RESUMO
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.
Assuntos
Anastomose em-Y de Roux/métodos , Ductos Biliares/cirurgia , Bile/química , Eletrocoagulação/métodos , Intestino Delgado/cirurgia , Peritonite/cirurgia , Anastomose em-Y de Roux/instrumentação , Animais , Ductos Biliares/microbiologia , Ductos Biliares/patologia , Modelos Animais de Doenças , Eletrocoagulação/instrumentação , Escherichia coli/patogenicidade , Escherichia coli/fisiologia , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/patologia , Infecções por Escherichia coli/cirurgia , Humanos , Intestino Delgado/microbiologia , Intestino Delgado/patologia , Peritonite/microbiologia , Peritonite/patologia , Coelhos , Técnicas de Sutura/instrumentação , SuturasRESUMO
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.
