[Treatment of different variants of the mixed form of portal hypertension]. / Lechenie pri razlichnykh variantakh smeshannoi formy portal'noi gipertenzii.

Among 425 patients who were under observation for portal hypertension 72 (16.9%) had its mixed form. Thrombosis of the portal vein in liver cirrhosis occurred in 6 patients. Marked hepatic fibrosis caused by obstruction of the portal vein was encountered in 14 patients. Compression of the hepatic segment of the inferior vena cava was found in 44 patients with cirrhosis of the liver. Nutmeg cirrhosis developed in 8 patients in prolonged disorder of venous flow from the liver. Coexistence of pre- and intrahepatic forms of portal hypertension occurred in the first two situations and coexistence of intra- and suprahepatic forms in the second two. The variety of mixed forms of portal hypertension should be borne in mind in choosing the method of operative treatment and defining its prognosis.

[Bilateral tumors of the adrenal cortical substance]. / Dvustoronnie opukholi korkovogo veshchestva nadpochechnikov.

The results of surgical treatment of 4 patients with bilateral tumors of the adrenal cortical substance are presented. In 1 patient, glucosteronoma was revealed, in 2--malignant glucoandrosteronoma, in 1--nonfunctioning cancer. The patients with functioning tumors were operated on in two stages with the interval of 3-4 weeks. In 1 patient, 3 years after removal of the left adrenal gland for cancer, a tumor of the contralateral gland was removed. In removing the nonfunctional tumors and aldosteronomas, the median laparotomy is expedient, in glucosteronomas and glucoandrosteronomas--extraperitoneal lumbotomic approach. All the patients are alive 1.5-8 years after the operation.

[Multi-channel programmed electric stimulation in the prevention of complications after pancreatoduodenal resection]. / Mnogokanal'noe programmiruemoe élektrovozdeistvie v profilaktike oslozhnenii pankreatoduodenal'noi rezektsii.

Based on investigation of the course of the postoperative period in 144 patients after pancreatoduodenal resection the authors have developed a complex of measures aimed at earlier recovery of motility of the digestive tract including the following: blockade of pain impulses from the operated area, disloading of the gastrointestinal tract with the help of permanent jejunal probe, pharmacological stimulation of peristalsis, direct programmed electrostimulation of the intestines. The application of it results in the recovery of peristalsis in the 2nd-3d days after operation and in less amount of postoperative complications.

[Surgical tactics in the esophago-gastric hemorrhages of liver cirrhosis patients]. / Khirurgicheskaia taktika pri pishchevodno-zheludochnykh krovotecheniiakh u bol'nykh tsirrozom pecheni.

The character of the source and rate of bleeding were taken into consideration in determining the surgical tactics in 342 patients with cirrhosis of the liver complicated by gastro-esophageal bleedings and with high risk of their appearance. The operation of choice is thought to be arrest of the gastro-esophageal collateral blood flow. At high portal pressure or its considerable growing after the separating operation the latter should be associated with vascular anastomosis. When cirrhosis of the liver is associated with ulcer disease of the duodenum the separating operation should be added by selective proximal vagotomy, for ulcer disease of the stomach--by a parsimonious resection.