[The significance of dynamic ultrasound study in the choice of the treatment strategies of patients with pancreatic necrosis]. / Znachenie dinamicheskogo ultrazvukovogo issledovaniia v vybore taktiki lecheniia bol'nykh s pankreonekrozom.

The results of examination and treatment of 18 patients with pancreonecrosis were analysed. If the liquoric formation was revealed in retroperitoneal space according to the ultrasonic investigation data obtained the puncture of it was performed with its content aspiration conduction and further bacteriological investigation of punctate. The diagnosin of wide, with lowered echogenicity, "nonhomogeneous" zones in retroperitoneal space trusted the purulent-septic complications occurrence.

[Evaluation of severity of the state of patients with peritonitis by the modified APACHE II system]. / Otsenka tiazhesti sostoianiia bol'nykh s peritonitom s ispol'zovaniem modifitsirovannoi sistemy APACHE II.

According to the APACHE II modified method 201 patient with an acute peritonitis was examined using the results of investigations available during the first 30 min after hospitalization of patient. Veritable differences of the modified APACHE II indexes were established in patients with local and diffuse peritonitis in dead and survived patients and in those who died in the first day and later after hospitalization.

[The surgical treatment of diseases of the patent urachus]. / Khirurgicheskoe lechenie zabolevanii nezarashchennogo mochevogo protoka.

In the clinic, 23 patients were operated on the weeping umbilicus. A patent urachus was revealed in 10 patients: its complete patency--in 3, a stone-containing cyst--in 3, phlegmon of the abdominal wall--in 4. Total excision of the urinary duct was performed in all the patients.

[The surgical procedure and treatment of paravesical abscesses in acute cholecystitis in middle-aged and elderly patients]. / Khirurgicheskaia taktika i lechenie paravezikal'nykh abstsessov pri ostrom kholetsistite u bol'nykh pozhilogo i starcheskogo vozrasta.

The results of 238 operations performed for acute cholecystitis within 1985-1990 have been analysed. Of them in 11 (4.6%), paravesical (8 cases) and intrahepatic (3) abscesses were revealed. In 8 patients, the presence of an abscess at the preoperative period was supposed. All the patients were admitted to the hospital later than 24 h from the onset of the disease and operated on within 1 to 5 days. Perforation of the gallbladder was revealed in 5 patients, gangrene with destruction of its wall--in 3. Abscess location near the gallbladder fundus was noted in 4 patients, near its neck--in 2, along the medial surface--in 2. A unicameral abscess was revealed in 5 cases, a multicameral one--in 3. The operative treatment presents technical difficulties and consists in performance of cholecystectomy (sometimes--Pribram's mucoclasis), external drainage of the common bile duct and abscess cavity, drainage of the subhepatic and subphrenic space. One 82-year old patient died.

[Acute intestinal obstruction caused by gallstones in aged patients]. / Ostraia neprokhodimost' kishechnika, obuslovlennaia zhelchnym kamnem, u patsientov starcheskogo vozrasta.

The results of treatment of 6 patients operated on for acute ileus caused by a gallstone have been analysed. The authors consider the elderly and senile age not to be a contraindication for operation.

[Surgical tactics in complicated forms of acute cholecystitis]. / Khirurgicheskaia taktika pri oslozhnennykh formakh ostrogo kholetsistita.

The analysis of the results of surgical treatment of 223 patients with complicated forms of acute cholecystitis was carried out. Resulting from complex examination, the correct preoperative diagnosis was established in 93% of patients, in 7%--the character of complications was revealed at operation. Surgical treatment was aimed at adequate correction of all the complications revealed.

[Several problems of surgical treatment in acute biliary pancreatitis]. / Nekotorye voprosy khirurgicheskogo lecheniia ostrogo biliarnogo pankreatita.

The authors used in 39 patients with the intact gallbladder and after previously performed cholecystectomy the therapeutical tactics developed on the basis of consideration of the peculiarities of clinical course of acute biliary pancreatitis, and as well the original methods of treatment (auriculotherapy, selective hepatic vagotomy). This permitted to achieve the reduction in incidence of complications down to 11.5%, lethality--to 2.8%.

[Repeated and combined operations in tumors of the retroperitoneal space]. / Ob povtornykh i kombinirovannykh operatsiiakh pri opukholiakh zabriushinnogo prostranstva.

Based on an experience with the treatment of 76 patients with tumors of the retroperitoneal space the authors show the expediency of operations of a "region resection" type with the intraoperative control of hemostasis. Such operations were performed in 18 patients with left-side tumors and in 7 patients with the right-side localization of tumors. The choice of the regional resection is considered by the authors to elevate the resectability in patients with tumors of the retroperitoneal space.

[Prevention of hepatitis B in the surgical clinic]. / Profilaktika gepatita B v khirurgicheskoi klinike.

The introduction of prophylactics of hepatitis B in surgical departments results in 2 times lower growth of HBsAg carriers among medical men. The main prophylactic measures consist in an analysis of the donor blood and HBsAg examination of surgical patients, treatment of HBsAg carriers as acutely contagious persons, centralized sterilization of medical instruments and individual protection of the personnel.

[Causes, diagnosis and treatment of the "postcholecystectomy syndrome"]. / Prichiny diagnostika i lechenie "postkholetsistéktomicheskogo sindroma".

On the basis of clinical examinations and treatment of 174 patients the authors substantiate the importance of using special and instrumental means of diagnosis as well as the expediency of exploratory laparotomy for establishing the real cause of the disease. The efficiency of selective vagotomy in persistent spasm of the major duodenal papilla is shown.

[Early and repeated operations for mechanical jaundice arising after interventions on the liver, gallbladder and extrahepatic bile ducts]. / Rannye i povtornye operatsii pri mekhanicheskoi zheltukhe, razvivsheisia posle vmeshatel'stv na pecheni, zhelchnom puzyre i vnepechenochnykh zhelchnykh protokakh.

An experience with the treatment of 83 patients with recurrent jaundice or jaundice developed after operations on the liver, extrahepatic bile ducts and gallbladder was used by the authors for an analysis of causes of the appearance of jaundice, diagnosis and treatment of such patients. Indications for relaparotomy were restricted due to using retrograde cholangiography and endoscopic papillotomy.