[The choice of the endoscopic treatment method in patients with acute cholecystitis, complicated by choledocholithiasis].

Peculiarities of the endoscopic methods application while treating 530 patients, suffering an acute cholecystitis, complicated by choledocholithiasis, were studied. Certain advantages of a two-staged treatment of the patients with initial management of biliary problems, using endoscopic retrograde cholangiography, were established.

[Stenosing papillitis--a problem of miniinvasive surgery].

The results of conduction of endoscopic transpapillary interventions in 976 patients, suffering stenosing papillitis in 2000 - 2014 yrs, were summarized. In 48 (4.9%) patients complications have had occurr, all the patients are alive.

[Prognostication of the performance possibility for laparoscopic exploration of common biliary duct in an acute calculous cholecystitis].

The results of miniinvasive treatment of 319 patients, suffering complicated acute calculous cholecystitis, using laparoscopic technologies, were analyzed in retrospective investigation. The risk factors for unfaithful conduction of laparoscopic intervention on biliary ducts were determined. The chances for possibility of laparoscopic choledocholithoextraction performance on biliary ducts were established, using binary regressive analysis. Reduction of rate of unfaithful laparoscopic interventions, made on common biliary duct, from 18.6 to 5.9% was promoted by application of mathematically elaborated criteria in accordance to the prospective investigation data.

[The modern approach to endoscopic drainage of pancreatic pseudocysts].

The results of endoscopic surgical procedures performed in 72 patients over postnecrotic pseudocysts (PPC) of the pancreas. Complications occurred in 9 (12.5%) patents, recurrence PPC pancreas after endoscopic procedures were observed in 6 (8.3%).

[Endoscopic drainage of biliary system in acute obstruction of common bile duct].

The peculiarities of endoscopic transpapillar interventions (ETPI) application in 630 patients, age from 11 to 94 years old with acute obstruction of common bile duct (CBD) were studied. In cases, when endoscopic biliary decompression was not possible, the biliary plastic stent or nasobiliary drain were used for prevention or treatment of cholangitis. In case of insufficiency of endoscopic treatment, 92 (14.6%) patients underwent biliary surgery; 37 (5.9% of them were operated laparoscopically.

[Peculiarities of performance of endoscopic transpapillary interventions in the early period after cholecystectomy].

The peculiarities of performance of endoscopic transpapillary interventions (ETI) during the early period after cholecystectomy were studied up. There were examined 1788 patients, aged from 18 to 90 yrs old, in whom postcholecystectomy syndrome was diagnosed. Emergent interventions were performed in 780 (43.6%) patients (main group). Into the comparison group 1008 (56.4%) patients were included, who were admitted to the hospital in 0.5-552 (Me 36) months after cholecystectomy conduction. The indications to perform the urgent endoscopic intervention were excessive transdrainage biliary output (more than 350 ml a day) from a subhepatic indignation (in 442 patients) and the obturation jaundice presence (in 338). Using ETI the cause of biliary obstruction in the early postoperative period was established in 93.5% of patients. Miniinvasive methods were applied in 82.2% patients of the main group and in 93.4%--of the comparison group.

[Diagnostic algorithm for complicated calculous cholecystitis].

This paper contains results of 312 patients who were examined and treated over complicated calculouscholecystitis Institute of Surgery and Transplantology named A. A. Shalimov NAMS of Ukraine from 2010 to 2012. Depending on the complexity of the diagnosis of the patients were divided into two groups. The first group--188 patients in which was enough to do a standard algorithm testing. The second group consisted of 124 patients in whom standard survey methods were insufficient to establish the correct diagnosis.

[Endoscopic contact lithotripsy--modern alternative in the therapy of patients with large stones of the common bile duct].

The peculiarities of therapeutic ERCP and contact lithotripsy in patients with choledocholithiasis were studied. 6516 patients (age from 11 to 94 years old) with choledocholithiasis were examined Endoscopic sphincterotomy/balloon dilation with stone extraction was effective in 5507 (84.5%), in 539 (8.8%)--we achieved bile ducts clearance by using mechanical or electrohydraulic lithotripsy. Additional usage of contact lithotripsy increased the effectiveness of therapeutic ERCP to 93.2%. Contact lithotripsy decreased number of specific for ERCP complication from 7.83% to 1.57% in patients with large (> 25mm) stones. Electrohydraulic lithotripsy was successful in destruction of hard bile stones, when mechanical lithotripsy failed.

[Peculiarities of postoperative complications in laparoscopic surgery].

Retrospective analysis of postoperative complications, occurred in patients, to whom laparoscopic interventions were performed in the Department of Laparoscopic Surgery and Cholelithiasis, was conducted. The rate of inflammatory and thromboembolic complications have constituted 2.2 and 0.1%, accordingly.

[Endoscopic treatment of pancreatic pseudocysts].

The results of endoscopic treatment of 42 patients for pancreatic pseudocysts, including 8 (19%) women and 34 (81%) men, were analyzed. In 7 (16.7%) patients the complications had occurred and the pancreatic cyst recurrence after its endoscopic treatment--in 3 (7.1%).

[Diagnosis and endoscopic treatment of stenosing papillitis].

The results of endoscopic papillosphincterotomy (EPST), performed in 2000-2008 yrs in 462 patients for stenosing papillitis, were analyzed. Typical EPST was performed in 166 (35.9%) patients and atypical one--in 296 (64.1%). Complications after performance of typical EPST had occurred in 9 (5.4%) patients and after atypical one--in 12 (4.1%). All the patients are alive.

[Complex treatment of patients with cholangiogenic hepatic abscess].

Results of treatment of 47 patients with cholangiogenic hepatic abscess were analyzed. Clinical, laboratory and special methods of investigation were applied for diagnosis. The authors consider ultrasound investigation (USI), computer tomography and the abscess puncture under the USI control with subsequent cytological and bacterial control the decisive methods in diagnosis of hepatic abscess. In complex of treatment of patients miniinvasive technologies were applied--the abscess puncture, its cavity drainage under USI control transcutaneus transhepatic cholangiostomy, endoscopic papillosphincterotomy with lithotripsy and nasobiliary drainage, according to indications. Efficacy of the abscess cavity sanation, using miramistinum and decasan, was proved. In general therapy the directed transport of medicines was applied.

[Application of laparoscopic technologies in the treatment of choledocholithiasis]. / Zastosuvannia laparoskopichnykh tekhnolohii pry likuvanni kholedokholitiazu.

Pre-operation algorithm of diagnostics of cholecystolithiasis was elaborated and inculcated into clinical practice. The results of treatment of 6120 patients with cholecystitis were analyzed. Based on this, the indications and method of performance of laparoscopic intervention on common bile duct are substantiated and results in 73 patients are given. Laparoscopic revision with sanation of biliary ducts was successful in 95% of patients. The complications occurred in 11 patients (15%), all patients remained alive.

[Diagnosis and surgical treatment of Mirizzi's syndrome]. / Diahnostyka ta khirurhichne likuvannia syndromu Miritstsi.

Retrospective analysis was done concerning the course of cholelithic disease, the results of laboratory, ultrasonographic, radiological, endoscopical methods of investigation, conducted in 52 patients with different forms of Mirizzi syndrome. The method and extent of surgical correction of the disease are recommended.

[Endoscopic methods in the treatment of the obturation of the papilla magna duodeni]. / Endoskopichni metody likuvannia obturatsiï velykoho sosochka dvanadtsiatypaloï kyshky.

Endoscopic methods of treatment were applied in 320 patients with the duodenal papilla magna (DPM) obturation. After performance of endosurgical correction of the bile outflow the pain disappeared in 54%, subsided significantly in 38% patients. In 48 patients endoscopic suprapapillar choledochoduodenostomy was performed, cryodestruction of tumor--in 17 for cancer affection of DPM. In 197 patients with wedged ampullar DPM calculus the atypical papillosphincterotomy was performed successfully. Three (0.9%) patients died.