[Modern tendencies in surgical treatment of patients with obturation jaundice complicated by hepatic insufficiency].

The article is devoted to the problem of efficacy of the hepatic insufficiency (HI) prophylaxis and treatment methods in obturation jaundice. The role of energy-depending processes and the oxygen deficiency in tissues in the HI occurrence and progressing, the possibilities of medicinal correction of such disorders were studied up. The authors follow the concept of expediency of the oxygen-bearing preparations, which improve the erythrocytes function and oxygen delivery to the tissues in combination with miniinvasive decompression of bilioefferent ways, incorporation into the treatment complex of HI of mechanic genesis.

[Estimation of efficacy of the correction methods for hepatic functional disorders in cholestasis of mechanical nature].

Efficacy of the prophylaxis and treatment methods for hepatic insufficiency in obstructive jaundice was studied. The role of an energy-dependent processes and the tissue deficit of oxygen in the hepatic insufficiency occurrence and progress, possibility of these disorders medicinal correction was delineated. The expediency of introduction of preparations, improving the erythrocytes function and the oxygen delivery to tissues in conjunction with miniinvasive biliary decompression, in therapeutic complex for hepatic insufficiency of mechanical nature was noted.

[Drainage operation for the infectious pancreonecrosis]. / Dreniruiushchie operatsii po povodu infitsirovannogo pankreonekroza.

The prospective investigation a was conduct in 218 patients and retrospective ones--in 253 patients. The results of drainage operations in infectious forms of pancreonecrosis were studied basic task in preoperative period was adequate antibacterial therapy, directed on all microorganisms.

[Versions of the bile outflow restoration in reconstructive and restorative surgery on the bile duct]. / Varianty vosstanovleniia zhelcheottoka pri vypolnenii rekontruktinynoi i vosstanovitel'noi operatsii na zhelchnykh protokakh.

The results of performance of 90 restoration and reconstructive operations in 71 patients with iatrogenic injury of extrahepatic biliary ducts were analyzed. The risk factors of iatrogenic injury were delineated. Original methods of restoration of the bile outflow into intestine were offered. The method of external extraperitoneal cholangiostomy via hepatic round ligament was recommended. Total postoperative mortality had constituted 15.7%.

[Surgical aspects of treatment of acute pancreatitis and its complication]. / Khiurugicheskie aspekty lecheniia ostrogo pankreatita i ego oslozhnenii.

The variants of an operative intervention completion were analyzed in 197 patients with purulent-necrotic complications of an acute pancreatitis. There were studied up the advantages and faults of various methods of drainage of purulent-necrotic focus in bursa omentalis and in retroperitoneal space cellular tissue.

[Clinical signs, strategies of treatment and complications of postnecrotic pancreatic cyst]. / Klinicheskie priznaki, taktika lecheniia i oslozhneniia postnekroticheskoi kisty podzheludochnoi zhelezy.

There were examined 130 patients with postnecrotic pancreatic cyst (PNPC). In 16.2% of them the cause of the cyst formation was not established. Operative intervention performance is indicated after establishment of the PNPC diagnosis before occurrence of complications.

[Influence of ozone on biochemical and cytochemical indexes of the blood in early period after experimental hepatic trauma]. / Vliianie ozona na biokhimicheskie i tsitokhimicheskie pokazateli krovi v rannem periode posle éksperimental'noi travmy pecheni.

The influence of isotonic solution of ozonized chloride sodium (OISCHS) on the peroxide oxidation of lipids (POL) intensity, the antioxidant system (AOS) and aminotranspherase enzymes activity, the middle molecular mass peptides (MMMP) concentration in the blood serum and activity of dehydrogenase in neutrophils of peripheral blood in 1, 3, 6, 9 hours after modelling of mechanical dosaged hepatic trauma was studied in experiment on 20 dogs (principal group). OISCHS was infused intravenously by dropper, the ozone concentration was 1.3-1.5 mg/l. Essential bioregulating effect of ozone brought to the system POL/AOS balance normalization, surveying the aminotranspherases and dehydrogenases, activization, stable lowering of MMMP concentration.

[Destructive-perforative complications of an acute pancreatitis]. / Destruktivno-perforativnye oslozhneniia pankreatita.

There were examined 80 patients with fistula of various localization as complication of an acute pancreatitis.

[External drainage of bile ducts via the ligamentum teres hepatis]. / Naruzhnoe drenirovanie zhelchnykh protokov cherez krugluiu sviazku pecheni.

The experience of external drainage application of biliary ducts via lig. teres hepatis was summarized. The lowering of complications rate by 7.8%, lethality--by 4.1% was promoted by the above mentioned method application.

[Hemodynamic changes in the liver, kidney, small intestine and pancreas in experimental acute pancreatitis]. / Izmenenie gemodinamiki v pecheni, pochkakh, tonkom kishechnike i podzheludochnoi zheleze pri éksperimental'nom ostrom pankreatite.

In an acute experiment on dogs using methods of hydrogen clearance detection and polarography it was established, that in early stages of an acute pancreatitis vasoconstriction occurs in pancreas, liver, kidneys, small intestine, changing into vasodilatation, accompanying by the tissues hypoxia.

[Choledochotomy and its results]. / Kholedokhotomiia i ee iskhod.

Of 21 patient to whom after choledochotomy the external drainage of common bile duct was conducted, the suture insufficiency have occurred in 3, 2 patients died. After choledochoduodenostomy conduction the suture insufficiency was observed in 3 of 17 patients, 2 patients died. After papilloshincteroplasty conduction the complications were revealed in 5 of 23 patients, 3 patients died. Of 4 patients, in whom the twin internal drainage was conducted, 3 died.

[Intralymphatic therapy of peritonitis]. / Endolimfaticheskaia terapiia peritonita.

The lymphatic system catheterization methods, the appropriate catheterization side choice were developed by the authors. It was established that the peritonitis progress is accompanied by endolymphatic therapy effect lowering, what demands the application of active organism detoxication methods, hepatoprotective and immunocompensatory therapy.

[The experimental validation of a method for the intraoperative assessment of the degree of severity of pancreonecrosis]. / Eksperimental'noe obosnovanie sposoba intraoperatsionnoi otsenki stepeni tiazhesti pankreonekroza.

In the experiment on 35 dogs, it was established that the normal pancreas had constant bioimpedance parameters: ohmic resistance, polarization coefficient and capacitance. In development of pancreonecrosis, the capacitance increases, and the ohmic resistance and polarization coefficient decrease.

[Variants of reconstructive and reparative surgery in high strictures and injuries of the biliary system]. / Varianty rekonstruktivnykh i vosstanovitel'nykh operatsii pri vysokikh strikturakh i travmakh zhelchnykh putei.

The authors' views of the problem of reconstructive and restorative surgery of the biliary tract are set forth and original methods are suggested for external and through drainage after formation of hepatohepatic- and hepaticojejunal-anastomosis (via the inferior surface of the right lobe of the liver in the region of the gallbladder bed and through the round ligament of the liver). Some problems of operative techniques in establishment of the anastomoses are discussed. A total of 39 operations were carried out: 25 reconstructive and 14 restorative. The postoperative mortality was 28.2% (11 patients). Preference is given to restorative operations because they are technically simpler.

[Effect of endolymphatic antibiotic therapy on the status of cellular immunity in peritonitis]. / Vliianie éndolimfaticheskoi antibiotikoterapii na sostoianie kletochnogo immuniteta pri peritonite.

The immune status in 68 patients with diffuse and generalized peritonitis was studied. It was established, that a degree of the impairment in immune response depended on peritonitis spreading. Endolymphatic antibiotic therapy had immunostimulating effect in patients with diffuse peritonitis, in generalized peritonitis, this was not observed. In patients with generalized peritonitis, it is necessary to include into the complex of treatment the other methods of immunologic correction.

[Drainage variants in reconstructive and restorative operations for high strictures and injuries of the biliary tract]. / Varianty drenirovaniia pri rekonstruktivnykh i vosstanovitel'nykh operatsiiakh po povodu vysokikh striktur i travm zhelchnykh putei.

The article deals with the author's views on certain aspects of the problem of reconstructive and restorative surgery of the biliary tract. Original methods are suggested for external drainage (through the inferior surface of the right hepatic lobe in the region of the gallbladder seat and through the round ligament of the liver) in formation of ++hepato-hepatico- and hepaticojejunoanastomoses. Problems of operative techniques in formation of the anastomoses are discussed. Thirty-nine operations have been carried out in the clinic in the recent decade in high strictures and traumas of the biliary tract, 25 were reconstructive and 14 restorative. Postoperative mortality was 28.2% (11 patients). Intoxication and hepatargia associated with cholangiolytic abscesses of the liver were the main causes of death.