Diagnostic and therapeutic laparoscopy in acute cholecystitis in middle and old age]. / Diagnosticheskaia i lechebnaia laparoskopiia pri ostrom kholetsistite v pozhilom i starcheskom vozraste.

Laparoscopic decompression of the gallbladder in elderly and senile patients having acute cholecystitis and in patients with severe coexistent diseases allows arresting the acute inflammatory process in the gallbladder, reducing the amount of forced operations which are extremely dangerous for this contingent of patients. Sanitation of the gallbladder with the electrolytic silver solution and irradiation of the bladder mucosa with laser is highly effective. Microcholecystostoma performed with a catheter having a diameter not less than 2.5 mm maintains adequate decompression of bile ducts and allows performing complete examination of them.

[A method of carrying out ultrasonic dopplerography of the abdominal cavity during laparoscopy and a device for its accomplishment]. / Sposob provedeniia ul'trazvukovoi doplerografii organov briushnoi polosti vo vremia laparoskopii u ustroistvo dlia ego osushchestvleniia.

Laparoscopic Doppler echography allows detection of early abdominal ischemia, eliminating the need for risky, complicated and labour consuming angiographic tests. With the help of this procedure it is possible to reveal even disorders in the local blood circulation. This procedure is a simple and highly informative method of rapid diagnosis.

[Ultrasonic defectoscopy combined with laparoscopy in the diagnosis of the liver and biliary tract]. / U'ltrazvukovaia defektoskopiia v sochetanii s laparoskopiei v diagnostike zabolevanii pecheni i zhelchnykh putei.

A new technique and a device developed by the authors allowed obtaining additional data at panoramic laparoscopy thus promoting valid diagnosis in complicated cases of choledocholithiasis and cholelithiasis+ as well as in parenchymatous abscesses and cysts. The accuracy of the diagnosis rose by 10-15%.

[Silver electrophoresis in the treatment of lactation mastitis]. / Elektroforez serebra v lechenii ostrykh laktatsionnykh mastitov.

The results of treatment of 476 patients with lactation mastitis (infiltrative, with abscess formation, phlegmonous) are discussed. The patients were treated by intra-tissue or intracavitary silver electrophoresis and by the commonly applied methods (control group). Treatment by silver electrophoresis alone and, in cases of an abscess cavity, with addition of drip-flow lavage with silver electrolyte improved the results considerably and reduced the term of in-patient treatment to one half as compared to the control group of patients.

[Use of fluorouracil combined with laser irradiation of the pancreas in the treatment of acute pancreatitis]. / Primenenie ftoruratsila v sochetanii s lazernym oblucheniem podzheludochnoi zhelezy v lechenii ostrogo pankreatita.

Direct irradiation by a helium-neon laser of the pancreas in acute pancreatitis potentiates the action of fluorouracil, permits to reduce its dosage, improve the results of treatment.

[Right-sided hemicolectomy using a compression suture]. / Pravostoronniaia gemikoléktomiia s ispol'zovaniem kompressionnogo shva.

Results of rightsided hemicolectomy performed in 23 patients using the compression suture with the help of apparatus AKA-2 and apparatus NZhKA-60 supplied with silicon paddings are described. The use of compression sutures have considerably shortened the time of formation of anastomosis and large intestine stump and allowed to standardize the technical methods of the operation. The ideal union of the sutured intestinal walls, antiseptic condition of the operation, high hermetic property facilitated the healing of anastomoses and the stump by first intention. The proposed method gives better functional results due to advantages of the compression method of joining the tissues.