RESUMO
For the period of 6 years we have 110 patients with recurrent bile duct stones (BDS). Were evaluated the changes of the bile duct and bile papilla (BP), predisposing to the recurrence of BDS; the causes of recurrent BDS after endoscopic papillosphincterotomy (EPST). To improve the treatment results in patients with recurrent BDS is necessary: at the primary operation to estimate the changes of the BP and periampulyarnuyu area, in patients with completed EPST to prescribe litolitic therapy; in patients with a complex BDS after unsuccessful attempt of EPST to do holedoholitotomy with a blind stitch or in combination with the drainage of Pikovsky.
Assuntos
Colecistectomia/métodos , Coledocolitíase , Esfinterotomia Endoscópica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Colangiopancreatografia Retrógrada Endoscópica , Coledocolitíase/diagnóstico , Coledocolitíase/prevenção & controle , Coledocolitíase/cirurgia , Ducto Colédoco/cirurgia , Drenagem , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Prevenção Secundária , Fatores de Tempo , Resultado do TratamentoRESUMO
A crystallization method was proposed to assess disturbances in the lipid system; it was based on the interaction of a serum lipid fraction with a lecithin matrix. A total of 255 invidividuals were examined. A model experiment was performed by using chemically pure cholesterol (96 samples) and 10 different cholesterol esters (240 samples). There were a great differences in the frequency of various pattern structural types (homogeneous texture, fan crystals) in the healthy persons and patients. The test results were found to be related to the ratio of esterified to non-esterified cholesterol in the serum lipid fraction. The application of rheopolyglucin, , hemosorption, quantum hemotherapy in the patients contributed to normalization of crystallization test indices.