[Medicinal and diagnostic laparoscopy in conditions of appendicitis].

The article presents the results of analyze of diagnostic laparoscopy on the example of 1028 patients with clinical characters of appendicitis, diagnosis of 682 patients (66.3%) is conformed. 667 patients (99.3%) had transformation of laparoscopy from diagnostic to medicinal. Postoperative prearranged sanitational laparoscopy was conducted with 28 patients (4.5%), including 1 time--21 patients, 2 times--6 patients, 3 times--patient. 24 patients had different complications (intraperitoneal hemorrhage, commissural and paralytic terminal ileuses, abscesses and infiltrates of abdominal cavity, infiltrates of anterior abdominal wall, subcutaneous eventration of small intestinal loop). There were no lethal outcomes. Average day in a hospital in conditions of acute appendicitis is 4.2 day, in conditions of chronic appendicitis--3.1 day.

[Discussable questions of non-typical endoscopical papillothomiya].

The article is dedicated to non-typical methods of operation of endoscopical papillothomiya. The article presents the history of elaboration of different methods of non-typical endoscopical papillothomiya, the results of analyze of data from the literature with a survey of discussable items about the necessity, effectiveness and safety of non-typical methods of endocsopical papillothomiya. The authors offered the classification of these methods, defined the conditions of using and gave the data of their own researches of effectiveness and frequency of complications during the process of operation of endoscopical papillothomiya by non-typical methods.

[An endoscopic method of the treatment of complicated acute calculous cholecystitis]. / Endoskopicheskii sposob lecheniia oslozhnennogo ostrogo kal'kuleznogo kholetsistita.

Surgical treatment of acute cholecystitis attended by an affection of the extrahepatic bile ducts often leads to severe complications, particularly in elderly and old-aged patients, the mortality rate in such cases reaches 5-12%. The authors developed and introduced into practice a method of endoscopic treatment of acute combined diseases of the gallbladder and bile ducts, which included endoscopic papillotomy, antegrade catheterization of the gallbladder (laparoscopic cholecystostomy, transhepatic gallbladder drainage), antegrade perfusion with antiseptics under pressure, and various types of ante- and retrograde lithotripsy. Endoscopic method of treatment of combined diseases of the gallbladder and bile ducts makes it possible to remove the acute inflammatory process and in some cases may be an alternative to an emergency surgical operation.

[Endoscopic diagnosis and treatment of tumors of the major duodenal papilla]. / Endoskopicheskaia diagnostika i lechenie opukholei bol'shogo duodenal'nogo sosochka.

Gastroduodenoscopy with target examination of the major duodenal papilla (MDP) and morphological study of the tumor, and endoscopic retrograde pancreatocholangiography were conducted in 104 patients with bening and malignant tumors of the MDP to establish the diagnosis. A precise diagnosis was made. Endoscopic papillotomy alone and in combination with nasobiliary drainage and endoprosthetics of the bile ducts were undertaken for therapeutic purposes in this category of patients. Analysis of the results showed that in cancer of the MDP, these methods can be the tool of treatment or an effective one of preoperative decompression, whereas in bening tumors of the MDP endoscopic papillotmy should be the method of choice.

[Role of colonoscopy in emergency surgery of the colon]. / Rol' kolonoskopii v neotlozhnoi khirurgii tolstoi kishki.

The article analyses the results of using colonoscopy as a method for emergency identification of the causes of acute colonic obstruction and intestinal hemorrhage. The diagnostic informativeness of emergency colonoscopy was 98.7% in colonic obstruction and 97.2% in intestinal hemorrhage. With the use of the results of emergency endoscopy in the choice of the therapeutic tactic for patients with acute colonic obstruction and intestinal bleeding, the percentage of fatal outcomes in the group of patients who underwent operation reduced significantly: to 18.8% in operations for acute colonic obstruction and to 14.8% in operations for intestinal hemorrhage.

[Effect of low-energy laser radiation on the levels of cyclic nucleotides and lactic acid of the mucous membranes in gastric and duodenal ulcers]. / Vliianie nizkoenergeticheskogo lazernogo izlucheniia na uroven' tsiklicheskikh nukleotidov i molochnoi kisloty v slizistoi obolochke pri iazvennoi bolezni zheludka i dvenadtsatiperstnoi kishki.

The level of cyclic nucleotides in biological material undergoes changes due to endoscopic treatment of gastric and duodenal ulcers with the help of helium-neon laser radiation which, in addition to dynamics of the clinical picture and gastroduodenoscopic data, makes it possible to diagnose the disease remission and in certain cases to predict the course of peptic ulcer.

[Endoscopic papillotomy in diseases of the extrahepatic bile ducts and major duodenal papilla]. / Endoskopicheskaia papillotomiia pri zabolevaniiakh vnepechenochnyk zhelchnykh protokov i bol'shogo duodenal'nogo soska.

An experience with using this operation in 500 patients aged from 22 to 90 is described. The authors suppose that endoscopic papillotomy in the majority of patients may be the method of treatment not requiring any additional curative measures. The application of not typical methods of operation makes the possibilities of endoscopic papillotomy wider in obstructive lesions of the major duodenal papilla.

[A method of studying microcirculation in the gastric and duodenal walls]. / Metod issledovaniia mikrotsirkuliatsii v stenke zheludka i dvenadtsatiperstnoi kishki.

The paper is concerned with the results of clinical application of a new method of investigation of microcirculation in the gastric and duodenal wall. The method is based on the administration of a radiopharmaceutical in the submucous layer of the stomach and duodenum through the bioptic channel of a gastroscope with further recording of its rate of discharge on a gamma-chamber. A total of 48 patients with different gastroduodenal diseases were investigated. Good reproducibility of the method and good correlation of its results with clinical findings were confirmed.

[Role of endoscopy in diseases of the extrahepatic bile ducts in patients after cholecystectomy]. / Rol' éndoskopii pri zabolevaniiakh vnepechenochnykh zhelchnykh protokov u bol'nykh, perenesshikh kholetsistéktomiiu.

The use of gastroduodenoscopy and retrograde pancreatocholangiography in patients after operation on bile ducts made it possible to choose the most effective therapeutic tactics. An analysis of the results of examination of 318 patients showed that most diseases of extrahepatic bile ducts after cholecystectomy were not correctable by surgery as a result of insufficient examination of the patients in the preoperative and operative periods. Endoscopic papillotomy is a method of treatment for patients with choledocholithiasis, stenosis of the major duodenal papilla (MDP) and MDP adenoma after operations on the beliferous system and can be regarded as an alternative to surgical operation. Surgical treatment in this group of patients is indicated for patients with extended stenosis of MDP and the terminal part of the common bile duct, strictures of the extrahepatic bile ducts and large-size choleliths in ineffective EPT.

[Endoscopic phototherapy in the combined treatment of gastric and duodenal peptic ulcer]. / Endoskopicheskaia fototerapiia v kompleksnom lechenii iazvennoi bolezni zheludka i dvenadtsatiperstnoi kishki.

Irradiation of mucosal defects with coherent and incoherent red light with a positive effect can be employed in multimodality therapy of gastric and duodenal ulcer. It makes it possible to reduce the time of therapy of patients with gastric and duodenal ulcer and to achieve healing of the defects without rough cicatrization and deformity of organs.