[Evaluation of the effectiveness of vagotomy in uncomplicated duodenal ulcer based on its results 10 years after the operation]. / Otsenka éffektivnosti vagotomii pri neoslozhnennoi iazvennoi bolezni dvenadtsatiperstnoi kishki na osnovanii rezul'tatov ee cherez 10 let posle operatsii.

Under analysis are results of vagotomy performed in 95 patients with uncomplicated ulcer of the duodenum after ineffective conservative treatment 10 years after operation. During this time recurrent ulcer developed in 26 patients (27.4%). The disease reappeared more frequently in patients with high level of night gastric secretion before surgery. Results of the operation in 25 patients (26.3%) could be estimated only as satisfactory because of various disorders (dumping-syndrome, diarrhea, gastric dyspepsia). But a usual basis for such an assessment was not a medial degree of some disorders (2 patients) but a combination of light degree disorders (23 patients). One patient was included into the IVth Wisik's group due to severe dyspepsia. Only 43 patients (45.3%) were included in the I and II groups by the Wisik's scheme. Results of vagotomy in patients who had no ulcer complications before operation were compared with the efficiency of vagotomy used totally for all indications and were found to be much worse. The authors make a conclusion that it is not expedient to widen indications to vagotomy at the expense of patients with uncomplicated ulcers.

[Experimental development of methods of organ-sparing operations in mechanical injuries of the spleen]. / Ob eksperimental'nykh razrabotkakh metodov organosokhrania-iushchikh operatsipri mekhanicheskikh povrezhdeniiakh selezenki.

Experiments in dogs have shown that injuries of the spleen in these animals are of another character than those in men. Even in severe injuries hemorrhage spontaneously stops within several minutes without any surgical procedures and the spleen wounds heal rather quickly. Dogs easily endure traumas of the organ. The authors make a conclusion that results of the development of methods of treatment of injuries of the spleen in experiment can not give a correct estimation of possibilities to effectively use them for humans.

[Diagnosis and treatment of Zollinger-Ellison syndrome]. / Diagnostika i lechenie sindroma Tsollingera-Ellisona.

An analysis of data concerning 37 patients with the Zollinger-Ellison syndrome (ZES) has been made, 36 of them were operated upon. Gastrinoma was found in 21 patients. Diagnosis of ZES was made in two steps: the first one is fulfilled in general medical institutions, the second one-in specialized clinics. The diagnosis of ZES must be either confirmed or rejected with certainty. When choosing the method of operative treatment several groups of patients must be born in mind: ZES without a gastrinoma detected, ZES with a gastrinoma, ZES with malignant ulcerogenic tumour. The main operation for ZES remains to be gastrectomy.

[Results of truncal vagotomy in duodenal ulcer 10 years or more after the operation]. / Rezul'taty stvolovoi vagotomii pri iazve dvenadtsatiperstnoi kishki cherez 10 let i bolee posle operatsii.

Results of truncal vagotomy for duodenal ulcer performed in 201 patients ten and more years ago were analyzed. The dumping syndrome, diarrhea and gastric dyspepsia of moderate degree were observed in 7% of the patients. No severe disorders were noted. Recurrent ulcers could develop at any time after operations, 10 years later as well, but mostly within the first three years. During 10 years recurrent ulcers were found in 11,5% of the patients. The incidence of recurrencies was influenced by the age of the patient by the time of operation and high level of acid night gastric secretion. A single course of conservative treatment was followed by a persistent healing of every third patient with recurrent ulcers.

[Suture threads as a cause of biliary calculi]. / Shovnye niti kak prichina obrazovaniia zhelchnykh kamnei.

On the basis of 34 observations the authors reject the common opinion of a rare formation of bile stones on suture threads. The complication was not often recognized because the concrements removed in repeated operations were not subjected to destruction and thorough examination. To prevent the formation of stones on suture threads in operations on bile pathways threads of a slowly resolving material should be used.

[Current problems of diagnosis and treatment of choledocholithiasis]. / Aktual'nye voprosy diagnostiki i lecheniia kholedokholitiaza.

The article gives an estimation of a number of diagnostic methods of examination, modes of intraoperative revision of the ducts, means of finishing the operations. The endoscopic retrograde cholangiopancreatography is highly estimated as revealing the stones before the operation in 96% of cases in patients with jaundice and a post-cholecystectomy syndrome. The importance of a certain sequence of using the methods of intraoperative diagnosis (such as cholangiography and cholangiodebitometry--before choledochotomy; choledochoscopy, instrumental revision of the duct and control cholangiography--after choledochotomy) is stressed. The authors are against the tight suture of the common bile duct and show advantages of T-shape drains for the external drainage. The development of methods of non-operative removal of the retained stones with the external drainage of the ducts being present allows sharp restriction of indications for creating biliodigestive anastomoses for multiple stones in the common bile duct.

[Surgical treatment of duodenal ulcer (concerning A.A. Rusanov's article "Vagotomy in gastric and duodenal ulcer")]. / O khirurgicheskom lechenii iazvy dvenadtsatiperstnoi kishki (Po povodu stat'i A.A. Rusanova "Vagotomiia pri iazve zheludka i dvenadtsatiperstnoi kishki").

On the basis of the materials published in the literature and our data, the present state of the question concerned with the treatment of duodenal ulcer by the operation of vagotomy and resection of the stomach is elucidated. Despite A.A. Rusanov's opinion, the authors of the article believe vagotomy to have a substantial advantage, especially the proximal selective vagotomy. As voluminous literature shows there is no coolness to this method of treatment.

[Choledocholithiasis after cholecystectomy]. / Kholedokholitiaz posle kholetsistéktomii.

Concrements were found in the ducts of 172 patients subjected to secondary surgical interventions on bile ducts. The detailed analysis of the data failed to answer the question whether the stones could be formed immediately in the ducts without such conditions as a mechanical obstacle for the outflow of bile, the presence of foreign bodies and a big stump of the cystic duct. Such a formation of stones can take place in very few cases. The authors have shown that control cholangiography and especially choledochoscopy can reduce the danger to leave the stones in the ducts, but does not eliminate the danger completely. Nevertheless they think that now it is possible to lessen the indications for biliodigestive anastomoses in choledocholithiasis since the retained stones can be revealed within the first days after surgery and, as a rule, removed with instruments or by other methods using the drainage left in the ducts.

[Gangliectomy in the treatment of obliterating arterial diseases of the lower extremities]. / Gangliéktomiia v lechenii obliteriruiushchikh zabolevanii arterii nizhnikh konechnostei.

The work is based upon the experience with the treatment of 400 cases of obliterating diseases of the lower limbs arteries by means of gangliectomy. The evaluation of the operation is grounded on 2- and 10-years observations over the patients. When the blood flow insufficiency is not too severe, it, most commonly, results in a considerable decrease of the intensity of intermittent limping and favours the removal of destructive lesions. Beneficial results of the surgery most often persist for many years. In a higher obstruction of the arteries the results are somewhat poorer, the same as in case of obliterating atherosclerosis when compared to obliterating endoarteritis.

[Therapeutic action of stress caused by surgical intervention in viral hepatitis and other diseases]. / Lechebnoe deistvie stressa, vyzvannogo khirurgicheskim vmeshatel'stvom, pri virusnom gepatite i nekotorykh drugikh zabolevaniiakh.

The data on 27 cases of parenchymatous jaundice resulting from acute virus hepatitis (16) chronic hepatitis (6), primary biliary liver cirrhosis (5) are analyzed in this work. All the patients underwent diagnostic laparotomy. The authors have come to the conclusion that the stress induced by surgical interventions results, as a rule in a rapid favorable change in the clinical course of virus hepatitis. Surgical interventions are not likely to exert a therapeutic effect upon patients with chronic hepatitis and primary biliary liver cirrhosis.

[Surgical tactics in peptic ulcer devleoped after gastrectomy]. / Khirurgicheskaia taktika pri pepticheskikh iazvakh, razvivshikhsia posle rezektsii zheludka

The authors analyse the materials pertaining to 96 patients with peptic ulcers arising after gastric resection. Eighty seven of them were subjected to 94 surgical interventions. Attention is called to different causes of the ulcer occurrence and possibilities of their recognition. Depending on the cause of ulcer various operations were undertaken i.e. reresection of the stomach, vagotomy, removal of the remained protion of antral duodenal mucosa, total resection of the gastric stump. Indications to each kind of surgery under consideration are discussed.

[Large stump of the cystic duct]. / O bol'shoi kul'te puzyrnogo protoka

The authors concluded that a large stump of the gall-bladder duct is of no independent importance as a cause of the affection. However, concretions may be formed in the stump, that was evident in three cases, therefore, the gall duct stump should be no more than 0.5 cm.