[The comprehensive assessment of the degree of severity of their condition in patients with mechanical jaundice]. / Kompleksnaia otsenka stepeni tiazhesti sostoianiia bol'nykh s mekhanicheskoi zheltukhoi.

The authors examined 42 patients with obstructive jaundice of various severity. Comparison of the findings of radiohepatography with intoxication values according to the medium-weight molecule test and the biochemical parameters revealed statistically significant differences of some quantitative indices depending of the severity of jaundice. The results of the study made it possible to recommend the use of the values of blood clearance, time of maximum accumulation of a radiopharmacological agent in the liver, hepatic and blood retention index, and the medium-weight molecule test for objective quantitative appraisal of the severity of obstructive jaundice. Study of the time course of changes of the above parameters showed that normalization of hepatic function in resolving jaundice begins only from the second week after decompression of the biliary tract, which must be borne in mind in choosing the optimal time for the operation.

[Diagnostic value of determining plasma levels of middle molecule toxins in patients with mechanical jaundice]. / Diagnosticheskaia tsennost' opredeleniia urovnia molekul srednei massy v plazme krovi u bol'nykh s mekhanicheskoi zheltukhoi.

On the basis of complex examination of 54 patients with obstructive jaundice, the authors show the diagnostic value of testing the level of middle-mass molecules for qualitative appraisal of the severity of the intoxication as well as for determination of the rational tactics in the management of patients with obstructive jaundice. With the use of the test for middle-mass molecules, the volume of nonoperative therapy and the time for the operative interventions will be determined more rationally, as the result of which the results of treatment of this severe disease will improve.

[Surgical tactics in mechanical jaundice]. / Khirurgicheskaia taktika pri mekhanicheskoi zheltukhe.

On the basis of complex examination and treatment of 167 patients with obstructive jaundice of various etiology, the authors suggest a differentiated approach to the choice of the volume, method, and duration of detoxification therapy as well as the time and volume of an operative intervention. The necessity of preoperative correction of cholestasis by nonoperative measures and instrumental methods of decompression of the biliary tract is substantiated. It is shown that intraarterial regional infusion therapy must be applied in patients whose condition is most serious.