[Functional condition of the liver after surgical treatment of cirrhosis in children as revealed by hepatoscintigraphy]. / Funktsional'noe sostoianie pecheni posle khirurgicheskogo lechenia tsirroza pecheni u detei po dannym stsintigepatografii.

Scintigraphy with colloid 99mTc (56 cases) and the radiopharmaceutical preparation 99mTc--HIDA (43 cases) was performed in children with early and developed cirrhosis of the liver to study the functional condition of the hepatic Kupffer's and parenchymal cells in the long-term periods after surgical treatment. Increased activity of the parenchymal cells and inactivation of Kupffer's cells were revealed after splenectomy. The formation of a portocaval shunt and denervation of the hepatic artery promoted activation of hepatocyte functioning in these patients.

[Scintigraphic semeiotics of gallbladder anomalies in children]. / Stsintigraficheskaia semiotika anomalii zhelchnogo puzyria u detei.

Altogether 103 children with different variants of gallbladder abnormalities (deformities, bends, contractions, septa, diverticula) were examined using radionuclide cholescintigraphy with 99mTc-HIDA. Scintigraphic signs of organic lesion were characterized by symptoms associated with the unevenness of the filling of the gallbladder, its shape and contours. Their frequency depended on anatomical defect site. Changes in the cervical part (70%) and in the body area (60%) were better diagnosed. Changes in the gallbladder fundus (12.5%) were practically undetectable. The calculation of quantitative indices of gallbladder filling and motor function made it possible to objectify the gravity of organic change of the organ, the nature and degree of its functional compensation.

[Hepatobiliary scintigraphy in the diagnosis of common bile duct cysts in children]. / Gepatobilistsintigrafiia v diagnostike kist obshchego zhelchnogo protoka u detei.

A cyst of the common bile duct, the most frequent variant of cystic dilatation of the extrahepatic biliary tract, presents a serious diagnostic problem. Using serial scintigraphy with 99mTc-HIDA 13 children with cysts of the common bile duct confirmed by the results of operative cholangiography, were examined. In 8 of them a radionuclide study was performed at varying times after operation (cyst extirpation with the establishing of hepatoenteroanastomosis--4 patients, and variants of internal drainage operations--4 patients). Typical scintigraphic signs were the following: sacculated or spheroidal dilatation of the common bile duct in combination with dilatation of the left (7), right (1) or both lobular bile ducts, absence of the gall bladder visualization. In the first 15 min of examination in large size cysts zones of the lowered accumulation of the radiopharmaceutical agent were revealed in the area of the portal fissure. Indicators of absorptive-excretory hepatic function changed mainly in children with spheroid-shaped cysts demonstrating alongside with the time of intestinal visualization the degree of disorder of permeability of the choledoch distal parts. The recovery of the anatomic-functional state of the biliferous system occurred earlier (up to 1.5 year) in children after cyst extirpation than after internal drainage operations. It manifested itself in returning the diameter of the bile ducts to normal and in the improvement of absorptive-excretory hepatic function.

[Surgical treatment of choledochal cysts in children]. / Khirurgiia kist kholedokha u detei.

Examinations and operations were performed in 32 children aged from 2 months to 15 years with common bile duct cysts. The extirpation of the cyst, hepaticojejunostomy were performed in 13 patients, cystoduodenostomy in 13, cystojejunostomy --in 4, external drainage--in 3 patients. The follow-up observations lasted for 1-10 years. Good results were obtained in most of the patients.

[Surgery of chronic noncalculous cholecystitis in children]. / Khirurgiia khronicheskogo beskamennogo kholetsistita u detei.

The significance of the anomalous development and acute inflammation of the bile cyst for the appearance of chronic acalculous cholecystitis in children is shown on the basis of results of complex investigations. Restoration of the bile cyst functions is shown to be possible in case of an isolated injury of the neck-duct zone by dissection of the injured tissues and cholecystocholedochostomy. The surgical treatment of chronic acalculous cholecystitis with a deformity of excretory portions of the bile cyst in children is stressed to be necessary.