RESUMO
The results of ultrasound diagnostics of focal fluid lesions of the liver in 132 patients are presented. Echographic semiotics of abscesses and nonparasitic cycts of the liver is described. The possibilities of using transcutaneous minimally invasive puncture and drainage methods in 80 patients under ultrasound control were analyzed. We formulated indications and contraindications to puncture-aspiration and puncture-drainage operations, methods of sclerotherapy of cysts and techniques of drainage and sanitation of the abscess cavities. The results of treatment of focal fluid lesions of the liver by minimally invasive methods of surgery under ultrasound control were thoroughly analyzed. These techniques permit achieving good results with few complications and minimal lethality. The methods can be recommended for wider use in practical work.
Assuntos
Cistos/diagnóstico por imagem , Drenagem/métodos , Abscesso Hepático/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Cistos/cirurgia , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Abscesso Hepático/cirurgia , Hepatopatias/diagnóstico por imagem , Hepatopatias/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia , Adulto JovemRESUMO
The authors have analyzed results of surgical treatment of 79 patients with cholelithiasis using a mini-access. The method can be widely used in patients with high operative risk. It is minimally traumatic, has less lethality and a fewer number of early and late postoperative complications. It also considerably decreases stay of the patients at the hospital.
Assuntos
Colecistectomia/métodos , Colelitíase/cirurgia , Laparotomia/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Resultado do TratamentoRESUMO
The choice of the optimum technique of the sanitation procedure in treatment of acute necrotizing pancreatitis (ANP) is now one of the most disputable problems. Clinical estimation of the efficiency of various operative techniques of treatment of ANP at various stages of disease has been made. In the aseptic phase laparoscopic decompression of the pancreas is indicated when the patient has evident hemorrhagic parapancreatitis. In the phase of septic sequestration of ANP the optimum method of minimally invasive surgical intervention is considered to be minilaparotomy which is expedient for abscesses of small volume, lipid abscesses of any volume with the minimal content of necrotizing tissues as the first step of sanitation in critical patient. High quantity of the necrotizing tissues in the zone of the destructive focus requires traditional laparotomy of the abscess under conditions of preventive maintenance of the endotoxic shock.
