[ENDOSCOPIC RESECTIONS FOR BENIGN TUMORS OF DUODENAL PAPILLA MAGNA].

The results of endoscopic interventions, performed in 63 patients, suffering benign tumors of duodenal papilla magna (DPM) in Department of Laparoscopic Surgery and Choledocholithiasis in 2005-2014 yrs, were studied. Total one-staged papillectomy was performed in 15 patients, fragmentary total papillectomy--12, local resection of DPM--11, adenomectomy--25. Complicated have had occur in 8 (12.7%) patients. All the patients are alive.

[Prophylaxis of injuries of biliary ducts in laparoscopic cholecystectomy: clinical recommendations of Ukrainian association of specialists for miniinvasive, endoscopic and laser technologies].

Wide introduction of laparoscopic cholecystectomy (LCHE) caused during last 20 years a significant enhancement of rate of the biliary ducts injuries (BDI). Taking into account the experience gained in performing of more than 40,000 operations of LCHE in a leading clinics, including such in a technically complex situations, as well as experience of more than 500 operations performance for BDI, clinical recommendations, based on principles of a substantiality medicine were elaborated. More than 100 sources of foreign and domestic literature were analyzed, summarizing the results of more than 150,000 operations of LCHE, special attention was drawn to the sources I (meta-analysis and prospective randomized investigations) and II (systematic reviews, thoroughly planned prospective comparative investigations) levels of substantiality. Every paragraph is accompanied by a certain level of a recommendation strength (RS, A-C). It is necessary to follow these recommendations strictly today.

[Endoscopic surgery of the duodenal large papilla tumors].

The results of endoscopic papillectomy, performed in 17 patients for tumors of duodenal large papilla in 2005-2010 yrs, were studied up. In 7 (41.2%) patients complications have occurred, including hemorrhage--in 4 (23.5%). All the patients are alive.

[Possibilities of transpapillary and laparoscopic methods of choledocholithiasis treatment].

The results of surgical treatment of patients, suffering choledocholithiasis, were adduced. In 493 patients laparoscopic exploration of common biliary duct was accomplished, in 297 of them the choledocholithiasis diagnosis was definitely established while performing laparoscopic cholecystectomy (LCHE); in 136--endoscopic papillosphincterotomy (EPST) was done preoperatively, but the attempts to perform transpapillary lithoextraction and lithotripsy have failed; in 60--a residual choledocholithiasis was noted. In 930 patients EPST and lithoextraction were performed preoperatively and as a second stage--LCHE.

[Atypical endoscopic papillotomy in diagnostic-treatment algorhythm for obstruction of terminal part of the common biliary duct].

The results of atypical endoscopic papillotomy with subsequent transpapillary intervention, performed in the clinic in 2001-2006 for the diagnosis-treatment aim in 1090 patients, suffering obstruction of terminal part of common biliary duct, were studied. Complications had occurred in 62 (5.7%) patients, bleeding--in 34 (3.1%) of them. All the patients had survived.

[Modern tactics for choledocholithiasis treatment].

There is presented tactics of treatment of 1325 patients, in whom choledocholithiasis was diagnosed. In 1023 (7.4%) of them in the first stage endoscopic papillosphincterotomy was performed and transpapillar endobiliary manipulations, in 1-2 days--laparoscopic cholecystectomy. In 302 (2.9%) patients laparoscopic exploration of common biliary duct with cholecystectomy were performed. Intraoperative complications occurred in 28 (2.7%) and postoperative--in 72 (7%) patients. All patients are alive.

[Complications of endoscopic transpapillary interventions].

The results of endoscopic papillosphincterotomy with subsequent endobiliary intervention performance in the clinic in 2235 patients in 2000-2006 yrs were studied up. Early complications had occurred in 113 (5.1%) patients, including hemorrhage--in 57 (50%); late complications--in 64 (2.9%). All the patients are alive.

[Possibilities of miniinvasive interventions in isolated stenosis of lobar biliary ducts].

In 2000-2004 yrs miniinvasive interventions for isolated stenosis of lobar biliary ducts were performed in 27 patients. The stenosis was caused by nontumoral (choledocholithiasis, primary sclerosing cholangitis) or malignant lesion of biliary ducts. Miniinvasive technologies included interventions, using laparoscopic and endoscopic transpapillary accesses. The authors consider expedient and justified the performance of such interventions in present contingent of patients, because this promotes improvements of immediate and late results of treatment and quality of life as well.

[Prophylaxis and treatment of intraabdominal purulent complications after performance of laparoscopic cholecystectomy using interventions with ultrasonographic control].

The results of treatment of 9103 patients, to whom laparoscopic cholecystectomy was performed, were adduced. In 6714 patients intraabdominal postoperative complications were absent, ultrasonographic investigation (USI) was not performed. Dynamical USI was done in 2389 patients, permitting to estimate timely the wound course severity in the gallbladder bed, to administer an adequate therapv, in 9 of them--to perform puncture of subhepatic formations under USI control. Intraabdominal infectious complications were revealed in 65 (0.71%) of patients.

[Simultaneous operations during laparoscopic cholecystectomy]. / Simultannye operatsii pri vypolnenii laparoskopicheskoi kholetsistektomii.

Simultant laparoscopic operations were performed in 1993-2003 yrs period in 321 patients, including 287--using laparoscopic and 34--the combined (laparoscopic and open) access. Concurrent diseases were diagnosed preoperatively in 219 (68.2%) of patients and were disclosed while doing intraoperative revision--in 102 (31.8%). The simultant operations performance, as a rule, enhanced mildly the total duration of a basic stage, did not influence the duration of postoperative period and the patients rehabilitation essentially, as well as for frequency of the intra--and postoperative complications occurrence. The authors consider that it is expedient to perform laparoscopic intervention simultaneously for concurrent surgical diseases of abdominal cavity.

[Laparoscopic choledocholithotomy. Indications and methods of completion]. / Laparoskopicheskaia kholedokholipotomiia. Pokazaniia i sposoby zaversheniia.

Modern views on diagnostic and medical algorithm using mini-invasive technologies for complicated cholelithic disease (CHLD) were summarized. Main indications and methods of the laparoscopic choledocholithotomy completion in 71 patients with choledocholithiasis were presented. Original, elaborated in the clinic methods were presented along with conventional diagnostic methods. Introduction of the proposed diagnostic-medical complex had permitted to improve the results of planned and urgent operations for complicated CHLD.

[The application of extracorporeal shock-wave lithotripsy in the treatment of choledocholithiasis]. / Primenenie ékstrakorporal'noi udarnovolnovoi litotripsii v lechenii kholedokholitiaza.

The method of extracorporal shockwave biliary lithotripsy was introduced in the clinic since 1993 yr in patients with residual choledocholithiasis. The method was applied in 25 patients. Cholecystectomy with external drainage of common biliary duct was performed in all patients beforehand. Positive result was noted in 16 observations. All patients are alive.

[Lessons on laparoscopic cholecystectomy (summary of the experience]. / Uroki laparoskopicheskoi kholetsistéktomii (obobshchenie opyta)].

The experience of laparoscopic cholecystectomy conduction in 6524 patients with nontumoral diseases of gallbladder (chronic calculous cholecystitis, an acute calculous cholecystitis, chronic noncalculous cholecystitis, the gallbladder polyposis) was summarized. While comparing the initial seizing experience in laparoscopic cholecystectomy in the clinic the tendency was noted, trusting the skills improvement in management of laparoscopic technique, permitting to reduce the contraindications quantity for laparoscopic cholecystectomy. Several principles were elaborated, which is necessary to follow doing laparoscopic cholecystectomy for improvement of results of treatment in patients and for complications reduction.

[Laparoscopic interventions on choledochus: 5 year experience]. / Laparoskopicheskie vmeshatel'stva na obshchem zhelchnom protoke: piatiletnii opyt.

Complex examination of 69 patients with complicated cholelithic disease was performed. The elaborated in the clinic algorithm for preoperative examination of the patients was applied to reveal the main bile ducts pathology. Indications for the laparoscopic interventions on choledochus performance were substantiated.

[Diagnosis of cancer of the pancreatic body and tail]. / Diagnostika raka tela i khvosta podzheludochnoi zhelezy.

Results of 194 patients observation with cancer of corpus et cauda pancreatis are adduced. Clinical forms of the disease are distinguished. Rational algorithm for the examination of patients with probable cancer of corpus et cauda pancreatis diagnosis was elaborated grounded on the efficacy analysis of various methods of examination (ultrasonic investigation, computed tomography, endoscopic retrograde cholangiopancreatography, selective, angiography and so on). The algorithm application permitted to improve significantly the diagnosis of disease.

[A rational procedure for the treatment of patients with chronic calculous cholecystitis complicated by choledocholithiasis]. / Ratsional'naia taktika lecheniia bol'nykh s khronicheskim kal'kuleznym kholetsistitom, oslozhnennym kholedokholitiazom.

The results of surgical treatment of 156 patients with chronic calculous cholecystitis complicated by choledocholithiasis have been analysed. In 62 patients, cholecystectomy in combination with choledocholithotomy was performed. Ninety four patients underwent additional drainage operations on the terminal common bile duct. Endoscopic papillosphincterotomy was performed in 90% of cases, other drainage interventions (choledochoduodenostomy and transduodenal papillosphincterotomy)--in 10%.