[Endoscopic papillosphincterotomy in patients with para-ampullar diverticulosis]. / Endoskopicheskaia papillosfinkterotomiia u bol'nykh s parafateral'nym divertikulom.

It is suggested that the numerous variants of diverticula occurring in the region of the major duodenal papilla should be grouped into four types. Type I--the major duodenal papilla (MDP) is on the floor of the diverticulum; type II--the MDP is in the region of the lower ++semi-circumference of the diverticular orifice while the longitudinal fold runs radially on the wall of the diverticulum; type III--the MDP is in the region of the orifice of the diverticulum while the longitudinal fold does not pass on its wall; type IV--two diverticula located above the MDP to both sides of the longitudinal fold. Endoscopic papillosphincterotomy is considered contraindicated in patients with type I diverticulum. When indicated, the intervention was carried out in patients with types III and IV diverticula. Endoscopic papillosphincterotomy can be conducted in patients with type II diverticulum measuring more than 2 cm.

[Diagnosis and treatment of mechanical jaundice]. / Diagnostika i lechenie mekhanicheskoi zheltukhi.

Various instrumental methods of examination were applied in 364 cases with obstructive jaundice. Drainage of the biliary tract in 190 patients was conducted by laparoscopic cholecystostomy, percutaneous, transhepatic cholangiostomy, endoscopic papillosphincterotomy. The results of 167 operations performed at the peak of obstructive jaundice were compared with those of 81 operations undertaken after successful preoperative drainage of the biliary tract. The incidence of complications reduced from 40.5% to 22%, the death rate from 22% to 9.8%.